SDxLabs Payment Portal

Return to SDxLabs

Payment Form

- Step 1 of 3

Please enter your contact details below so that we can properly credit your account.

Name *

First

Last

Date Test Conducted

Email *

Phone

Billing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Please complete the information below to process your payment.

Claim Number, Invoice Number and Invoice Amount can be found on your Invoice.

Please give us a call at (412) 677-0664 if:
• You need a new Invoice or have trouble finding this information
• You have more than 6 invoices
• The amount on your Invoice is different than what the Insurance Company reimbursed you

Do you have multiple invoices?

Invoice Number *

Invoice Amount *

Second Invoice Number

Second Invoice Amount

Third Invoice Number

Third Invoice Amount

Fourth Invoice Number

Fourth Invoice Amount

Fifth Invoice Number

Fifth Invoice Amount

Sixth Invoice Number

Sixth Invoice Amount

Is the amount shown on your invoice different than the amount you receieved in your Explanation of Medical Benefits (EOMB)?

Explanation of Medical Benefits Upload

Click or drag files to this area to upload. You can upload up to 6 files.

If you answered yes above, please upload a picture of your EOMB(s) here and adjust the invoice amount(s) so that they reflect the amount on your EOMB(s).
You can upload up to 6 files in the following formats: .pdf, .png, .docx, .jpg.

Total

$ 0.00

Payment Information *

Card Number

Expiration

Security Code

Updating preview…

This is a preview of your submission. It has not been submitted yet!
Please take a moment to verify your information. You can also go back to make changes.

SDxLabs Payment Portal

Payment Form

Please enter your contact details below so that we can properly credit your account.

Please complete the information below to process your payment.

Thanks for choosing SDxLabs!