Lab Express

Enter Order

Enter Account # or Pickup Facility to select an existing location.
If the location is not found you can enter a new location by first entering Pickup Facility name.

Pickup Date:

Account #:

Notes:

Pickup Facility: *

Street Address: *

City: *

State:

Zip: *

Pickup Instructions:

Contact Name: *

Contact Phone#: *

Email Address for Confirmation: *

Number of Specimens:

Type of Specimen: AmbientRefrigeratedFrozenOther
PharmacySurgical Supplies

Type of Pickup Needed:

Regular

Stat

Special

Lockbox Sweep

Other

Supplies

Mission Critical

Will Call

COD

Airport – Regular

Airport – Special

Patient Name:

RX #:

BOL #:

Delivery Location

Account Number:

Notes:

Delivery Facility: *

Street Address: *

City: *

State:

Zip: *

Special Instructions:

Lab: *

Processing Order

Jan	Feb	Mar	Apr
May	Jun	Jul	Aug
Sep	Oct	Nov	Dec