Required Documents
When you have successfully completed the quiz, we will contact you to let you know the specific requirements applicable to your facility. Please
download the Sample Collection Provider Agreement Form and submit it together with
the following items, if applicable:
- Your business license
- Proof of liability insurance
- Phlebotomy certificate and/or documentation of experience and
competency in collecting blood
- Photographs of your facility—the front entrance and the
room where collections will be performed
Mail the documents to:
Sample Collection Provider Program
DNA Diagnostics Center
205 Corporate Court
Fairfield, Ohio 45014
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