*AI*********Z*
AI*********Z
Instructions for Service Provider
Please proceed to the following location:
Drug Screen Solutions
STE 209
BRANDON, FL 33511
Providers with eScreen123 must scan ePassport into eScreen123. Use eScreen Scheduled Event Account. Scan this barcode into eScreen123®
Instructions for Mariah Harris
Participant ID:
Account: 129205-21
TEKsystems Office-00021
This order must be completed by:
12/7/2021 10:49 AM (ET)
Account Type: National Account
Phone:
© 2019 Abbott. All rights reserved. All trademarks referenced are trademarks of either the Abbott group of companies or their respective owners.
Note: Completion time displayed does not mean that the service provider is open until the time shown. Note: Please visit the service provider's website or call to confirm operational hours.
Additional Notes:
Bill services to: eScreen, Inc., PO Box 25902,
Overland Park, KS 66225
• You are required to take a photo ID,
this ePassport, and all documents with
which it printed.
• If you are under 18, a parent or legal
guardian may be required in order for
services to be performed. Verify with
the service provider before arriving.
See Next Page
Fax: 813-***-****
Services(1):
Regulation: NON-DOT
Reason for Test: Pre-employment
1. eCup
Please allow for 3 hours of testing time (prior to ePassport expiration and clinic closure). Leaving the clinic before providing an adequate specimen may be considered a
refusal to test and will make you temporarily ineligible for employment. If medical services are also needed, please refer to additional ePassport. During the COVID 19 pandemic, we recommend wearing masks when visiting a clinic for services. If you have questions regarding measures being taken at the facility, please call the clinic. Additional Requirements/Notes:
Clinic ID: 9807 Acct #: 129205-21 Confirmation #: AI549778116Z Bill services to:
eScreen, Inc.
PO Box 25902
Overland Park, KS 66225
Contact Customer Services with questions: 800-***-**** opt. 5