Span Corporation - Order Form

Order Form

Span Corporation
1505 White Street
Ann Arbor MI 48104
Phone: 734.623.7726
Fax: 734.769.6268
Email: customerservice (at) spancorp.com

Full Name: *

(first, middle, last name)

Company Name:

Email: *

Phone #:

()

Street Address

Address continued

City

Zip

State

Miles:

Type of Drug Screen Desired

Urine screen, lab-based

Urine screen, "Instant" (with lab confirmation)

Urine screen, "Instant" (without lab confirmation)

Hair screen

Oral fluids screen

Zip Code of site area requested:

Urine Testing Supplies

Off-site, lab-based

On-site, lab based

On-site, instant, with lab confirmation

On-site, instant, no lab confirmation

Off-site, lab-based EtG testing

Hair Testing Supplies

Choose one:

Oral Fluid Testing Supplies