Physicians Laboratory Online Bill Pay

Phone (605) 322-7200

Requisitions
CLIA Certification
Advanced Beneficiary Notices (ABNs)
Gyn Codes
Quality Improvement Codes
Instructions & Consent Forms
Cancer Patient Information
Medicare & Insurance Guidelines
Requisitions

Forms

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On-Line Request Forms

Note:  Please be sure to add your Clinic or Hospital name under the Account Number section when filling out the requisition.  The PAP request forms and the Surgical request forms may be typed on-line.  The Non-Gyn forms must be downloaded, printed and filled out by hand.   

HPV Typing Request Form

Gynecological (PAP) Request Form - Iowa

Gynecological (PAP) Request Form - South Dakota

Surgical Pathology Request Form - Iowa

Surgical Pathology Request Form - South Dakota

Non-Gyn/Fluid Request Form - Iowa

Non-Gyn/Fluid Request Form - South Dakota