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Get CO Children's Hospital General & Microbiology Lab Requisition 2018

Ipping Address: Children's Hospital Colorado Clinical Laboratory - Room B0200 13123 E. 16th Ave Aurora, CO 80045 FAILURE TO COMPLETE BELOW FIELDS WILL DELAY RESULTS ***PLEASE PROVIDE COMPLETE BILLING INFORMATION ON THE BACK OF THIS FORM*** Contact Information Ordering Institution Address Street City, State, Zip Ordering Provider Phone Ordering Provider (Last, First, and Middle Initial) Result Contact Name Result Phone Result Fax Patient.

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