LAP Fee Schedule Request

LAP Fee Schedule Request

Please complete the fields below to submit a fee schedule request. Once your request is submitted, you will receive a copy of the fee schedule from an LAP staff member in 1-2 business days.

Lab Contact First Name:*

Lab Contact Last Name:*

Lab Name:*

Lab Contact Email:*

Lab Contact Phone Number:

Phone

Lab ID Number (if applicable):

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Check this box if you would like to be subscribed to the AIHA LAP Newsletter mailing list.

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