Part 1: Company Information
Company Name
Primary Contact Name
Primary Contact's Email
Address
City
State
Zip
Phone
Fax
Website
I am a current DATIA Member
Part 2: Additional Categories for Industry Directory

Please check the additional categories under which you would like your company's listing to appear in the industry directory.


Additional category listings can be purchased for $15 per category.

Service Categories
Employer*This category is not listed on the searchable directory and does not count towards your total category choices. Alternative Specimen Testing Consortium/TPA
Collection Services DOT Physicals Employee Assistance Programs
Alcohol Testing – BAT Medical Review Officer Freelance Specimen Collection
Supervisor/Employee Training Consulting
Mobile Collections Non-mandated Testing On-Site Testing
Drug-Free Policy Development Substance Abuse Counseling/Treatment Substance Abuse Professional
Student Drug Testing 24 Hour Availability QA Services
Background Screening DNA Testing Laboratory
Wellness Programs Franchise & Business Opportunities
Supplier Categories
Urine Specimen Collection Supplies Hair Drug Testing Supplies Oral Fluid Drug Testing Supplies
Drug Testing Laboratory - Urine Drug Testing Laboratory - Oral Fluids Drug Testing Laboratory - Hair
Breath Alcohol Testing Instruments/Supplies Oral Fluid Alcohol Testing Instruments/Supplies Point of Collection Drug Testing Kits
Drug and Alcohol Testing Software Training Supplies
Agencies and Modes
FAA FMCSA FRA FTA PHMSA USCG DOD DOE NASA NRC
Description Listing
Increase the effectiveness of your listing by including a 50-word description of your company's products and/or services. The description will be included in all categories under which your company appears. This feature is available for $50. This description is complimentary for Sustaining Members.
(No descriptions beyond 50 words will be accepted)
Bolding
YES! Please print my listing in Bold Print.
Part 3: Totals
This is a correction of existing information (no new categories, new description or bolding)
This is a an addition of categories
Category Listings 50 Word Description Bold Print Listing
Total
=
TOTAL
 Part 4: Payment Information
Payment Type:
MC VISA AMEX
Card #
Cardholder's Name
Exp. Date
This online registration form is secured utilizing the highest level of encryption security possible. This means you can rest assured that communications (e.g. credit card numbers) between your browser and this site's web servers are private and secure.
This is a secure order form but if you prefer to print this out our Fax is: (202) 315-3579

For Check payments please print this out and send to: DATIA • 1325 G Street, NW, Suite 500#5001 Washington, DC 20005