Blood Testing Order Form

Tube,Sodium Citrate 2.7mL, Light Blue (100 per rack)

Tube, K2 EDTA 4mL, Lavender (100 per rack)

Tube, SST 5mL, Gold (100 per rack)

Tube, Serum 4mL, Red (100 per rack)

Transport Tube"10 ML, 15 MM x 86 MM, Clear, Polypropylene, Serum Vial, Pre-Capped, Freestanding, Non-Sterile, with Screw Cap (100 per unit)

Transport Tube "10 ML, 16 MM x 92 MM, Transparent, Polypropylene, Self-Standing, Transport Tube with Amber Polyethylene Screw Cap (100 per unit)

Transfer Pipets 7mL, Transfer Pipet, 4mL Bulb, Graduated up to 3mL

Dark Blue Wing, Safety Blood Collection Set with 12"" Tubing 25 Gauge (Limited Supply)

Light Blue Wing, Safety Blood Collection Set with 12"" Tubing 23 Gauge (Limited Supply)

Green Wing, Safety Blood Collection Set with 12"" Tubing 21 Gauge (Limited Supply)

Needle Holder (HUB)

Safety Needle 22 Gauge (48 per Box)

Safety Needle 21 Gauge (48 per Box)

Tourniquet

Urine cups

Bag 6x9 Transport Biohazard 3 wall, zip (100 per pack)

Preprinted Laboratory Requisition forms (Pack of 25)

FedEx Shipping Pouch (Pack of 20)

FedEx Return Shipping Label (Pack of 20)

UPS Shipping Pouch (Pack of 20)

UPS Return Shipping Label (Pack of 20)

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Please do not submit any Protected Health Information (PHI).