Powered By Exceltox Laboratories LLC

Testing Services
- Pharmacogenomic Testing
- Covid-19 Testing
Order Process
- New Account Setup
- Request Supplies
About
- Our Clinical Staff
Contact

Testing Services
- Pharmacogenomic Testing
- Covid-19 Testing
Order Process
- New Account Setup
- Request Supplies
About
- Our Clinical Staff
Contact

New Account Setup

Primary Account Details

Facility Name

Contact Name

Work Phone

Email

Address

Address Line 2

City

State

Zip Code

Secondary Shipping Address

Is your shipping address the same as your primary account address?

Yes (Skip to Specimen Processing) No (Fill in the shipping address below)

Address

Address Line 2

City

State

Zip Code

Specimen Processing / Reporting

Testing Type

COVID-19 (SARS-CoV-2) Antibody (SARS-CoV-2 IgM/IgG)

Billing Type

Portal Email Fax

Pickup Day(s)

Mon Tue Wed Thu Fri

Pickup Time

Testing Start Date

Please allow 5 Days for New Account Processing

Provider / Portal Users / Account Rep

Provider Setup

Please include Name, NPI# and Email. If adding multiple providers, please separate them with a line space.

Web Portal Users

All web portal users must have a signed PHI agreement on file. Please include Name and Email. If adding multiple users, please separate them with a line space.

Account Representative

Sales Rep Name

Organization

Email

Mobile No.

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Powered By Exceltox Laboratories LLC

Testing Services
COVID-19 Testing
Pharmacogenomic Testing

About
Order Process
Team
Contact

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Privacy Policy
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Testing Services
- Pharmacogenomic Testing
- Covid-19 Testing
Order Process
- New Account Setup
- Request Supplies
About
- Our Clinical Staff
Contact