Drug Test Supply Order Form

Complete the following form to order drug testing supplies with your LabCorp account number.

Contact Information
Supplies Requested
Please indicate whether you are the LabCorp customer or a collection facility ordering supplies on behalf of the customer.
Enter quantity requested for each item ordered. Specimen Collection Kits (minimum 10 kits – max. 200, increments, of 25)
Kit includes: 1 - Biohazard Specimen Shipping Bag 1- Wide Mouth Collection Cup with Temperature Strip 2 - 45ml UrineSpecimen Transport Vial
Kit includes: 1 - Biohazard Specimen Shipping Bag 1 - 90ml Urine Specimen Container with Temperature Strip
Chain of Custody Forms
(min.10 forms, increments of 25, max 500)
Web Chain of Custody (COC) Form Paper with tamper-evident specimen seals (1000 page increments)
(min.10 forms, increments of 25, max 500)
Miscellaneus Supplies
Employer Information

Required for all chain of custody orders (A-D)

Copy from Contact Information

Medical Review Officer Information

Required for all chain of custody orders (A-D)

Copy from Contact Information

Shipping Information

Required for all chain of custody orders (A-D)

Copy from Contact Information

Overnight Shipping Request
All supplies shipped via ground unless customer’s overnight courier account information is provided.
Allow 3-10 business days for ground delivery.
 
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