Client Supplies Requisition
Client Number
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Client Name
Ordered By
Other Supplies/Notes
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Clear Form
Specimen Transport Material
Plastic Specimen Bags(Small) (Packs of 100)
100 Bags
200 Bags
300 Bags
400 Bags
500 Bags
Plastic Specimen Bags(Large) (Each)
10 Bags
20 Bags
30 Bags
40 Bags
50 Bags
Clear Transfer Tubes (Each)
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Transfer Pipettes (Each)
25 Pipettes
50 Pipettes
75 Pipettes
100 Pipettes
Urine/Stool Collection
Sterile Containers (Stool/Urine) (90 ml.) (Each)
10 Containers
20 Containers
30 Containers
40 Containers
50 Containers
24 Hour Urine Containers (Each)
1
2
3
4
5
6
7
8
9
10
Cups for Urine Collection (Packs of 100)
100 Cups
200 Cups
300 Cups
400 Cups
500 Cups
Wipes for Sterile Collection
1 Box (50 wipes)
2 Boxes (50 wipes)
3 Boxes (50 wipes)
Ova and Parasite Kits (Yellow)
5 Bottles
10 Bottles
15 Bottles
Stool Culture/Enteric Pathogens (Orange)
5 Bottles
10 Bottles
15 Bottles
Hemocult Stool Cards (3X)
5 Sets of 3
10 Sets of 3
15 Sets of 3
NEW!! OC LIGHT Occult Blood
10 Containers
20 Containers
30 Containers
OC Light is the same test as the old 3x hemocult stool cards except that the container is closed cap system, the patient only needs to collect the stool specimen once and does not need to have any dietary restrictions. We have a 24 hour turn around on this test.
Requisitions, Forms, Billing Policy
General Test Requisition
50 Forms
100 Forms
150 Forms
200 Forms
Custom Test Requisition
50 Forms
100 Forms
150 Forms
200 Forms
Reorder Number
Client Supplies Requisition
Yes
Patient Information Forms
Yes
Test Directory
Yes
Billing Policy Pad
1 Pad
2 Pads
3 Pads
4 Pads
5 Pads
Blood Collection Needles
Straight Needle 21G (Box/50)
50 Needles
100 Needles
150 Needles
200 Needles
Straight Needle 22G (Box/50)
50 Needles
100 Needles
150 Needles
200 Needles
Butterfly Needle 21G (Box/50)
50 Needles
100 Needles
150 Needles
200 Needles
Butterfly Needle 23G (Box/50)
50 Needles
100 Needles
150 Needles
200 Needles
Butterfly Needle 25G (Box/50)
50 Needles
100 Needles
150 Needles
200 Needles
Clear Needle Holders (OSHA single use-only)
10 Holders
20 Holders
30 Holders
40 Holders
50 Holders
Blood Collection Tubes
Corvac (SST) 9.5ml
100 Tubes
200 Tubes
300 Tubes
Lavander (EDTA) 5 ml
100 Tubes
200 Tubes
300 Tubes
Light Blue 4.5 ml
100 Tubes
200 Tubes
300 Tubes
Red (Plain) 9.5 ml
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Gray 7 ml
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Green (Heparin) 10 ml
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Royal Blue 7ml (Plain)
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Royal Blue 7ml (EDTA)
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Yellow (ACD) 8.5 ml
25 Tubes
50 Tubes
75 Tubes
100 Tubes
Black SST for NMR/LpPLA2
10 Tubes
20 Tubes
30 Tubes
40 Tubes
More: Call
Swabs
Throat, Wound, Routine
10 Swabs
20 Swabs
30 Swabs
GC/CT (Gen-Probe)
10 Swabs
20 Swabs
30 Swabs
MDL- Naso Swab (PCR)
10 Swabs
20 Swabs
30 Swabs
MDL- One Swab (PCR)
10 Swabs
20 Swabs
30 Swabs
MDL- Uro Swab (PCR)
10 Swabs
20 Swabs
30 Swabs
Blood Collection (Alcohol Pads, Band Aids, Gauze, Tourniquet)
Alcohol Prep Pads
1 Box (100/Box)
2 Box (100/Box)
3 Box (100/Box)
4 Box (100/Box)
5 Box (100/Box)
Band Aids
1 Box (100/Box)
2 Box (100/Box)
3 Box (100/Box)
4 Box (100/Box)
5 Box (100/Box)
Gauze 2x2
1 Package
2 Packages
3 Packages
4 Packages
5 Packages
Tourniquet
5
10
15
Computer Supplies
Paper
1 Ream
2 Reams
3 Reams
Labels
1 Reel
2 Reels
3 Reels
Ink Cartridges
Black
Magenta
Cyan
Yellow
Printer Name
Miscellaneous Supplies
Thin Prep Bottles w/ swab
5 Bottles
10 Bottles
20 Bottles
30 Bottles
Biopsy Bottles (Formalin)
5 Bottles
10 Bottles
20 Bottles
30 Bottles
Blood Culture Bottle Sets
1 Set (An/Aer)
2 Set (An/Aer)
3 Set (An/Aer)
4 Set (An/Aer)
5 Set (An/Aer)
Glucola Bottles (100g)
1 Bottle Dextrose
2 Bottle Dextrose
3 Bottle Dextrose
4 Bottle Dextrose
5 Bottle Dextrose
Should be Empty: