Clinical Laboratories
Order Form

Community Physician Office Supply Order Form

Community office personnel: Please complete the following form to request supplies.

Thank you.

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Contact Information
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Item:
How Supplied:
Quantity Requested:
Microbiology
SABHI with CC for dermatology culture
PK (10) Plates
MTM for Neisseria gonorrhea culture
PK (10) Plates
Aerobic Culture Swabs (Red Label)
PK (50) Swabs
Anaerobic Culture - eswab transport system
Each
Blue Top Swabs
Box (100) Swabs
Para-Pak for Stool Culture (orange cap)
Box (20) Vials
Para-Pak for Ova and Parasites (pink & blue caps)
Box (20) Vials
Blood Culture Bottle Aerobic Yellow Cap
Each
Blood Culture Bottle Anaerobic Purple Cap
Each
Aptima Swab (orange), for Female Vaginal specimens
Each
Aptima Swab (purple), Male or Female Cervical specimens
Each
COVID-19 Test Kits
50 Test Kits/package
Green top culture collection swab
50/pk
UTM Transport Media
Each
 
 
Urine
Sterile Urine Cups
Each or Case of 300
Urine collection cup w/transfer device
Each
Urine U-Bag Collectors
Each
Grey Tube for Urine Culture
Each
Red/Yellow Tube for Urinalysis
Each
 
 
Phlebotomy
Lead Specimen Card
Pack (100) Cards
Vacutainer Adapters
Bag (250) Adapters
Tourniquets
Box (25) Tourniquets
MicroTainer Extender
PK (50) Extenders
Heel Warmers
Box (25) Warmers
 
 
Blood Collection Needles
Vacutainer Blood Collection: Butterfly 21G
20/Pkg
Vacutainer Blood Collection: Butterfly 23G
20/Pkg
Vacutainer Blood Collection: Butterfly 25G
20/Pkg
 
 
Chemistry and Hematology
MicroTainer Lancets Newborn 1.8mm
Box (200) Lancets
MicroTainer Lancets Pediatric 2.0mm
Box (200) Lancets
MicroTainer Lavender
Bag (50) Tubes
MicroTainer Red
Bag (50) Tubes
MicroTainer Green
Bag (50) Tubes
MicroTainer Yellow
Bag (50) Tubes
Vacutainer: Lavender
Tray (100) Tubes
Vacutainer: Gold
Tray (100) Tubes
Vacutainer: Lime Green
Tray (100) Tubes
Vacutainer: Green
Tray (100) Tubes
Vacutainer: Red
Tray (100) Tubes
Vacutainer: Tan
Tray (100) Tubes
 
 
Specimen Transport and Order Forms
Specimen Bags
PK (100) Bags
Specimen Bags (STAT)
PK (100) Bags
Ancillary Order Forms
Pad (50 Forms)
Ancillary Order Forms - Allergen
Pad (50 Forms)