Fillable Vermont Department of Health Laboratory Microbiology Specimen Collection (Vermont Department of Information and Innovation on behalf of Vermont Dept of Health)

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Vermont Department of Health Laboratory Microbiology Specimen Collection (Vermont Department of Information and Innovation on behalf of Vermont Dept of Health)

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BROWSE VERMONT DEPARTMENT OF INFORMATION AND INNOVATION ON BEHALF OF VERMONT DEPT OF HEALTH (VT) FORMS

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Vermont Department of Health Laboratory –Microbiology Specimen Collection Kit Order Form
Mailing Address: PO Box 1125, Burlington, VT 05402-1125
Physical Address: 359 South Park Drive, Colchester VT 05446
(802) 338-4724 / (800) 660-9997 in VT only
Before using specimen collection kits, please be certain no components have expired.
Return expired kits to the laboratory (see above address).
Orders may be submitted using one of the following options:
1. Mail: Vermont Department of Health Laboratory 2. Phone: 802-338-4736 or 1-800-660-9997
(see mailing address above)
3. Fax: 802-338-4706
4. Email:
AHS.VDHLabKitOrders@vermont.gov
Clinical Laboratory/Practice Information
Clinical Laboratory/ Practice Name
Send to the Attention of:
Address
Shipping Address (if different than mailing address)
City/Town
State
Zip Code
Telephone Number
Comments
VDHL Kit Number
Description
1
Enteric Bacteria (Salmonella, Shigella, Campylobacter, E. coli:O157, Shiga-
like Toxin, Yersinia, Vibrio, Culture Independent Diagnostic Test (CIDT))
2
Parasitology
4
Bacteriology (Reference Identification)
5
Pertussis
6
Legionella culture, Mycobacteriology, Mycology
7
Gonorrhea and Chlamydia (Amplified) - Swab
7
Gonorrhea and Chlamydia (Amplified) - Urine
9
Influenza PCR
10
Quantiferon-TB Gold Plus kit (QFT)
11
Measles PCR
11
Mumps PCR
12
Legionella Urine Antigen
13
Serology Mailer with Blood Collection Tube
14
Serology Mailer without Blood Collection Tube
17
Pinworm
18
Orasure HIV-1 Oral Fluid
23
Norovirus PCR
Admin 502 Rev 1 10/2019 Page 1 of 1
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Vermont Department of Health Laboratory Microbiology Specimen Collection (Vermont Department of Information and Innovation on behalf of Vermont Dept of Health)

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Completed 13 August 2020

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