Client Sign-Up

Our laboratory representatives will contact you quickly to set up your account. Any further questions please contact us at info@tzs.b72.myftpupload.com

Facility or Provider Name*
Facility or Provider Address*
Office Phone Number*
Office Fax
Contact Email Address*
Provider Name*
Please also include Post-Nominal letters of provider. For example: MD or NP.
NPI*
Provider Name
Please also include Post-Nominal letters of provider. For example: MD or NP.
NPI
Provider Name
Please also include Post-Nominal letters of provider. For example: MD or NP.
NPI
Initial Supply Order
Specimen collection supplies
Urinalysis Temperature (Transport) Cups
Oral Swabs
Specimen Bags
COVID-19 Test Kits
Forms & Shipping Supplies
Respiratory Molecular Diagnostic Requistion Forms
Requisition for COVID-19 testing along with other respiratory panels such as Influenza A or Influenza B.
Urine Toxicology Requisition Forms
Requisition forms for drug screens and confirmations.
Preferred Choice of Shipping Supplies
- UPS
- LSO
- Other
Return Labels
Shipping Bags
Special Instructions
Shipping Boxes
(Multiple of 20)

Client Sign-Up

Initial Supply Order

Specimen collection supplies

Forms & Shipping Supplies