Toxicology Supply Request

Toxicology Supply Request
Allow 2-3 days to receive supplies.
Facility Name*
Address*

Street Address

CityState

Zip Code
Submitted By*
Email*
Phone Number*
Please enter a valid phone number.
Toxicology Testing
Toxicology Collection Kit
Kit Includes: Temp Strip Cup, Tube, and Bio Bag
Urine Transfer Straws
Urine Hats
Packing Materials
UPS Paks W/ Labels
Fedex Paks W/ Labels
Please contact supplies@ildp.com with any questions!
Notes:
Should be Empty: