Anti-14-3-3η Multiplex Test

Provider Sign Up

Please complete the following form to register as a provider for the Anti-14-3-3η Multiplex Test. Our staff will review your application and email your new credentials when ready.

Why choose the Provider Portal?

Simplify Your Workflow with Our Provider Portal!

Key Benefits:

Digital Efficiency: Submit and track test requisitions online.
Time-Saving: Print pre-filled blank forms to streamline your process.
Enhanced Accuracy: Reduce errors with digital data entry.
Real-time Updates: Monitor the status of all submitted tests.

Note: While digital orders are convenient, a printed requisition still needs to be shipped with the sample. We recommend printing the portal-generated requisition form, having your patient sign it, and including it on the outside of the specimen bag.

How would you like to place test orders?(Required)

Use online provider portal

Order via paper requisition

A copy of the completed requisition must be shipped or couriered with the specimen regardless of online or paper preference.

Name(Required)

First Middle Last

Account Email(Required)

This is the email address you will use to access the portal.

Results Contact Email(Required)

This is the email address that patient results will be sent to. If the same as your account email, enter the same address.

NPI Number(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country