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Client Supply Order Form
Cytolab Add-On Form
PPL Add-On Form
Quad Screen Patient Info

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BLOOD COLLECTION TUBES MICROBIOLOGY
Bx. Red Top Tube - 10 ml only Set Blood Culture Set 70ml w/ prep & hub
Bx. Lavender Top (EDTA) Tube - 4ml only Set Blood Culture Set 20ml w/ prep & hub
Bx. Serum Sep Tube (SST) Ea. Orange Cap BBL Culturette (Amies w/Char)
Bx. Lt Blue Top Tube (Na Citrate) - 2.7 ml only Ea. White Cap BBL Culturette (Liq Am Sngl App)
Bx. Gray Top Tube (Flouride) 4 ml only Ea. Red Cap BBL Culturette (Liq Stuart Dbl App)
Bx. Yellow top tube (ACD-A) - 8.5 ml only Ea. Black Cap BBL Culturette (Amies w/Char)
Bx. Pink Top Tube (EDTA) - 6ml only Ea. CT/NG Male Swabs w/ no media (blue label)
Bx. Pearl Top Tube (PPT, EDTA w/gel) - 5 ml Ea. DP CT/NG HSV 1&2 or Group B Strep by PCR
Bx. Green Top Tube (Na Hep) Ea. BD Affirm Kits
Bx. Green Top Tube (Li Heparin) Limited Quantity Items
Bx. Light Green Top PST (Li Heparin w/gel) 3 ml Ea. M4 Kits (viral type cultures w/ Poly Swab)
Dark Blue Top Tubes (specify below) Ea. Pertussis Culture
Bx.  w/ Tr Elem K EDTA 6 ml (ex:heavy mtls) TRANSPORT SUPPLIES
Bx.  no additive 7 ml (ex: alum, arsenic, zinc) Pk. Specimen Bag (100/Pk) Routine
Microtainer Tubes (specify below) Ea. Large Plastic Bag (20x20)
Ea. Ea. Paper Bag w/ Handles
SPECIMEN COLLECTION Bag Plastic Pour-Off Tubes w/Blue Screw Caps
Eclipse Vacutainer Bag Amber Plastic Pour-Off Tubes w/White Caps
Bx. MISCELLANEOUS
Bag Vacutainer Holder (w/o safety device) Glucola (Specify Below)
Bx. "Pronto" Quick Release Colored Holders Bx. Orange
Bx. Butterfly Needles Ea. Lemon-Lime
Bx. Syringe Ea. Fruit Punch
Bx. Transfer Device Other
Urine Collection Ea. Lancets
Bag Urine Collection Cups CYTOLOGY SUPPLIES
Ea. 24hr Urine Jugs Pk. SurePath Liquid Vials w/ brooms (25)
Bx. Urine C&S Transfer Kits (Gray Top) Pk. SurePath Liquid Vials only (25)
Bx. Urinalysis Transfer Kits (Yellow/Red Speckled) Pk. SurePath Brooms only (25)
Ea. Urine Hat Collection Device Pk. Scored Cervical Brushes (25)
Stool Collection Pk. Scored Brush w/ Scored Spatula (25)
Ea. Ova & Parasite (OVP) Kits (Protofix CLR) Ea. Cervic Combi Brush
Ea. Red Cap ETM Stool Culture Media Ea. Plastic Spatulas only (25)
Ea. Stool Collection Cont for commode (white) Bx. Conventional Pap Pak with brush/slide (25)
Ea. Pinworm Collectors Ea. Purple Top Slide Holder w/ Alcohol
Ea. ColoScreen Occult Blood Kits Ea. Purple Top Slide Holder w/o Alcohol
Ea. FBOT Kit Bx. Urine Cyto/FNA Fix (Saccomanno)(24)
PATHOLOGY SUPPLIES REQUISITIONS / REPORTING / FORMS
Bx. Biopsy bottles - 10% formalin - 1 oz(32) Ea. Clinical/Pathology/Cytology Requisition
Bx. Biopsy bottles - 10% formalin - 2 oz(32) Bx. PPL Report Paper - Plain (500 sheets)
Ea. Biopsy container (empty) 2oz Bx. PPL Report Paper - Beaker (500 sheets)
Ea. Biopsy container (empty) 16oz Bx. PPL Report Paper - Teal Bar (500 sheets)
Ea. Biopsy container (empty) 32oz Pd. Add-On Forms (50/pad)
Ea. Biopsy container (empty) 64oz Pk. Green Special Handling Forms (25/pk)
REQUISITIONS / REPORTING / FORMS (cont'd)
Pd Supply Request Form (25/pad) Ea. ABN forms for Medicare
Ea. Draw Site Maps - 6 Combined Ea. Draw Site Maps - Wallingford
Ea. Draw Site Maps - Downtown Ea. Draw Site Maps - Issaquah
Ea. Draw Site Maps - Bellevue Ea. Draw Site Maps - Lynnwood
Ea. Draw Site Maps - Renton Ea. Printer Ribbon (Okidata 320)
Ea. Toner Cartridge-Printer Model
  
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