Lab-in-a-Box Supply Order Form

* denotes mandatory fields
Ways to Place Your Order:
Online: Use this online form
Phone: 860-657-8271
Email: [email protected]
Local Option (Please allow three to five days for your shipment to arrive)
PSC/Drop-Box Option (HH5010)
Use this option to order Lab-in-a-Box for Patient Service Center (PSC) or Drop-Box Options. 
FedEx® Option (HH5000)
Use if you service: VA, NC, SC
Use if you service: KY, WV, IL, IN, MI, OH, WI
Use if you service: FL
Use if you service: TX, OK, AR, MO, KS, NE, IA, MN, ND, SD, NM, AZ, CO, UT, NV, ID, WY
Use if you service: ME, NY, PA, VT, RI, CT, NH, NJ, MD, MA, DE
Use if you service: TN, LA, MS, AL, GA
Use if you service: WA, OR, CA
Add Ons
(When drawing multiple patients, specimens can be packed together in one Lab-in-a-Box for drop off.)
2 green top, 1 gray top, 1 blue top, and purple top, LIAPouch, Vacutainer® holder, luer adapter, safety vacutainer needle, test request form, wicking pad, and biohazard bag.
Lab-in-a-Box Multi-Pack and 2 navy top tubes
2 Blood culture bottles
One culturette swab
Culture tube, UA tube, collection cup, and transfer straw
Para-Pak® Clean Vial Stool
Para-Pak® C&S Stool
Para-Pak® O&P Stool
FOBT Stool
Ship-to Address
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