Order Form - Summit Pathology

Order Page

CONTACT INFORMATION
Contact Person*
First Last
Office*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
SURGICAL PATHOLOGY SUPPLIES
Surgical Pathology Requisitions - 250/Bundle
20ml Tissue Vials (Formalin) - 24/Box
60ml Tissue Vials (Formalin) - 24/Box
90ml Tissue Vials (Formalin) - 24/Box
120ml Tissue Vials (Formalin) - 24/Box
1/2 Gallon Tissue Containers - Each
Prostate Biopsy Kits - Per Box
Urine Cups - Each
Slide Holders - Each
Bone Marrow Kits - Each
CYTO / MOLECULAR SUPPLIES
Pap/Biopsy Requisitions -250/Packgage
ThinPrep Bottles - 25/Flat
Cytobrushes & Plastic Spatulas - 25 Each/Bag
Cervical Papettes (brooms) - 25/Bag
Aptima Gen Probe Swabs (purple) - 50/Box
Aptima Gen Probe Swabs (orange) - 50/Box
Aptima Gen Probe Urine Kits (yellow) - 50/Box
BD Affirm VPIII Pathogen Swab kit - 10/Box
Conventional Slide Pap Kit - Each
BD Universal Viral Transport (Herpes Only) Kit - Each
NON-GYN SUPPLIES
30ml Cytolyt Solution Cups - 50 per Box
30ml Cytolyt Solution Centrifuge Tubes - 20 per Yellow Tray
32 oz. Bottle Cytolyt Solution - Each
50% Alcohol Cups - 50 per Box
Thyroid FNA Kits - Each
GENERAL SUPPLIES
Specimen Biohazard Bags (small 6x9) - 100/Bundle
Specimen Biohazard Bags (large 12x16) - Each
Supply Request Forms - 10/Bundle
Specimen Tracking Forms - 250/Bundle
ADDITIONAL REQUEST
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