Lab-in-a-Box® Supply Order Form

Ways to Place Your Order:
Online: 
Use this online form
Phone: 860-657-8271
Fax: 888-631-5960
Email: [email protected]
 
Local Option (Please allow three to five days for your shipment to arrive)
PSC/Drop-Box Option (HH5010)
Contains: 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, biohazard bag, shipping container (Styrofoam), and TempPacks.
Use this option to order Lab-in-a-Box for Patient Service Center (PSC) or Drop-Box Options.
FedEx® Option (HH5000)
Use this option to order Lab-in-a-Box when it’s necessary to ship the specimen via FedEx. ​​​​​​​ Contains: 2 green top, 1 gray top, 1 blue top, and purple top, LIAPouch, Vacutainer holder, luer adapter, safety vacutainer needle, TRF, wicking pad, biohazard bag, shipping container (Styrofoam), TempPacks, and FedEx Airbill with mailer.
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
Supplies cannot be shipped to a residential address.