top of page

Providers Online Lab Request Form

Head Office: 917 Beville Road, South Daytona, Suite B, Unite 2, Florida 32119

Call: 386-562-1052       Fax: 888-919-5502

Email: rsunitedhealth@gmail.com

Physicians are asked to complete the form or attach lab request documents at the bottom of the form. 

You also have the option to fax or email us the requisition forms. 

bottom of page