Apply for a Professional Account

Proven Medical Testing sells exclusively to licensed healthcare practices and professionals. Complete the application below — our team reviews every application manually, verifies credentials, and enables wholesale pricing and ordering on approval.

Practice information

Practice or business name

Practice type

Contact name

Work email

Phone (optional)

Shipping address

Street address

City

State

ZIP

Professional credentials

We verify credentials as part of manual review. Provide the licence under which products will be purchased and used.

State licence number

Licensing state

NPI number (optional)

CLIA / state laboratory number (optional)

New York practices may operate under a state permit rather than a separate CLIA number, and Washington practices may hold a state Medical Test Site licence — either is acceptable here.

Professional-use affirmations

I affirm that I am a licensed healthcare professional, or an authorized purchaser acting on behalf of a licensed healthcare practice or business.

I affirm that products purchased from Proven Medical Testing will be used in a professional healthcare setting and not for personal or consumer use.

I affirm that products purchased will not be resold or transferred to consumers.

I affirm that the information provided is accurate, and I understand that account approval is subject to verification and may be declined or revoked.

Every application is reviewed manually by our team — there is no automatic approval. We may contact you to verify licensure before enabling pricing and ordering. Your submission, including the affirmations above, is retained as part of your account record.

Item added to your cart

Apply for a Professional Account

Practice information

Shipping address

Professional credentials

Professional-use affirmations

Country/region