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Get AL Newborn Screening Program Reorder Form

Ning materials available, complete this form and mail or fax it to the State Health Laboratory at the address below when your stock has reached a 2-4 week supply. ALABAMA DEPARTMENT OF PUBLIC HEALTH Bureau of Clinical Laboratories Newborn Screening Division 8140 AUM Drive, Zip 36117-7001 P.O. Box 244018, Zip 36124-4018 Montgomery, AL FAX (334) 260-3439 Name of Hospital or Doctor: Street/Shipping Address ONLY No P.O. Box: City, State, and Zip Code: Telephone Number: Signature and Title: Number o.

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