Register – KarmaCareDx

Search

Please fill out our form to register for access to our LIMS portal

Facility Name

Specialty

Primary Care Urgent Care Pediatric Care Nursing/Rehabilitation Surgery Other

Street Address

City

State

Zip

Phone Number

Fax Number

Hours of Operation

Days

Mon Tue Wed Thu Fri Sat Sun

Name of EMR/EHR

Test Report Delivery Preference

Online Portal Secured Fax (fax # required above)

Esitmated Number of New Patients per Week

Esitmated Number of Recuring Patients per Week

Contact(s) and/or Physician(s) authorized for Portal access

Clinic Contact

Email

Clinic Contact

Email

Clinic Contact

Email

Physician Name

NPI Number

Physician Name

NPI Number

Physician Name

NPI Number

Prospective Testing

Medicare Medi-Cal IEHP Blue Cross Blue Shield CA Cal-Optima CHOC Health Alliance Alpha Care Optum Inland Faculty