Covid-19 Testing Kit Purchase Order
*Package includes testing kits, paid delivery, and testing for sample collected. Tests results will be sent back to you within 24 hours once samples are received by Valley Medical and Wellness. Our kits are able to be transported/shipped at room temperature. Purchaser is responsible for cost of shipping specimens back to Valley Medical and Wellness. If you need a larger supply of testing kits, please call us at (612) 286-8366.
Facility Name
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Contact Person
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First Name
Last Name
Contact Number
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Area Code
Phone Number
Your E-mail
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Street Address
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Street Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
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Nevada
New Hampshire
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New Mexico
New York
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Ohio
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South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal/Zip Code
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Select a testing kit package* size
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10 Testing Kits - $1,000
20 Testing Kits - $2,000
30 Testing Kits - $3,000
40 Testing Kits - $4,000
50 Testing Kits - $5,000
60 Testing Kits - $6,000
70 Testing Kits - $7,000
80 Testing Kits - $8,000
90 Testing Kits - $9,000
100 Testing Kits - $10,000
A confirmation email will be sent once your order ships! On the next page you will be able to pay for your testing kits. Use the Name and Date of Birth for the contact person as the "Patient Name" and "Date of Birth".
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