Laboratory Test Directory








Home Visit Requisition Form

DATE / TIME

* Date (DD/MM/YYYY)
Calendar   Time  
AM


PHYSICIAN INFORMATION

* Physician's Name
* Account Number
* Office Phone
* Office Fax


PATIENT INFORMATION

* First Name
* Last Name
  MI
  D.O.B.
Calendar
* Male/Female
Select
* Address (Street)
  Address (Line 2)
* City
* State
* ZIP
* Phone #
* Social Security #

INSURANCE INFORMATION

* Insurance Name
* Insurance ID
  Medicaid #
  Medicare #


A.M.A. Panels

10 SS
27 SS
11 SS
38 SS
12 SS


Other Panels

29 SST
P20 SS, LV
62 SST
2254 SS
39 SST
P123 SS
GTT2 4GY
983
24 GY, LV
Y19
31 SS, LV


Additianal Tests

CLICK HERE TO SEE MORE TESTSCLICK HERE TO HIDE TESTS
1120 UA
319 SS
61 LV/RE
321 SS
Q099 SS
318 SS
197 SS
320 SS
101 SS
A701 SS
102 SS
IRIB SS
106 SS
123 SS
105 SS
1877 SS
0301 SS
S806 LV
302S SS
140 SS
107 SS
3369 SS
113 SS
S157 SS
129 SS
S090 SS
S204 SS
LYME SS
136 SS
125 SS
Q472 ST
944 SS
684 SS
12 UA
696 SS
765 SS
A042 SS
S100 ST
A063 SS
770 ST
103 SS
787 LV/SS
2007 SS
150 RE
20 LV
127 SS
383 SS
134 SS
135 SS
A134 SS
110 SS
181 SS
112 SS
142 SS
1536 SS
PROS SST
606 SW
131 SS
CULC FL
196 SS
534 SW
S123 SS
604 SW
036 BL
602B ST
037 BL
Q190 LV
247 LV
148 RE
304 SS
151 RE
305 SS
A043 SS
311 SS
T267 SS
246 LV
1210 SS
056 LV
185 SS
133 SS
115 SS
980 SS
S892 BL
145 SS
163 SS
252 SS
139 SS
144 SS
5620 SW/UA
A623 RE
116 SS
156 RE
179 GY
132 SS
117 GY
146 SS
119 LV
T315 SS
SS
187 SS
HPYG SS
137 SS
7110 SS
030 UA
147 SS
S031 UC
108 SS
69 UC
S747 LV
S128 BD/Affirn
HERP SS
962A RE
303 SS
VAP SS
0980 SS
S402 SS
677 SS
162 SS
A232 SS
995 SS



