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 documents to:

Sample Collection Provider Program
DNA Diagnostics Center
205 Corporate Court
Fairfield, Ohio 45014