Pick Up Request Form

PLEASE NOTE:

Industry Lab has fully transitioned to UPS for all pickups. If you have any questions or need help with the process, please reach out to your sales representative or email upspickup@ildp.com for further instructions. Thank you!
Facility Name
Number of Specimens Ready for Pickup
Where To Collect?
Your Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Facility Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Request

MonthDayYear
Date
Should be Empty:

PLEASE NOTE: