INVENTORY MANAGEMENT

Specimen Collection Supplies Request Form

If you are enrolled for service with you can use this form to request your specimen supplies. Your supplies will be delivered to your default location.
If you wish to change your default location, please contact our office.

LIPATH Satellite Laboratory 240 Meeting House Lane Ste. 3 Southampton, NY  11968

Toll free: 888.454.7284 Ph: 631.726.8264 Fax: 631.726.8262

PLACE AN ORDER VIA FAX
To place your order , fill out the form, print it and fax it.

PLACE AN ORDER VIA EMAIL
To place your order , fill out the form, PRESS SUBMIT BUTTON.
Your email program will appear with the order included. Just send the email.

PLACE AN ORDER USING SCREEN CAPTURE
The FIRESHOT browser plugin can capture the entire page, After installing the plugin, fill the form, capture entire page, and email as an attachment.