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The undersigned health care provider may revoke this authorization or change the fax number, provided that the undersigned health care provider gives LabCorp reasonable written notice. Visit the Dirt Track Legends to see photos from the monthly luncheon.



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The undersigned health care provider may revoke this authorization or change the fax number, provided that the undersigned health care provider gives LabCorp reasonable written notice. Representative is usually the person filling out this form.



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LabCorp strongly encourages all clients to physically safeguard fax machines, so that the location, access, and use of such machines comply with all HIPAA requirements. A Message about error of signup. Speedway News Photo Gallery.


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  1. The undersigned health care provider may revoke this authorization or change the fax number, provided that the undersigned health care provider gives LabCorp reasonable written notice. A Message about error of signup A Message about error of signup.