Client Supply Order Form

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REQUISITIONS / REQUESTS for TESTING
UNIT Order CD Description
Ream (of 50) SurgPath Surgical Pathology Requisition
Ream (of 50) ClinPath Clinical Pathology Requisition
Ream (of 50) GynPath Gynecological Cytology Requisition with Molecular Co-Testing
Ream (of 50) OpthPath Opthalmic Pathology Requisition
Ream (of 50) UroPath Urologic Pathology Requisition

KIT SUBMISSION / CUSTOMIZED COLLECTION
Each Prostate_Kit Kit, Prostate Biopsy Collection, 16 jar pre-filled formalin containers
Each BM_Kit Kit, Bone Marrow Collection
Each BioFire_Kit-I Kit Assembly for Patient Collection of Stool Samples, paper dispo dish
Each BioFire_Kit-II Kit Assembly for Patient Collection of Stool Samples, plastic dispo dish
Each BioFire_Kit-RP Kit Assembly for Physician Collection of Respiratory Samples, swab + transport

BLOOD COLLECTION
Each 141912 Vacutainer, 3mL Plain Serum (Red Top)
Each 53712 Vacutainer, 10mL Plain Serum (Red Top)
Each 61764 Vacutainer, 3mL EDTA (Lavender Top)
Each 141997 Vacutainer, 4mL EDTA (Lavender Top)
Each 141874 Vacutainer, 4mL Sodium Heparin (Green Top)
Each 180824 Vacutainer, 10mL Sodium Heparin (Green Top)

SURGICAL PATHOLOGY
Each GR2030-20 Prefilled Formalin Containers, 20mL, 10% Neutral Buffered Formalin
Each GR2040-30 Prefilled Formalin Containers, 30mL, 10% Neutral Buffered Formalin
Each GR2030-40 Prefilled Formalin Containers, 40mL, 10% Neutral Buffered Formalin
Each GR2030-60 Prefilled Formalin Containers, 60mL, 10% Neutral Buffered Formalin
Each GR2030-120 Prefilled Formalin Containers, 120mL, 10% Neutral Buffered Formalin
Each GR2040-250 Prefilled Formalin Containers, 250mL, 10% Neutral Buffered Formalin
Each GR2040-500 Prefilled Formalin Containers, 500mL, 10% Neutral Buffered Formalin
Each GR2040-1000 Prefilled Formalin Containers, 1000mL, 10% Neutral Buffered Formalin
Each GR2040-1GL Prefilled Formalin Containers, 1.0 GAL, 10% Neutral Buffered Formalin
Each GR2040-1.25GL Prefilled Formalin Containers, 1.25 GAL, 10% Neutral Buffered Formalin
2.5GAL RS4060-A 10%  Neutral Buffered Formalin, 2.5 GAL cube/carboy
5.0GAL RS4061 10%  Neutral Buffered Formalin, 5.0 GAL cube/carboy
Each RPMI R.P.M.I. (transport medium for tissue/cell culture)
Each 45435 Zeus Fixative (Michel’s)
Each BOUIN Bouin’s Fixative, pre-filled, 20mL jar
Each Urine-Cyt Urine Collection Cup for NG Cytology, CytoLyte Solution, box of 50 cups
Each TP Vial ThinPrep Vials, tray of 25 each
Each Brush Cervical / Vaginal Collection Device, Brush/Spatula type, bag of 25 each
Each Broom Cervical / Vaginal Collection Device, Broom type, bag of 25 each
Each Unisex Swab Aptima™ Swab Collection Kit, Female Endocervical/Male Urethral, bag of 10 tubes
Each Urine-Mol  Aptima™ Urine Collection Kit, bag of 10 tubes
Each Vag Swab Aptima™ Vaginal Swab Collection Kit, bag of 10 tubes

MICROBIOLOGY/VIROLOGY
Each 34515 Swab, Calcium Algimate, Calsiswab
Each 141850 Swab, Amies, Mini Tip, Green Cap
Each 60104 Swab, Dual Amies Gel
Each 141902 Swab, Amies Gel, Anaerobic
Each 132858 Swab, Culture, Stuarts, Aerobic
Each 180822 Swab, Dacron
Each 161558 E-swab, Minitip, Blue Cap
Each 141974 Urine, Culture & Sensitivity, w/ straw
Each 137135 Sterile Urine Cup, 90mL

PACKAGING / TRANSPORT
Each GR2046-A Biohazard Specimen Bag, 6” X 9”
Each GR2046-D Biohazard Specimen Bag, 8” X 10”
Each GR2046-C Biohazard Specimen Bag, 12” X 15”
Each GR2046-B Biohazard Specimen Bag, 15” X 17”
Each EM0172-A Pad Sponge, Blue, for Tissue Cassette
Each GR2078-32 Container, 32oz., Pathology seal, dry without fixative
Each GR2078-64 Container, 64oz., Pathology seal, dry without fixative