SJRHC Laboratory Outreach - Supply Order Form  (979)776-5981
CLIENT NAME:    DATE:
ORDERED BY: PHONE #:
 
Requested Item Unit Stock # Delivered
  Alcohol Prep Packets #6818 BX 000748  
  Blood Culture Bact/Alert Pedi Bottles #51005 EA 005127  
  Blood Culture Anaerobic #51008 EA 001257  
  Blood Culture ChloraPrep Kit Applicators EA 009763  
  Blood Culture Collection Device EA 022615  
  Container, Spec Sterile #2300SA EA 011314  
  Culture Swab Coll& Trans (Red) #4320109 EA 001260  
  Culture Swab, Minitip (Green) #220133 EA 014685  
  Cytology Spray, Fixative Spray Cyte EA 005360  
  Container, Formalin 30mL SM #C4320-30B EA 011498  
  Container, Formalin 7.5mL XSM #C4320-7.5B EA 011532  
  M4-RT GC/Chlam PCR Media -Female EA 022099  
  M4-RT GC/Chlam PCR Media-Male EA 022080  
  GenProbe - Female EA REF016  
  GenProbe - Male EA REF015  
  Label, Yellow Edge Thermal-Small ROLL 016163  
  Butterfly set 21 gauge PK (50) 009851  
  Butterfly set 23 gauge #367297 PK (50) 009850  
  Butterfly set 25 gauge #367298 PK (50) 009852  
  Needle, Vacutainer 21Gx1 #368607 PK (48) 001281  
  Needle, Vacutainer 22Gx1 #368608 PK (48) 001282  
  Vacutainer, Adapter Blue Multi #367290 PK (100) 013752  
  Vacutainer Safety Needle Holder PK (250) 010108  
  Requisition Forms - Clinical EA 017451  
  Requisition Forms - Tissue EA 017450  
  Tourniquet #LXS-3206 EA 000923  
  Bag, Biohazard 6x9 #B1209-12 PK (50) 011521  
  Transport Tubes and Tops EA REF005  
  Vacutainer, Green 4 mL Lith Hep #367884 PK (100) 007489  
  Vacutainer, Lavender 4 mL #367861 PK (100) 017237  
  Vacutainer, Blue 2.7 mL PK (100) 010906  
  Vacutainer, Pink 6 mL #367899 PK (100) 018152  
  Vacutainer, Red 4 mL  #367812 PK (100) 009029  
  Vacutainer, Royal Blue (EDTA) EA REF007  
  Vacutainer, Royal Blue No Additive EA REF008  
  Vacutainer, SST 3.5mL #367983 (Gold) PK (100) 021974  
  Vacutainer, SST 8.5mL #367988 (Tiger) PK (100) 001290  
  Vacutainer, Yellow (ACD A Soln) 8.5mL EA REF009  
  Urine, 24 HR Collection Container #U30101 EA 000940  
  Urine, Cult Coll/Trans Kit (Vac)  #364987 EA 001097  
  Urine, Cult Midstream Kit  #364949 EA 014843  
  Hemoccult SensaSlide(3 slide) #64130 EA 006194  
  Para Pak Stool, C&S Vials EA 012666  
  Ova & Parasite Transport (Formalin Vials) EA REF003  
  Virology Collection Containers EA REF013  
  Pap-Pak, Cytology  #C-100 PK (25) 012669  
  ThinPrep Collection Vials EA REF026  
  ThinPrep brush/spatula PK (25) 024341  
  ThinPrep broom PK (25) 024570  
  Cytolyt Collection Vials (non-gyn) EA 024590  
  SJRHC Laboratory Outreach Brochure EA REFBROC  
         
         
PLEASE RETURN ALL EXPIRED SUPPLIES TO OUTREACH