Supply Ordering

Order specimen labels, collection tubes, shipping materials, and other supplies

Facility Information

Facility Name *

Requesting Physician *

Department

Email Address *

Phone Number *

Delivery Address *

City *

Postal Code

Preferred Delivery Date

Standard specimen identification labels

Plain / Clot Activator tubes

Serum Separator Tubes

EDTA tubes for CBC

Sodium Citrate for coagulation

Heparin tubes

Sodium Fluoride for glucose

Specimen shipping boxes

Temperature control packs

Protective packaging materials

Biohazard specimen transport bags

Printed referral/request forms

Special Instructions or Notes