Order Supply

SUPPLY ORDER FORM

ALLOW UPTO 48 HOURS ( 2 BUSINESS DAYS) FOR DELIVERY BY COURIER

    • Full Name (Enter client's name)
    • Client ID
    • E-mail Address
    • Phone Number
    • Address
    • Facility City
    • State
    • Zip
    • Ordered By
    • Date
    • PHLEBOTOMY

      SST (25/bag)


      Plain Red 8.5 mL (10/bag)


      Lavender 4.0 mL(25/bag)


      Light Blue 4.5 mL (10/bag)


      NMR LIPO Tubes (Black) (10/bag)


      Royal Blue EDTA (10/bag)


      Royal Blue Serum (10/bag)


      Yellow ACD 8.5 mL (10/bag)


      Green Sodium Heparin 10 mL (10/bag)


      Green Lithium Heparin 10 mL (10/bag)


      21G Safety Butterfly (Green) Needles (10/bag)


      23g Safety Butterfly (Light Blue) Needles (10/bag)


      GreyTop Sodium Fluoride Potassium Oxalate 10mg/8mg (10/bag)

    • REQUISITIONS

      Blood Requisition Form(50/pack)


      Toxicology Requisition Form(50/pack)


      RPP Requisiton Form(50/pack)

    • SPECIMEN BAGS

      Transport Bag 6x9 w/Pad(100/bag)


      Transport Bag 12x15 500/c (100/bag)

    • MISCELLANEOUS

      Blue Bags (Rolls)


      Copy Paper(pack)


      Toner For Brother Printer


      Breath Test Kit


      Specimen Log Book


      Cash Log Book


      Reciept Book


      Frozen Transfer Kit


      Sharps Container


      2x2 Gauze Pads


      Alchohol Prep Pads (Box)


      Band-Aids (Latex Free)(Box)


      Needle Holder Plastic(5/bag)


      Stool Culture Kits(10/bag)


      Ova & Parasite Stool Kit


      Blood Culture Tubes(10/bag)


      Nasopharyngeal Swab(50/bag)"

    • URINE COLLECTION

      Urine Analysis Tube 8.5 m (10/bag)


      24 Hour Urine Containers (10/bag)


      Urine Cups( Non-sterile plastic w/ho lid) (100/bag)


      Urine Transfer Straw Kit (10/bag)


      Urine Culture Tubes (10/bag)


    • TOXICOLOGY

      Urine Drug Screen Cups(10/bag)


      Oral Fluid Collection Swab(25/box)

    • GLOVES(For Clarity Employees Only)

      Small


      Medium


      Large

    • Comments