Alabama

 

 

 

Blood Assurance

Physician' Orders:

Require "Request for Phlebotomy" form to be completed by attending physician. Form requires patient name, address, social security number, diagnosis, minimum hemoglobin, frequency of phlebotomies and attending physician's name, address and phone number.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call to receive the "Request for Phlebotomy" form and to make an appointment.

 

 

Locations:

1906 Glenn Blvd. Fort Payne, AL 35968-3545

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 1-800-962-0628

 

 

Email:

 

 

 

Website:

www.bloodassurance.org/BA.html

Tennessee

 

 

 

Blood Assurance

Physician' Orders:

Require "Request for Phlebotomy" form to be completed by attending physician. Form requires patient name, address, social security number, diagnosis, minimum hemoglobin, frequency of phlebotomies and attending physician's name, address and phone number.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call to receive the "Request for Phlebotomy" form and to make an appointment.

 

 

Locations:

Main Location: 705 East 4th Street

Chattanooga, TN 37403-1916

 

1740 Gunbarrel Road, Suite B

Chattanooga, TN 37421-7183

 

2855 Keith Street NW

Cleveland, TN 37312-3738

 

975 East Third St.

Chattanooga, TN 37403

 

1920 Northpoint Blvd., Suite A

Hixson, TN 37343-6700

 

155 W Broad Street

Cookeville, TN 38501

 

1500 North Jackson St., Suite 200

Tullahoma, TN 37388

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 1-800-962-0628

 

 

Email:

 

 

 

Website:

www.bloodassurance.org/BA.html

Arizona

 

 

 

United Blood Services

Physician' Orders:

Doctor's prescription indicating diagnosis, frequency of draws, lower level of maintenance primary HH physician is requesting and latest labs indicating Ferritin level.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call Alternative Collection Department (480) 344-5901 to make an appointment.

 

 

Locations:

Please visit website or call for locations.

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 1-800-288-2199

 

 

Email:

legestad@bloodsystems.org

 

 

Website:

www.unitedbloodservices.org

California

 

 

 

Blood Centers of the Pacific

Physician' Orders:

Only required if you will be receiving phlebotomies more than once every 56 days.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

1-888-393-4483 or online at www.bloodcenters.org

 

 

Locations:

Irwin Center 270 Masonic Ave. San Francisco, CA 94118

Downtown Center 264 Bush Street, San Francisco, CA 94104

Peninsula Center 1791 El Camino Real Burlingame, CA 94010

Redwood City Center 260 Main Street, Suite C Redwood City, CA 94063

Marin Center 4050 Redwood Highway San Rafael, CA 94903

North Bay Center 1325 Gateway Blvd. C1 Fairfield, CA 94533

 

Napa Center 1834 Soscol Ave, C Napa, CA 94559

 

Vallejo Center 480 Redwood St, Suite 31 Vallejo, CA 94590

 

Ukiah Valley Center 620 Kings Court, Suite 110 Ukiah, CA 95482

Shasta Blood Center 2420 Athens Ave. Redding, CA 96001

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 1-888-393-4483

 

 

Email:

lbloch@bloodcenters.org

 

 

Website:

www.bloodcenters.org

Colorado

 

 

 

Bonfils Blood Center

Physician' Orders:

Require physician orders with information about diagnosis, frequency of phlebotomies and cut off point.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call to make an appointment.

 

 

Locations:

15075 E. Mississippi Ave. Aurora, CO 80012

3113 28th St. Boulder, CO 80303

Parkway Center, Bldg. #2 541 West Highlands Ranch Parkway Highlands Ranch, CO 80129

13952 Denver West Pkwy. Building 53, Suite 335 Golden, CO 80401

1050 S. Wadsworth Blvd. Lakewood, CO 80226

717 Yosemite Street Denver, CO 80230

960 West 124th Avenue Westminster, CO 80234

3676 Parker Boulevard, Suite 380 Pueblo, CO 81008

100 Broadway, Suite 3 Sterling, CO 80751

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 303-363-2330 or 800-421-9529

 

 

Email:

 

 

 

Website:

www.bonfils.org

Georgia

 

 

 

Blood Assurance

Physician' Orders:

Require "Request for Phlebotomy" form to be completed by attending physician. Form requires patient name, address, social security number, diagnosis, minimum hemoglobin, frequency of phlebotomies and attending physician's name, address and phone number.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call to receive the "Request for Phlebotomy" form and to make an appointment.

