Lab Admin Portal

Order Information

Order No

Order Date

Client Information

Client

Provider Not Required

Provider

Choose Fax

Patient Information

Patient Type

First Name

Last Name

Date of Birth

Gender

Passport Numbe

Social Security Number (SSN)

Land Phone Number

Mobile Number

Which one of the Number you want to be a default number?

Land Phone Number Mobile Number

Do you want to send a text message?

Do you want to send Result?

Do you want to Send activation email?