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Why ImpetusDX?
Providers
- Order Our Test Kit
- Results Portal
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ORDER TEST KIT

FOR CURRENT CLINICS

Facility Name*

First & Last Name*

Address*

City*

State*

Zip Code*

Phone*

Fax

Email*

Submission Date*

Notes

Oral Health Kits

Select Requested Amount*

Kit includes: (5) Saliva tubes, requisitions, biohazard bags, (2) FedEx clinical packs & return labels

Upon submitting this order form, we will charge the card on file for the supplies ordered.

Contact Sales to set up your Account

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