Genetic Testing Kit Request Form

Thank you for your interest in Versiti Hematology Genetics. To request buccal (cheek swabs) and/or blood collection kits (EDTA – Purple Top tubes) for Clinical testing, please complete the form below.

You will need your Versiti client ID number to complete the request.

Client Number

To receive your client number, or for NEW clients who have not used Versiti Hematology Genetics testing in the past, please contact Versiti client services at 800-245-3117 x 6250, or Labinfo@versiti.org to set up your account before placing your kit request.

Megan Frey
Field Marketing Manager, Hematology

Requestor Information

Shipping Address

Kit Preferences

* Fields are required.

 
Diagnostic Laboratories
Diagnostic laboratory services including HLA testing, donor testing, immunohematology reference lab testing, hematology testing and more.
 
Hematology Genetics Testing
The Hematology Genetic Testing Lab provides specialized hematology genetics custom testing panels, single gene testing and more.
 
Requisitions
Access requisitions for Versiti Diagnostic Laboratories.