 

 

Locations:

100 West Walnut Avenue Dalton, GA 30720-8402

 

178 Shorter Avenue Northwest Rome, GA 30165

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 1-800-962-0628

 

 

Email:

 

 

 

Website:

www.bloodassurance.org/BA.html

Kentucky

 

 

 

Central Kentucky Blood Center

Physician' Orders:

Require a prescription (renewed annually) stating the following: diagnosis, hematocrit/hemoglobin value needed to perform the phlebotomy, interval between treatments.
Additional Information: other diagnosis in addition to hemochromatosis.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Bring a doctor's prescription to a fixed donor site. Also, an order form is available for doctor's offices. Please contact 888-775-2522 for more information.

 

 

Locations:

330 Waller Ave. Lexington, KY 40504

685 Hambley Blvd. Suite 1A Pikeville, KY 41501

200 North Lake Drive Prestonsburg, KY 41653

120 South Highway 27, Suite 4 Somerset, KY 42501

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Toll Free: 888-775-2522
Lexington: 859-276-2534
Pikeville: 606-432-4979
Prestonsburg: 606-886-1557
Somerset: 606-679-7414

 

 

Email:

info@ckbc.org

 

 

Website:

www.ckbc.org

Louisiana

 

 

 

The Blood Center

Physician' Orders:

Written physician's order required.

 

 

Fee:

$41

 

 

Payment Method:

Cash or check only.

 

 

Insurance:

Will not bill insurance. Fee is waived for patients who can present a Medicare card or for patients who bring in a blood donor that completes a successful donation at the same time the service is rendered to the patient.

 

 

Appointment:

Call for information.

 

 

Locations:

9848 Perkins Road Suite A Baton Rouge, LA 70810

433 Plaza Room 218 Bogalusa, LA 70427-3793

1951 Florida Avenue / Highway 190 Denham Springs, LA 70726-4912

18210 Hwy 1 Suite 6 Galliano, LA 70345

42268 Veterans Avenue Hammond, LA 70401

1814 N. Causeway Mandeville, LA 70448

4884 Highway 1 Raceland, LA 70395

3400 16th St. Metairie, LA 70002

2017 Tulane Avenue New Orleans, LA 70112

1599 Bienville Blvd. suite B Ocean Springs, MS 39564

7400 Judge Perez Blvd. Chalmette, LA 70043

522 Gause Blvd. Slidell, LA 70458

604 Canal Blvd. Thibodaux, LA 70301

1525 Lapalco Blvd. Suite 17 Harvey, LA 70058

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 504- 524-1322

 

 

Email:

 

 

 

Website:

www.thebloodcenter.org

Massachusetts

 

 

 

Cooley Dickinson Hospital

Physician' Orders:

Patient's name, address, date of birth, phone number, social security number and diagnosis. The frequency of phlebotomy, the Hgb or Hct level at which to discontinue phlebotomies, the physician's signature and date ordered.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call for information.

 

 

Locations:

30 Locust St. Northampton, MA 01061

 

 

Hours:

Mon, Wed, Thurs and Fri - 8:30 am to 4 pm. Tues - 1 to 8 pm

 

 

Phone/Fax:

Ph: 413-582-2162

 

 

Email:

Thomas_pavao@cooley-dickinson.org

 

 

Website:

www.cooley-dickinson.org

 

 

 

 

Anna Jaques Hospital

Physician' Orders:

Orders should be faxed or brought in by patient and should have physician's name, address, and telephone number. We also require the patient's name, date of birth, diagnosis, hematocrit cut-off (below which we would not perform the phlebotomy), frequency of phlebotomies and orders for other lab tests they would like performed.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

Additional tests requested by physician are submitted to patients health insurance company.

