Transcription of FEDERAL DRUG TESTING CUSTODY AND …
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FEDERAL DRUG TESTING CUSTODY AND …
FEDERAL drug TESTING CUSTODY AND CONTROL FORM. 800-877-7484. 80283219 SPECIMEN ID NO. STEP 1: COMPLETED BY COLLECTOR OR EMPLOYER REPRESENTATIVE LAB ACCESSION NO. OMB No. 0930-0158. A. Employer Name, Address, No. B. MRO Name, Address, Phone and Fax No. Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics Incorporated. Quest Diagnostics Incorporated. All rights reserved. QD20315-FED. Revised 10/10. SC2K - 111192. AWSI / BAKER HUGHES INC EMRO - Dr. Steve Kracht ANGELICA ROBERTS 7500 W 110th St. Ste 500. 17542 E 17TH ST STE 330 PO Box 25903. TUSTIN, CA 92780 Overland Park, KS 66225. PH: 713-466-2936 FAX: 713-466-2920 Ph: 888-382-2281 Fax: 913-469-4029. C. Donor SSN or Employee No. _____.
C. Donor SSN or Employee I.D. No. _____ D. Specify Testing Authority: HHS NRC DOT – Specify DOT Agency: FMCSA FAA FRA FTA PHMSA USCG
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