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Primary Care Provider
If applicable please fill out the fields below; If not applicable please indicate "N/A" in the Physician Name Field.
For submitting facilities only
Submitting Facility / Laboratory Information
Specimen Information
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Test Performed
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We accept HSA/FSA cards. Nonrefundable upfront payment is required, itemized receipts along with test results will be provided for insurance reimbursement. If Pay Pal is not your preferred method of payment, please proceed with the "Pay with Debit or Credit Card" option. For any additional insurance, payment or scheduling questions, please feel free to call our Rapid Test Specialist at (201) 425-1583 for an immediate response. If testing for travel purposes, please consult with your airlines regarding requirements. Please proceed to the next page by clicking submit, where you will be able to select your appointment time and receive a confirmation. Thank you.
