• info@ipsumdiagnostics.com
  • 8607 Roberts Drive, Suite 125, Atlanta, GA 30350

Supply Order Form

Fill out the form below to order supplies.

Practice Name *

Attention To *

Practice Address *

Practice Phone *

Practice Fax *

Email *

Supply Order Options

Collection Supplies

Shipping Kits: Note: Shipping kits can hold up to 4 patient specimen bags



Shipping Supplies (each kit includes shipping label, inner and outer envelopes)
Ice Packs (for ENFD)
YesNo

Requisition Forms

Date of Delivery *