International Drop Ship Shipping Charge

International Shipping Payment Form

The below form is only intended for International (Outside of the US) Shipping. If you are within the US, no additional shipping fees are required.
Thank you for ordering testing from Mosaic Diagnostics. In order for us to ship the test kit outside of the United States, we require the shipping fee to be paid in advance. The test fee will be collected when the sample arrives at our laboratory.
Reference/Confirmation Number*
It is included in the email you received.
Patient's Full Name*

First NameLast Name
Your email to receive confirmation of this payment*
example@example.com

Payment for shipping

Shipping Charges$104.00

This payment includes shipping fee from MDX to the patient's country and the return shipping fee using World-Wide Express Saver from UPS.

Please select the destination country
Item subtotal:$0.00

International Shipping Payment Form