 

 

 

Appointment:

Call for information.

 

 

Locations:

Anna Jaques Hospital 25 Highland Avenue Newburyport, Massachusetts 01950

 

 

Hours:

Monday  5 pm - 8 pm, Wednesday and Thursday  10 am to 6 pm

 

 

Phone/Fax:

Ph: 978 462-1098

 

 

Email:

blooddonor@ajh.org

 

 

Website:

www.ajh.org

North Dakota

 

 

 

United Blood Services

Physician' Orders:

Require a physician's prescription order with instructions regarding frequency of phlebotomy and hematocrit limits. Prescription should include diagnosis code for hereditary hemochromatosis. Must be renewed annually.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call for appointment.

 

 

Locations:

Fargo
Bismark
Minot
Aberdeen (South Dakota)

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Fargo 701-293-9453
Bismark 701-258-4512
Minot 701-852-2161
Aberdeen 605-225-7732

 

 

Email:

 

 

 

Website:

www.unitedbloodservices.org

Oklahoma

 

 

 

Oklahoma Blood Institute

Physician' Orders:

Written physician's order required. Photo ID, date of birth, social security number address and phone number required.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call for information (800) 375-8778

 

 

Locations:

Tulsa - 4601 E. 81st St

Ponca City - 518 N. 14th St.

Edmond - 3409 S. Broadway, Suite 300

Midwest City - 1113 South Douglas Boulevard, Suite C

Ada - 900 N. Mississippi, Suite B

Headquarters - 1001 N. Lincoln Boulevard

North - 5105 N. Portland

Norman - 1004 24th Avenue NW, Suite 101

Enid - 301 E. Cherokee

Ardmore - 1420 Veterans Boulevard

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: (405) 297-5597 or (800) 375-8778

 

 

Email:

 

 

 

Website:

www.obi.org

Texas

 

 

 

Blood and Tissue Center of Central Texas

Physician' Orders:

Contact Special Donations to get a copy of the "Physician's Request Form". Your doctor must complete this form once every six months.

 

 

Fee:

$20.00

 

 

Payment Method:

 

 

 

Insurance:

Not accepted (receipt provided for insurance purposes)

 

 

Appointment:

Make appointments with the Special Donations department at 512-206-1265

 

 

Locations:

4300 N. Lamar Boulevard Austin, TX 78756

 

 

Hours:

Mon-Fri 8am-6pm; Sat 8am-2pm

 

 

Phone/Fax:

Ph: (512) 206-1265

 

 

Email:

dmogonye@tcms.com
Dolly Mogonye Special Donations

 

 

Website:

www.bloodandtissue.org

 

 

 

 

Carter BloodCare

Physician' Orders:

Required. Must be dated on physician’s letterhead or prescription form. Must contain the patient

name, diagnosis, how often to phlebotomize and hemoglobin cutoff value. Carter BloodCare Therapeutic Request Form is also accepted.

 

 

Fee:

$75.00

 

 

Payment Method:

Money Order, Cashier’s Check or Traveler’s Check.

 

 

Insurance:

Receipt provided for insurance purposes. No charge for Medicare/Medicaid or Hereditary Hemochromatosis donors obtaining a Carter BloodCare no-fee card.

 

 

Appointment:

Please pre-book your appointment with our Special Donations department at 1-866-525-3378.

 

 

Locations:

1-800-DONATE-4

 

 

Hours:

Varies by location.

 

 

Phone/Fax:

Ph: 1-866-525-3378

 

 

Email:

 

 

 

Website:

www.carterbloodcare.org

 

 

 

 

Coffee Memorial Blood Center

Physician' Orders:

Required
Written orders should contain hemoglobin levels.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Make appointments either in person or by phone.

