As of November 10, 2023, the State’s CLIA-waived program has been decommissioned. This order form is for organizations that have their own CLIA.


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