NEW LABS CLIENT ONLINE SET UP FORM 

Thank you for choosing Revenue Management Corporation! Our first step to a successful partnership is completing the New Labs Client Online Set Up Form. This should only take a few minutes and to help make this a little easier prepare to provide Tax ID, Group PTAN Number, and Charge Master with CPT codes that are currently being supplied for billing. 

 

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Physical Address *
Physical Address
Mailing Address for Payments if different from above.
Mailing Address for Payments if different from above.
Office Phone *
Office Phone
Cell Phone *
Cell Phone
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