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NAME: ___DOB: ___ADDRESS: ___PHONE: ___EMAIL:___ Comprehensive Metabolic Panel$30 Complete Blood Count (CBC)$10 Lipid Panel (FASTING RECOMMENDED) $15 Iron$10 Phosphorous$5 Magnesium$5 Uric Acid$5
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Individuals who require specific lab tests or services without the need for a doctor's referral.
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Form direct access lab is a form used to report direct access laboratory testing services.
Healthcare facilities that perform direct access laboratory testing services are required to file form direct access lab.
Form direct access lab can be filled out electronically or in paper form with all the required information regarding direct access laboratory testing services.
The purpose of form direct access lab is to provide information about direct access laboratory testing services performed by healthcare facilities.
Information such as the name of the healthcare facility, types of direct access laboratory testing services offered, and number of tests conducted must be reported on form direct access lab.
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