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Supply Order Request

Fill out this form to request your laboratory supplies and testing materials

1
Account Information

2
Supplies

Specimen / Absorbent Bags

N/C (1 per sample)

Lab Shipping Bags

N/C (1 per 10 samples)

Return Shipping Labels

N/C (1 per 10 samples)

Clear Liner Bags

N/C (1 per 10 samples)

Shipping Boxes

N/C (Packaged in quantity of 20)

Toxicology Lab Requisition Forms

N/C

3
Drug Test Cups

7-Panel Discover

(BZO/BAR/COC/THC/MET/MOP/MTD/OXY/MDMA/AMP/PPX/BUP)

$75.00/25 ($3.00 each)

12-Panel Discover

(BZO/BAR/COC/THC/MET/MOP/MTD/OXY/MDMA/PCP/AMP/BUP)

$74.25/25 ($2.97 each)

4
Drug Test Dip Cards

4-Panel Discover

(COC/THC/MET/OPI)

$24.75/25 ($.99 each)

5-Panel Discover

(BZO/THC/OPI/AMP/BUP)

$30.25/25 ($1.25 each)

6-Panel Discover

(BZO/COC/THC/MET/OPI/OXY)

$39.25/25 ($1.60 each)

5
Other Items

Clear Urine Specimen Cups

N/C

Oral Fluid Collection Devices (for toxicology only)

N/C

Pharmacogenomics Lab Requisition Forms

N/C

Buccal Swabs (2 per patient)

N/C

Hereditary Cancer Genomics Lab Requisition Forms

N/C

6
Delivery Method

7
Additional Notes

Ready to Submit Your Order?

Please review your order before submitting. You will receive a confirmation email.