 

 

Locations:

1915 S. Coulter, Amarillo, TX 79106

 

 

Hours:

M-Th (8:00 a.m. - 7:00 p.m.), Fri (8:00 a.m. - 5:30 p.m.)

 

 

Phone/Fax:

Ph: 806-358-4563

 

 

Email:

mtownsend@thegiftoflife.org

 

 

Website:

www.thegiftoflife.org

 

 

 

 

South Texas Blood and Tissue Center

Physician' Orders:

Required
Physician's order with a Hgb level to be obtained.

 

 

Fee:

$35.00

 

 

Payment Method:

Check or credit card - NO CASH

 

 

Insurance:

Not accepted

 

 

Appointment:

Required - 210-731-5537

 

 

Locations:

6211 IH-10 West at First Park Ten Blvd., San Antonio, Texas 78201

 

 

Hours:

Varies

 

 

Phone/Fax:

Ph: 210-731-5537

 

 

Email:

RMaxey@bloodntissue.org

 

 

Website:

www.bloodntissue.org

 

 

 

 

Texoma Regional Blood Center

Physician' Orders:

Required
Must be dated and on the physician's letterhead or prescription form. Must contain the patients name, diagnosis, amount of blood to be drawn, how often to phlebotomize and the minimum and maximum hematocrit to be maintained.

 

 

Fee:

$25.00

 

 

Payment Method:

Cash or check

 

 

Insurance:

Not accepted (itemized statement provided for insurance purposes)

 

 

Appointment:

Not required

 

 

Locations:

3911 N. Texoma Parkway, Sherman, Texas 75090

 

 

Hours:

Mon - Fri 8:00am-5:30pm

 

 

Phone/Fax:

Ph: 903-893-8628

 

 

Email:

cbaker@texoma.net

 

 

Website:

 

 

 

 

 

United Blood Services - El Paso

Physician' Orders:

Required
Written orders or on prescription pad.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Required. Call 915-544-5422

 

 

Locations:

2325 Pershing Dr., El Paso, Texas, 79903

 

 

Hours:

Call for hours

 

 

Phone/Fax:

Ph: 915-544-5422

 

 

Email:

scarrasco@bloodsystems.org

 

 

Website:

 

 

 

 

 

United Blood Services - McAllen & Brownsville

Physician' Orders:

Required
Written orders or on prescription pad. They also have a form that can be completed by your doctor. Call for info.

 

 

Fee:

$0 if the blood can be used for a transfusion.

 

 

Payment Method:

Cash or local check

 

 

Insurance:

Not accepted

 

 

Appointment:

Required. Contact donor collections department; McAllen (956) 682-1314 ext 111 or Brownsville (956) 504-3809

 

 

Locations:

1312 Pecan Blvd., McAllen, TX 78501
2370 Central Blvd, Brownsville, TX 78520

 

 

Hours:

Call for hours

 

 

Phone/Fax:

Ph: 915-544-5422

 

 

Email:

hacevedo@bloodsystems.org

 

 

Website:

 

Utah

 

 

 

Mountainstar Healthcare Blood Bank

Physician' Orders:

Require a physician's prescription order with instructions regarding frequency of phlebotomy and hematocrit limits. Prescription should include diagnosis code for hereditary hemochromatosis.

 

 

Fee:

$0

 

 

Payment Method:

N/A

 

 

Insurance:

N/A

 

 

Appointment:

Call to make appointment, walkins accepted

 

 

Locations:

Ogden Regional Medical Center 5475 South 500 East Ogden, Utah 84405

 

 

Hours:

8AM-5PM M-W and 8AM-8PM TH-F

 

 

Phone/Fax:

Ph: 801-479-2389 or 800-237-9194 X 2389

 

 

Email:

 

 

 

Website:

www.mountainstarhealth.com