This order form is for organizations who are already approved, onboarded, and actively testing with the State of California’s CLIA-waived testing program.


This order form is for Professional CLIA-waived COVID-19 antigen tests, NOT At-Home (OTC) COVID-19 tests.   

To order At-Home COVID-19 tests instead, click HERE


Planning for Tests

  • Tests must be stored indoors and temperature-controlled (35.6-86°F)

  • Email confirmation is sent when an order is submitted and when it is approved.

  • Please allow 1-3 weeks for delivery.



Organization Information

Organization Point of Contact (Person Placing Order)

Delivery Point of Contact (Person Receiving the Shipment)

Delivery Information

Test Information

Additional Comments, Explanations, or Requests:

Please verify your order for accuracy before you submit. 

Your order information will be reviewed by our staff. You will receive an email when your order is confirmed, usually within 1 week. Delivery may take up to 3 additional weeks.

For additional questions, please email