Submit

Find Lab Locations in Your State

Bayonne Patient Service Center #1
546 Ave C, Bayonne NJ 07002
Phone: (201) 471-7031
Hours: 7:30 AM - 5:00 PM
East Orange Patient Service Center
108 South Munn Ave, East Orange, NJ 07018
Phone: (862) 520-5315
Hours: 10:00 AM-5:00 PM
Florham Park Patient Service Center
15 James St, Florham Park, NJ 07932
Phone: (973) 301-1909
Hours: 9:00 AM - 5:00 PM
Glassboro Patient Service Center
359 N Main Street, Glassboro, NJ, 08028
Phone: (856) 881-5320
Hours: 7:30 AM-3:30 PM
Hoboken Patient Service Center
450 7th Street, Hoboken, NJ 07030
Phone: (201) 850-1437
Hours: 8:00 AM - 4:00 PM
Irvington Patient Service Center
40 Union Avenue, Suite 205, Irvington, NJ 07111
Phone: (862) 231-6223
Hours: 9:00 AM - 7:00 PM
Jersey City Patient Service Center
709 Newark Ave 2nd Floor, Jersey City, NJ 07036
Phone: (201) 222-0178
Hours: 9:00 AM - 5:00 PM
Somerset Patient Service Center
1553 Rt.27, Somerset, NJ, 08873
Phone: (908)583-6645
Hours: 10:00 AM - 2:00 PM
Succasunna Patient Service Center
262 Route 10 West, Succasunna, NJ 07876
Phone: (973) 970-9314
Hours: 9:00 AM - 4:00 PM
Toms River Patient Service Center
508 Lakehurst Rd, Suite 3B, Toms River, NJ 08755
Phone: (732) 228-7528
Hours: 7:30 AM - 4:00 PM
Woodbridge Patient Service Center
1030 St.Georges Avenue, Lower Level, Suite V, Avenel, NJ, 07001
Phone: (732) 326-2966
Hours: 9:00 AM - 5:00 PM
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
New Hyde Park Patient Service Center
1575 Hillside Avenue, Suite 100-A, New Hyde Park, New York, 11040
Phone: (516) 233-2585
Hours: 8:00 AM - 4:00 PM
Wappingers Falls Patient Service Center
66 Middlebush Rd. , Suite U300, Wappingers Falls, NY 12590
Phone: (845) 632-6262
Hours: 7:30 AM- 4:00 PM
Yonkers Patient Service Center
970 N Broadway, Suite 301, Yonkers, NY
Phone: (914) 207-1295
Hours: 7:00 AM - 4:00 PM
Have questions or need assistance? Call (877) 733-4522
Bridgeport Patient Service Center
754 Clinton Avenue, Bridgeport, CT, 06108
Phone: (203) 290-4775
Hours: 8:00 AM - 4:00 PM
Stamford Patient Service Center
Stamford Patient Service Center. 111 High Ridge Road, First Floor, Stamford, CT, 06905
Phone: (908) 583-6607
Hours: 8:00 AM - 4:00 PM
Waterbury Patient Service Center
Waterbury Patient Service Center. 2247 E.Main Street, Suite 103, Waterbury, CT 06705
Phone: (203) 574-2030
Hours: 8:00 AM - 5:00 PM
Have questions or need assistance? Call (877) 733-4522
Athol Patient Service Center
1467 Main Street, Athol, MA 01331
Phone: (978) 249-3825
Hours: 8:30 AM - 4:00 PM
Greenfield Patient Service Center
33 Riddell St, Greenfield, MA 01301
Phone: (413) 775-0000
Hours: 8:00 AM - 3:00 PM
Lancaster Patient Service Center
136 High Street Ext, Lancaster, MA 01523
Phone: (978) 368-6352
Hours: 8:00 AM - 5:00 PM
South Weymouth Patient Service Center
70 Pleasant Street, So Weymouth, MA, 02190
Phone: (908) 583-6610
Hours: 7:00 AM - 4:00 PM
Have questions or need assistance? Call (877) 733-4522
Cambridge Patient Service Center
10 Aurora Street, Cambridge, MD, 21613
Phone: (410) 228-0556
Hours: 8:00 AM - 5:00 PM
Have questions or need assistance? Call (877) 733-4522
Fayetteville Area Patient Service Center
905 Skibo Road, Suite 101, Fayetteville, NC, 28314
Phone: (910) 867-7071
Hours: 9:00 AM - 6:00 PM
Walter Reed Patient Service Center
1220 Walter Reed Road, Suite A, Fayetteville, NC, 28304
Phone: (910) 491-1956
Hours: 7:00 AM - 4:00 PM
Have questions or need assistance? Call (877) 733-4522
Have questions or need assistance? Call (877) 733-4522
Bangor Patient Service Center
225 Erdman Avenue, Bangor, PA, 18013
Phone: (610) 452-9174
Hours: 7:00 AM- 3:00 PM
Hazelton Patient Service Center
101 South Church Street, Hazelton, PA 18704
Phone: (570) 455-0747
Hours: 8:00 AM - 4:00 PM
King Of Prussia Patient Service Center
491 Allendale Road, Ste 106, Kings Of Prussia, PA, 19406
Phone: (484) 679-1278
Hours: 9:00 AM - 5:00 PM
Kingston Patient Service Center
517 Pierce Street, Kingston, PA 18704
Phone: (570) 283-0674
Hours: 7:00 AM - 3:00 PM
Nanticoke Patient Service Center
233 South Prospect Street, Nanticoke, PA, 18634
Phone: (570) 735-2626
Hours: 7:00 AM - 1:00 PM
Have questions or need assistance? Call (877) 733-4522
Conlin Patient Service Center
4420 Conlin Street, Ste#100, Metairie, LA, 70006
Phone: (504) 302-2035
Hours: 8:00 AM - 5:00 PM
Lafayette Patient Service Center
850 Kaliste Saloom Road, Suite 111, Lafayette, LA, 70508
Phone: (337) 504-5926
Hours: 12:00 AM - 5:00 PM
Saxon Patient Service Center
4213 Saxon Street, Metairie, LA, 70006
Phone: (504) 779-8163
Hours: 7:00 AM - 4:00 PM
Have questions or need assistance? Call (877) 733-4522