Supply Order Form

Please allow 3 to 5 days turnaround on all supply requests. Thank you.

By regulation, the supplies we are sending are only to be used in the collection and submission of samples to Peterson Laboratory Services, P.A. for testing. Please assist us with compliance. Thank you.
Please enter the quantity of the item requested in the box. i.e. 1 pkg, 4 ea, 2 flats, etc.

YOUR INFORMATION

* indicates required field

  Your Name
  Client # (located on requisition) * 
  Company Name (please no abbreviations) * 
  City * 
  Phone Number
  Your Email Address * 

TRANSPORTATION SUPPLIES:


  UPS Shipping Labels
  Specimen Transport Bags (100/package)
  Shipping Boxes (25/package)

Requisitions / Test Request Forms (each; specify total #):


  PAP / Cytology (yellow)
  Non-Gyn Cytology (green)
  Surgical Pathology (pink)
  ABN Forms
  Dr. Borel’s Dermatopathology Requisitions Forms

CYTOLOGY SUPPLIES:


  5-Slide Holder, Plastic (each)
  2-Slide Holder, Plastic (each)
  Glass Slides, (Cytology) 72/box
  Cytology Spray Fixative (each)
  Medscand Cyto-Brushes and Spatula (25 each/package)
  ThinPrep PAP Test Vials (25/flat)
  ThinPrep Papette Broom (lt purple handle) (25/package)
  ThinPrep CytoLyt Solution FNAs (30 mL solution in 50mL VIAL) (20/flat)
  ThinPrep CytoLyt Solution NON-Gyns (30 mL solution in 120 mL container w/ blue lid) (each)

HISTOLOGY SUPPLIES:


  RPMI Vial (flow cytometry & cytogenetics)

Biopsy Bottles, W/Formalin (24/Box)

  20 ml
  40 ml
  60 ml

Biopsy Containers (screw top lids empty)

  120 ml (non-sterile yellow dot)
  240 ml (non-sterile red dot)
  500 ml (non-sterile green dot)
  1000 ml (non-sterile orange dot)

Biopsy Containers (snap top lids empty)

  128 oz

Miscellaneous Supplies:



   

Please allow 3 to 5 days turnaround on all supply requests. Thank you.