Application Form - Prime Diagnostics Lab INC.

Welcome to the Prime Diagnostics LAB Inc. Application Form Portal.
This secure portal is designed to collect accurate and complete information from applicants interested in working with or partnering with our toxicology laboratory.

Whether you are applying for employment, clinical collaboration, or vendor/contract services, please complete the form carefully to help us review your application efficiently.

Full Name

Date of Birth

Telephone

Address

Position Applying For

Employment Type

Available Start Date

Highest Level of Education

Institution Name

Graduation Year

Certifications / Licenses

Most Recent Employer

Job Title

Employment Dates

Key Responsibilities

Toxicology Testing Experience

Testing Platforms

LC-MS/MS GC-MS Immunoassay

Chain of Custody Experience

CLIA / CAP / COLA Experience

Authorized to Work*

Willing to Undergo Background Check*

Upload Resume (Required)

Upload Certifications (Optional)

Declaration & Submit

I certify that the information provided is true and complete to the best of my knowledge.

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