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S.E.D. Medical Laboratories   5601 Office Blvd., Albuquerque, NM 87109   (505)727-6300 or (800)999-LABS

This form is to be completed by individuals who have been requested to complete a drug test by the Los Alamos National Laboratory.  S.E.D. Medical Laboratories will contact the individual to schedule a specimen collection at the selected location.  The specimen will then be analyzed at S.E.D. Laboratories and the results forwarded to Los Alamos National Laboratory. 
Name
Phone: Email:
 
Site Needed City:  St:
Zip:
Candidate Needs results collected by:   Date

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