Pathology Center Electronic Supply Order Form



  Client Name:
  Contact Person:
  Phone Number:
  Email Address:
  Biohazard Bags
  6x9 (100/roll) Qty Rush
  8x10 (100/roll) Qty Rush
  STAT Bags (100/roll) Qty Rush
  Absorbent Pads Qty Rush
  Blood Collection Supplies Tubes (50/box unless indicated)
  Red Top 6 mL (100) Qty Rush
  Red SST Qty Rush
  Purple (EDTA) Qty Rush
  Blue (Na Citrate) Qty Rush
  Pink (Blood Bank) Qty Rush
  Royal Blue EDTA (EA) Qty Rush
  Royal Blue Serum (pack) Qty Rush
  Royal Blue Serum (EA) Qty Rush
  QuantiFERON - TB Gold (pack) Qty Rush
  QuantiFERON - TB Gold (EA) Qty Rush
  FDP Tubes (EA) Qty Rush
  Blood Collection Supplies Needles (Box of 100)
  21Gx1" Qty Rush
  22Gx1" Qty Rush
  Blood Collection Supplies
  Aliquot Tubes/Caps Qty Rush
  Arup Transfer Tubes Qty Rush
  Sims Protex Needle Pro (order by bags of 25) Qty Rush
  Culture Media & Kits
  Culturette II Qty Rush
  M5 Viral Transport Media Qty Rush
  CTNG Cobas PCR (GC/Chlamydia)
      Female Swab Qty Rush
      Urine Qty Rush
  Trich PCR (Trichomonas vaginalis)
      Trich PCR swabs Qty Rush
      Urine Qty Rush
  Enteric Plus Vials (20/pk) Qty Rush
  Enteric Plus Vials (EA) Qty Rush
  O & P Kit (10/pack) Qty Rush
  O & P Kit (EA) Qty Rush
  Swube Tube (EA) Qty Rush
  Remel A.C.T. 1 Media (EA) Qty Rush
  Blood Culture
  Aerobic/Anaerobic set Qty Rush
  Anaerobic Pouch System Qty Rush
  Chloroprep Qty Rush
  Agar/Media (Order in packages of 10)
  Blood Agar (pack) Qty Rush
  Blood Agar (EA) Qty Rush
  MacConkey Agar (pack) Qty Rush
  MacConkey Agar (EA) Qty Rush
  Chocolate Agar (pack) Qty Rush
  Chocolate Agar (EA) Qty Rush
  Thioglycollate (EA) Qty Rush
  Thayer Martin Plates (EA) Qty Rush
  Loops, 10 uL Blue (pack) Qty Rush
  Cytology/Histology
    Conventional Paps
  Slides Qty Rush
  Fixative Spray (per bottle) Qty Rush
  Liquid cytology containers (25/bx) Qty Rush
  Liquid cytology containers with brooms (25/bx) Qty Rush
  Liquid cytology containers with brushes/spatulas (25/bx) Qty Rush
  Formalin Jars
  20/10 mL Fill Box (24) Qty Rush
  40/20 mL Fill Box (24) Qty Rush
  120/60 mL Fill (EA) Qty Rush
  480/240 mL Fill (EA) Qty Rush
  960 mL (EA) Qty Rush
  White Tissue Containers (no Formalin) 172 oz. Qty Rush
  White Tissue Containters (no Formalin) 86 oz. Qty Rush
  Mailing/Courier Supplies
  Postal Mailers (SafeTPak) Qty Rush
  Slide Mailer 2 Slide, Cardboard (stack of 10) Qty Rush
  Slide Mailer 5 Slide, Plastic (bag/25) Qty Rush
  Miscellaneous
  ClikSeal Blue top containers sterile specimen cups Qty Rush
  ClikSeal Blue top containers clean catch urine Kits Qty Rush
  24hour Urine Container Qty Rush
  Fetal fibronecticn kits (Ea) Qty Rush
  Other Supplies