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The EAP's toll -free, 24 hour 7 day a week hotline is 800-731-6501. <br />You will need to present this letter and a valid picture ID at the collection facility. <br />Collector: If using Form Fox please use Quest Bar Code Account number 80303765 to generate <br />CCF. PLEASE PROVIDE RECEIPT for proof of testing. <br />Quest Diagnostics — South Bend (Preferred) <br />Any Lab Test Now — Mishawaka (Preferred) <br />16598 State Road 23, South Bend, IN 46635 <br />313 W. University Dr, Mishawaka, IN 46545 <br />Monday, Thursday, Friday - 7:30 am to 12:30 pm and 1:00 pm to 3:00 pm <br />Monday - Friday 8:00 am-6:00 pm <br />Tuesday and Wednesday - 7:30 am —1:00 pm <br />574-287-5041 <br />574-273-3323 <br />Professional Diagnostics & Safety — Nappanee (Preferred) <br />Windsor Work Care — Elkhart Preferred) <br />717 S. Oakland Avenue, Nappanee, IN 46550 <br />3100 Windsor Court, Elkhart, IN 46514 <br />Monday - Friday 7:00 am to 4:00 pm <br />Monday — Friday 7:00 am — 5:00 pm <br />574-773-1000 <br />574-266-6555 <br />Michiana Drug Testing Center — Cassopolis (Preferred) <br />Physicians Urgent Care — Warsaw <br />114 Spencer Road, Cassopolis, MI 49031 <br />2680 Escalade Way, Warsaw, IN 46582 <br />Monday, Thursday, Friday 10:00 am — 2:00 pm <br />Monday — Friday 8:00 am — 8:00 pm <br />Tuesday and Wednesday 10:00 am — 6:00 pm <br />574-306-4128 <br />Lifeplex Urgent Care — Plymouth <br />2855 Miller Drive, Plymouth, IN 46563 <br />Monday— Friday 9:00 am —7:00 pm <br />574-941-1000 <br />Lakeland Center for Outpatient Services — <br />St. Joseph <br />3900 Hollywood Road <br />St. Joseph, Michigan <br />Monday — Friday 6:00 am — 7:00 pm <br />269-556-2837 <br />I consent and authorize for the <br />following: <br />To provide a urine drug screen test <br />and/or breath alcohol as per The <br />NECA/Local Union 153 Substance <br />Abuse Policy. <br />When at the collection facility if you have any issues please contact ScreenSafe <br />or have the collection facility contact ScreenSafe at 877-727-3369. For the Medical Review Officer, to <br />release the results only to ScreenSafe <br />and/or the EAP. <br />DO NOT LEAVE THE COLLECTION FACILITY <br />For the EAP to release records for the <br />initial visit for Substance Abuse <br />Treatment to ScreenSafe. <br />Signature <br />Date of Birth <br />PLEASE REMEMBER IT IS YOUR RESPONSIBILITY TO KEEP NORTHERN IN'DIANA N6CA LI 1 153 INFORMED OF AN CHANGE IN YOUR ADDRESS <br />OR PHONE NUMBER <br />REMEMBER NORTHERN INDIANA NECAAU 153 OFFERS A FULLY INDEPENDENT PRC�FESSIONA,L EAP NEUhA AttENUE FI R,Y' U ANO YOUNt, <br />FAMILY. <br />