Order Supply

SUPPLY ORDER FORM

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

  • Full Name (Enter client's name)
  • Phone Number
  • Client ID
  • Address
  • 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