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(888) 80-QALAB or (888) 807-2522

Completion of this form verifies that you agree to Trelfa Labs’ Terms and Conditions.

Local Customers: please review the Lab Driver Travel Routes and Lab Driver Route Calendar prior to filling out the form below.

Parent company / company responsible for payment.
Doing Business As / alternate business name.
This person will be copied on test results via email unless you instruct us to remove them.
This person will be copied on your test results via email.
Your local Board of Health inspector will be copied on your test results via email.
You must notify the lab of any changes in your sampling schedule. Failure to provide samples for scheduled pickups are subject to a $30 minimum fee.
*Free parking. Semi-trucks welcome. First floor access. Company signage on entry door only. **All laboratory pickups incur driver fees. See Driver Route Schedule for predetermined pickup routes. Fees vary based on your area and needs. *** As needed pickups subject to availability and incur higher fees.
Exampe: 20 swabs/month, 10 air plates/quarter
You must notify the lab of any changes in your sampling schedule. Failure to provide samples for scheduled pickups are subject to a $30 minimum fee.
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