Drug Screen

$40

Used to detect possible drug use.

Description: This test searches for traces of amphetamines, barbiturates, benzodiazepines, cocaine metabolite, opiates, phencyclidine, propoxyphene, and THC metabolite. Recommended for monitoring whether drugs are present in the system.

Who is this test for?

Patient Information

Submit for each person receiving a test, including yourself.

First Name

Middle Initial

Last Name:

Address: (Street City, State, Zip)

Phone Number: (ex: 123-456-7890)

Date of Birth

Last 4 Digits of SSN:

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Test Name	QTY	Cost

TOTAL $0

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