Lakeland Health Care

Email Forms Manager

**Note:  Federal regulations enable us to supply only those materials necessary to submint specimens to our facility for testing.**

* Indicates required information
Lakeland Laboratory Printer Cartridges Supply Order Form 
Date *  (mm/dd/yyyy)
Client Name * 
Client Address 
Printer Cartridges 
Kit 6000 - 69G8256 
HP 1200 -C7115X 
HP 1300 - Q2613X 
HP 2015 -Q7553X 
Authentication * 

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    Center for Outpatient Services, St. Joseph  
    Hospice at Home Lakeland HealthCare Affiliate  
    Lakeland Community Hospital, Niles  
    Lakeland Community Hospital, Watervliet  
    Lakeland Regional Medical Center, St. Joseph  
    Lakeland Specialty Hospital, Berrien Center  
    Lakeland HealthCare Affiliate Physician Practices    
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