Testing Kit Request Form

Testing Kit Request Form

Whether you’re an existing partner or a new client, please complete the form to request kits directly to your facility.
Are you an existing client?*

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Please complete the Provider Registration Form before proceeding.

Order Details
Requested Delivery Date*

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My Products*
Categories:All

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Genetic Testing

Pharmacogenetics

Infectious Disease

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Genetic Testing

RenaDx Test Kit
$ Free Quantity



OncoDx Test Kit
$ Free Quantity



OralDx Test Kit
$ Free Quantity



CardioDx Test Kit
$ Free Quantity



Pharmacogenetics

Pharmacogenetics Testing KitEnter description
$ Free Quantity



Infectious Disease

Vaginal Microbiota Panel Test Kit
$ Free Quantity



Respiratory Pathogen Panel Test Kit
$ Free Quantity



Gastrointestinal Infection Test Kit
$ Free Quantity



Wound Infection Test Kit
$ Free Quantity



UTI Panel Test Kit
$ Free Quantity



Nail Infection Panel Test Kit
$ Free Quantity



STI Panel Test Kit
$ Free Quantity
Notes or Special Instructions
Authorization and Agreement*

I confirm that I am authorized to place this order on behalf of my facility.
(202) 802-8877 - info@pmcdx.com - www.pmcdx.com
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