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LABORATORY REQUISITION FORM 39 Norman Street Salem, MA 01970 Please check the type of kit ordered: Tel: (781) 6590704 SILO 82542 & 91065) (CPT (800) 2929019 Lactose 82542 & 91065) (CPT Fax: (781)
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How to fill out cl laboratory requisition form

01
Gather all necessary information such as patient name, date of birth, gender, and contact details.
02
Specify the tests and procedures required by the doctor on the requisition form.
03
Indicate any special instructions or considerations for the laboratory, if applicable.
04
Provide the date and time when the sample was collected or will be collected.
05
Include any relevant medical history or information that might assist the laboratory in analyzing the sample.
06
Ensure that the form is properly completed, signed, and dated.
07
Submit the requisition form to the designated laboratory or healthcare provider.
08
Keep a copy of the form for your records.

Who needs cl laboratory requisition form?

01
Patients who require laboratory testing or medical investigations.
02
Doctors, physicians, or healthcare professionals who order diagnostic tests.
03
Healthcare facilities or laboratories that offer testing services.
04
Insurance companies or third-party payers who require documentation for reimbursement purposes.
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CL laboratory requisition form is a document used to request laboratory testing or analysis from a clinical laboratory.
Healthcare providers, doctors, or medical professionals are typically required to file the CL laboratory requisition form.
The form usually requires information such as patient details, test requested, reason for testing, and healthcare provider information to be completed.
The purpose of the CL laboratory requisition form is to facilitate communication between healthcare providers and clinical laboratories for accurate testing and analysis of patient samples.
Patient demographics, test(s) requested, healthcare provider information, date and time of collection, and any relevant clinical information must be reported on the CL laboratory requisition form.
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