Supply Order Form: Garcia Clinical Lab provides supplies needed for specimen collection and preparation to our clients under contract. To place an order, please complete the form below or click here to download a form that can be faxed to us at 517-787-1249. Clinical Supply Order Form Facility Name: Facility Address: Email: Order Date: Facility ID: Phone: Attention: Special Instructions: If you have moved your physical location, please indicate new address here and contact customer service. SUPPLIES ARE GENERALLY SHIPPED VIA EITHER UPS OR FEDERAL EXPRESS. PLEASE ALLOW 5 WORKING DAYS FOR DELIVERY. PLEASE INDICATE THE QUANTITY OF EACH ITEM (NOT PACKAGES OR BOXES) WHEN PLACING YOUR ORDER. Description Qty. ea BLOOD COLLECTION TUBE Green Top Sodium Heparin 10ml Light Blue Top Sodium Citrate 4.5ml Microtainer EDTA 2ml PPT (Plasma Preparation Tube) 5ml Red Top Plain 10ml Blood Culture Set Red/Gray Top SST 10ml Royal Blue Top EDTA 7ml Royal Blue Top No Additive 7ml Yellow Top ACD "A" Solution 8.5ml Lavender Top Tube - 4ml Gray Top - 5ml URINE COLLECTION CONTAINERS 24 Hr. Rigid - plastic 60ml Sterile 5ml Urine Transport, Gray Top OTHER SPECIMEN COLLECTION Culturette, Anaerobic Culturette Aerobic Gen-Probe (R) Collection, Female Gen-Probe (R) Collection, Male PAP Kits Glucola Stool for Occult Blood Cards Lactose Powder NEEDLES Needle 20Gx1 Needle 21Gx1 Needle 21Gx 1-1/2 Needle 22Gx1 23G X 3/4 Butterfly Description Qty. ea TRANSPORT MEDIA M4 Multi-Microbe Transport Medium Kit Ova & Parasite Transport (Formalin Vials) Trasylol Kit C & S Transport Trichosel Broth Blood Culture Set PACKAGING/MAILING SUPPLIES Specimen Bag Small Specimen Bag Large Specimen Transport Kit (box, foam) Small, 12 tubes Specimen Transport Kit (box, foam) Large, 40 tubes Transport Tube, Plastic FORMS AND REQUISITIONS Client Supply Order Form Report Forms, Continuous 1-part Report Forms, Laser Requisition Forms, Standard Requisition Forms, Parole Specimen Log Book Cyto/Path OTHER SUPPLIES Boric Acid Tables Single Use Needle Holder (Portex) Amber Tube 10ml - plastic Tourniquets Alcohol Prep Pads Home | Client Services | Supplies | Contact Us © Copyright 2008 Garcia Clinical Lab. All Rights Reserved.