subject_line
SUPPLY REQUEST
BLOOD - COLLECTION SUPPLIES
"Tiger Top" Red-Grey Mottled Top - (SST) - 50 units
Lavender / Purple Top Tubes - 50 units
Needles (Butterfly) 23G x 7.5 in - 50 per units
Needles - Safety Needles 22G x 1in - 50 per unit
Needle Holder - 50 units
URINE - COLLECTION SUPPLIES
Urine Collection Cup - 50 per unit
Urine Vacuum Tubes - 50 per unit
CHLAMYDIA - COLLECTION SUPPLIES
Chlamydia Sterile Swab Kits - 50 per unit
ORAL SWABS - COLLECTION SUPPLIES
PGX Kits buccal swabs - 50 per unit
CGX Kits buccal swabs - 50 per unit
OTHER SUPPLIES
Red Sharps BIO-HAZARD Container
Bandages, Adhesive 3" x .75"
Specimen Bags
Tourniquets
Specimen Shipping Boxes
Shipping Return Labels
Cold Packs
Specimen Centrifuges
Site Location Name:
*
First Name
*
Last Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
Powered by
Report abuse