Thank you for visiting AYUMETRIX for your testing needs. We appreciate the opportunity to help healthcare providers better serve their patients. Please complete the information below so we may process your request. All the fields below are required.

All kit orders are shipped out to the provider at no cost. Please allow 3 – 5 business days for delivery time. The provider may also request overnight shipping at their own expense. Please feel free to contact us at 1-800-215-8898 to make special shipping arrangements.

Who is requesting test kits?

First Name *

Last Name *

Professional Title *

National Provider Identifier (NPI) *

Phone *

Your Email *

Which test kits are you requesting?*

How many test kits are you requesting?*

Where should we send the test kits?

Practice Name

Address*

City *

State*

Zip Code *

Country *

How did you hear about us?

We welcome you to contact us at 800-215-8898 or by email at info@ayumetrix.com

CONTACT US
221, Mount Olimpus, Rheasilvia, Mars,
Solar System, Milky Way Galaxy
+1 (999) 999-99-99
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