Order Supplies

    Account Name*

    First Name*

    Last Name*

    Phone*

    Email

    Account Number

    Date Requested

    Comments

    Shipper Kits (order collection media separately)

    AP Small Shipper Kit - 1 container (15/Case)

    AP Medium Shipper Kit - 1 container (10/Case)

    AP Large Shipper Kit - 2 containers

    Collection Kits (collection media included)

    8 Bottle Prostate Kits (30/Case)

    12 Bottle Prostate Kits w/Cassettes

    14 Bottle Prostate Kits (20/Case)

    Urovysion Kits (16/Case)

    24 hr Urine Kits

    Kidney Stone Kits

    FNA Kits (30/Case)

    BRCA KITS

    PCA3 KITS

    Bone Marrow Kits

    Hematopathology (Outpatient) (20/Case)

    Hematopathology Peripheral Blood Kit (16/Case)

    TTM

    Tissue Transport Media (TTM)

    Blood Tubes

    Blue Top

    Green Top (NA Heparin)

    Purple Top (EDTA)

    Cultures

    Blue Top Culture Tube

    Yellow Top Culture Tube Oral/Nasal

    Collection Media/Tubes

    172oz Plastic Container (10/Case)

    86oz Plastic Container (25/Case)

    32oz Plastic Container (100/Case)

    16oz Plastic Container (100/Case)

    Cytolyt Solution (20/Flat) (4 Flats/Case)

    FNA 95% Alcohol (fits 4 slides)

    Michels Fixative for Immunos

    CLO-Test

    Cytology Supplies

    Conventional Pap Packs (25/Box)

    ThinPrep Supplies

    ThinPrep Flats (25/Flat) (10 Flats/Case)

    ThinPrep Brushes/Spatula (25/Bag)

    ThinPrep Brooms (25/Bag)

    Surepath Supplies

    Surepath Vials (25/Flat) (10 Flats/Case)

    Surepath Brushes/Spatula (25/Bag)

    Surepath Brooms (25/Bag)

    Surepath Cervex Brush-Combi (25/Bag)

    Swabs & Brushes

    Digene Cervical Sampler (HPV Swab)

    APTIMA SWAB (WHITE) UNISEX (50/Case)

    APTIMA SWAB (Orange) (50/Case)

    APTIMA SWAB (YELLOW) URINE (50/Case)

    Surgipath C-E Brush (Snap-Off) (100/Bag)

    Histology Supplies

    1 Gallon Formalin - (4/Case)

    5 Gallon Formalin Cube

    120ml Formalin (24/Box) (2 Box/Case)

    90ml Formalin (12/Box) (4 Box/Case)

    60ml Formalin (27/Box) (2 Box/Case)

    40ml Formalin (12/Box) (2 Box Case)

    20ml Formalin (32/Box) (4 Box/Case)

    Client Supplies

    Plastic Bags----------------Small (100/Pack)

    Plastic Bags-------------Medium (100/Pack)

    Plastic Bags------------------Large (50/Pack)

    Plastic Bags------------------XLarge (50/Pack)

    Lock Box Floor - Small

    Lock Box Floor - Large

    Lock Box Door - Small

    Lock Box Door - Large

    Adv. Beneficiary Notice ABN

    Report Paper

    Printer Toner

    Supply Request Pad

    Requisition Forms

    Pathology Req------------------AMP-437

    OB/GYN Req--------------------AMP-001

    Non-GYN Cytology Req-----AMP-505

    Non-GYN Cyto w/Labels

    Oral Pathology Req-----------AMP-455

    Analysis Req--------------------AMP-413

    Hematology Req---------------CAD-407

    Hematology Req w/Labels

    Solid Tumor Analysis Req--CAD-409

    GI Pathology Req--------------AMP-430

    GI Pathology Req w/Labels-AMP-472

    GI Surgical Pathology Req--AMP-474

    GI Surg Path Req w/Labels-AMP-473

    GI Form F------------------------AMP-431

    Urology Pathology Req-----AMP-475

    Urology Path Req w/Labels-AMP-471

    Kidney Stone Req-------------AMP-477

    Kidney Stone Req w/Labels

    Breast Req----------------------AMP-438

    Breast Req (Special)---------AMP-439

    BRCA Req---------------QD20760-AMP

    Watson Req---------------QD20372-AP

    GS Custom Req---------------AMP-429

    AP Dermatology Req---------AMP-476

    GI NTSC Req-------------------AMP-482

    FedEx Supplies

    Air Bills - President

    Diagnostic Specimen Bags

    Miscellaneous Lab Supplies

    Urine Cups (Sterile)

    Urine Cups (non-Sterile)

    One End Frosted Slides

    Slide Spray Fixative

    Plastic Slide Holder (25/pack)

    Cardboard 2 Slide Holder

    Labels for Specimen Bottles

    Ice Packs