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NT INFORMATION (Consultant , Physician Laboratory ID: , Other ) PROJECT INFORMATION Company/Physician: Tel : Project ID: Address: Fax: Other ID: City: State & ZIP: Email: ERMI REQUESTOR INFORMATION (Patient , Property Owner Contact: , Other ) TURNAROUND TIME (TAT) UPON RECEIVING SAMPLES Tel: Address: State & ZIP: City: Name: Cell: STD: 5 Business Days (BD) ; *Sample(s) must be received before 2pm. Please enter the TAT next to sample I.

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