OncoExTra™ Specimen Kit Request

Complete the form below to order OncoExTra specimen kits. Please note that each order requires 2 samples (solid tumor tissue and matched-normal blood), which typically ship from different locations. Kit requests are usually processed within 1 business day and shipped priority overnight.

First Name*

Last Name*

Phone Number*

Email Address*

Account Name*

Account Street Address*

Account City*

Account State*

Account Zip Code*

Attention To

Number of Kits* (max. 20)

Please note, both tumor (tissue) and normal matched (blood) specimens are required to run the test. Would you like to send additional kits to a secondary location for sample collection (pathology, phlebotomy lab, etc.)?* Yes No

Account Name*

Account Street Address*

Account City*

Account State*

Account Zip Code*

Account Phone Number*

Attention To

Number of Kits* (max. 20)

By submitting this form, you agree to our Terms & Conditions. For more information about our privacy practices, please read our Privacy Policy.

I AGREE*

OncoExTra test supplies are provided at no charge and are to be used only with the OncoExTra test.

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