Louisville Testing Form
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  • Louisville Medicine Center Pharmacy Testing Appointments

    Patient Registration and Screening

  • Call 330-875-5525 for same day appointments. 

  • Please call the store directly for same day appointments. Thank you. 

  • COVID-19 and Flu testing will be done curbside. Please do not enter the pharmacy for these tests. Follow the signs in the parking lot.

  • For lipid panels - to ensure accurate results for triglycerides and glucose in the panel you must fast for at least 9 hours before the test. 

  • Patient Details

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  • Patient Contact Information

  • Health Screening

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  • Health Insurance Information

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  • I give conset for a staff member of the Medicine Center Pharmacy to collect and process my sample for test(s) I have selected. This will require a blood sample to be collected by a lancing device on a finger of my choice. If not enough blood is collected, it could require multiple finger pricks. 

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              Rapid COVID-19 TestAntigen test - results within 15-30 minutes
              $35.00
                
              Rapid COVID-19 plus Flu (A/B)Results in 15-20 minutes
              $60.00
                
              A1CResults in 5-10 minutes
              $35.00
                
              Lipid PanelResults in 10-15 minutes
              $35.00
                
              TSH (Thyroid-stimulating hormone)Lab mail off
              $46.00
                
              Total
              $0.00

            • **IMPORTANT** Lab sendoff information

              -Your insurance will be billed by Mobility Health Labs so please provide up to date information

              -Test results generally available next day but can take longer if there are any unexpected delays

              -To get your results faster, you need to make an account with lab BEFORE your appointment. You will be redirected after submitting. 

              You will only need to create an account once. If you have already made an account for a previous appointment, please skip this step.

              If the test is for a minor then a guardian will make an account under his or her name and the child will be added to the account during the appointment. 

            • MCP Staff Use Only - Please go back up to submit

            • Medicine Center Pharmacy -Louisville

              Located at: 700 W. Main Street. Louisville, Ohio 44641

              CLIA:36d0960795

              NPI:1114021177

              Phone Number: 330-875-5525

            • Specimen Information:

              Collected: {appointmentsminerva}

              Test Performed: {appointmentsminerva}

              Specimen ID: 1

               

            • Test ID - 20387

            • A1C Test
              Result:

            • Lipid Panel
              LDL: mg/dL
              HDL:      mg/dL
              Total Cholesterol:      mg/dL
              TRG:      mg/dL
              NON-HDL:      mg/dL
              TC/HDL:      
              Glucose:      mg/dL

            • Lot: Exp. Date:

            • Choose from one of the PayPal options to make your payment.

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