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Get Federal Drug Testing Custody And Control Form

RSON, CA 90745 PH:832-813-2729 B. MRO Name, Address, Phone and Fax No. EMRO-DR STEVE KRACHT NDA500020 7500 W 110TH ST STE 500 PO BOX 25903 OVERLAND PARK KS 66225 PH:888-382-2281 FAX:913-469-4029 FAX:661-716-5007 C. Donor SSN or Employee I.D. No. Pre-employment D. Reason for Test: Random Return to Duty E. Drug Tests to be Performed: Reasonable Suspicion/Cause Follow-up OMB No. 0930-0158 Post-Accident Other (specify) THC, COC, PCP, OPI, AMP THC & COC Only Other (specify) ( ) 7643N N.

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