Supplies

Order Supplies


Account Information:


Account Name:

Client Code:

Address:

Ordered by:

Date:



Product Information:


Collection Supplies

Amt per Unit

Qty

Alcohol Prep Pad 200/Box
Aerobic Culture Swab 50/Bag
Band Aids 100/Box
Biohazard Sharps Containers - Small
Biohazard Sharps Containers - Large
Biopsy Bottle - 20 mL 32/Box
Biopsy Bottle - 90 mL 24/Box
Coflex Individual Rolls
Commodes/Stool Hats Individual
Cotton Balls Large Bag
Genprobe Collection Kit Individual
Glucola 50 G 6/Pack
Glucola 75 G 6/Pack
Glucola 100 G 6/Pack
Gauze - 2x2 100/Pack
Gauze - 4x4 100/Pack
Gloves - Small 100 Pairs/Box
Gloves - Medium 100 Pairs/Box
Gloves - Large 100 Pairs/Box
Gloves - Extra Large 100 Pairs/Box
Hemocult Cards Individual
OB Towelettes 100/Box
Paper Tape Individual
Ova & Parasite Kits Individual
Specimen Bags - Small 100/Pack
Specimen Bags - Large Individual
Thin Prep Pap Kit 25/Tray
Thin Prep - Brushes & Brooms 25/Pack
Tourniquets Individual
Urine Cups - Sterile 100/Bag
Urine Cups - Non Sterile 100/Bag
Urine C&S Transport Individual
Urine 24 Hour Individual

Tubes

Amt per Unit

Qty

SST - Tiger Top 100/Pack
SST - Gold Top 100/Pack
Lavender Top 100/Pack
Light Blue Top 100/Pack
Grey Top 100/Pack
Light Green Top (Sod Hep) Individual
Dark Blue Top (EDTA) Individual
Dark Blue Top (No Add) Individual
ACD Solution A Individual
ACD Solution B Individual
Blood Culture SPS Individual
Plain Red Top Individual

Needles/Holders

Amt per Unit

Qty

21x1¼ Needle w/ Pre-Attached Holder 100/Box
23g Safety Lock Butterfly 50/Box
21g Safety Lock Butterfly 50/Box
Needle Holders 50/Box

Forms/Requisitions

Amt per Unit

Qty

Lab Blood Reqs Individual
Cyto/Path Reqs Individual
Toxicology Reqs Individual
Chain of Custody Reqs Individual
4Medica Paper 250/Pack
Yellow Result Paper 500/Pack
Supply Forms Individual

Shipping Supplies

Amt per Unit

Qty

Fedex Shipping Label Individual
Fedex Clinical Pak Individual
Printer Cartridge Model # or Printer Model:
Special Orders/Misc


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