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Supply Order Form Instructions

Fill out the top left hand corner of the Supply Order Form with the following information:

• Name and address of your facility
• Phone number 
• Contact person
• Date ordered placed

This information MUST appear on the form to ensure your order is filled and returned to you in a timely manner.

Mark quantity of supply requested next to the item on form

Return completed form to the Allina Medical Laboratories Reference Laboratory via your scheduled courier or fax form to 612-863-4067.

If you have any questions, contact Customer Service at 612-863-4678.

Here is the Supply Order Form in a PDF format that can be printed and faxed to the above number.

View Supply Order Form

Allina Medical Laboratories
800 E. 28th Street, Minneapolis, MN 55407
612-863-4678
1-800-281-4379
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