Diagnostic Centre Registration Form

Back to registration info Diagnostic Partner Registration

Diagnostic Centre Registration

Complete the form in 3 simple steps

Basic Details

Documents

Admin Details

Diagnostic Centre Name *

Centre Type *

Registration Number *

Address Line 1 *

Address Line 2

City *

State *

Pincode *

Phone *

Email *

Emergency Phone

Website

Registration Certificate *

Click to upload Registration Certificate

PDF, JPG, PNG (Max 5MB)

NABL / Lab License *

Click to upload NABL / Lab License

PDF, JPG, PNG (Max 5MB)

Diagnostic Centre Logo

Click to upload Diagnostic Centre Logo

JPG, PNG (Max 2MB)

Full Name *

Designation *

Mobile *

Email *

Password *

Confirm Password *

Your diagnostic centre registration has been submitted for verification.

Tracking ID:

We will review your documents and contact you within 48 hours.