< Return Order Supplies

Client Supply RequisitionRed fields required Client ID: Street: Client Name: Town: Contact Name: Phone: Email: FORMS UNIT /  QTY Supply order forms EA Medicare Waiver forms ABN EA HIV Consent forms EA 1-ply Clinical Requision CLP-10 EA 2-ply Clinical Requision CLP-10A EA 1-ply Custom Requision CLP-10B EA 2-ply Custom Requision CLP-10C EA 1-ply Cyto/Tissue Requision CLP-19 EA 2-ply Cyto/Tissue Requision CLP-19A EA 3-ply Pathology Requisition CLP-35 EA 1-ply Medicare Requisition CLP-30 EA 2-ply Medicare Requisition CLP-30A EA 2-ply Maternal Serum Screen CLP-20 EA 2-ply Cytogenetics Requisition CLP-25 EA BLOOD COLLECTION TUBES UNIT /  QTY Tube, Red/Gray 8.5ml SST EA Tube, Red No Additive 10ml EA Tube, Red No Additive 7ml EA Tube, Blue Coagulation 4.5ml EA Tube, Lavender 4ml EA Tube, Yellow ACD Solution A EA Tube, Pedi 3.32ml SPS Yellow EA Tube, 8.3ml SPS Yellow EA Tube, HH Blood Bank 6ml Pink EA Tube, Green Top Na-Heparin 4ml EA Tube, Green Top Na-Heparin 6ml EA Tube, Green Top Na-Heparin 10ml EA Tube, Gray 2ml EA Quantiferon In-Tube Collection Kit EA GLUCOSE TOLERANCE TEST UNIT /  QTY Orange Flavor Glucola 50g EA Orange Flavor Glucola 75g EA Orange Flavor Glucola 100g EA MICROBIOLOGY SUPPLIES UNIT /  QTY Affirm BV 10/bx EA Routine Culture BBL Swab Plus (blue) EA Mini-tip Culturette (orange) EA Rapid Group A Strep Swab (red) EA GC/Chlam. Aptima Urine Collector (Yellow) EA GC/Chlam. Aptima Swab Collector (Purple) EA Viral/Chlamydia/Mycoplasma Culture (M4 Media) EA MICROBIOLOGY SUPPLIES (continued) UNIT /  QTY Blood Culture Bottle Sets(blue & yellow) SET Sterile Specimen Cups (100/bag) EA U/A Red/Yellow top tube w/Transfer Device EA Urine C&S Gray top tube w/Transfer Device EA O & P Kit for Stool (10/bx) EA FOBT-Chek Patient Mailer (20/bx) EA BLOOD COLLECTION SUPPLIES UNIT /  QTY Alcohol Pads BX Band Aids (strips) BX Band Aids (spots) BX Gauze Pads 2x2 PKG Tourniquets - Latex Free EA Needle Holders (single-use) EA Needles 21G 1-1/4" Eclipse (48/box) BX CYTOLOGY/PAP SUPPLIES UNIT /  QTY Thin Prep Vials w/ Brush & Spatula PK/25 Thin Prep Vials w/ Cervical Broom PK/25 Surepath Vials w/ Brush & Spatula PK/25 Surepath Vials w/ Cervical Broom PK/25 PATHOLOGY/BIOPSY SUPPLIES UNIT /  QTY 60ml jar w/10% Formalin EA 20ml jar w/10% Formalin EA 240ml jar w/10% Formalin EA GENERAL LABORATORY SUPPLIES UNIT /  QTY Specimen Bags (regular) 100/pk PK Specimen Bags (stat) 100/pk PK Castile Soap Towelettes (100/box) BX Printer Paper Form 7A (CLP Logo) 6pks/cs PK/500 24 Hour Urine Container EA MISCELLANEOUS ITEMS & UNITS QTY Clinical Laboratory Partners reserves the right to supply only those items that are used to collect, preserve, and transport specimens to our laboratory for testing. Quantities shipped are to be in proportion with the amount of specimens received. Security Code: Enter Security Code above: < Return