GML Online Supply Order Form

Enter amounts after the items you wish to order and submit electronically.

Client Name:  
Address:          Suite, Apt #:
City:                 State: Zip code:
Contact Name: Phone Number:
ITEM
AMOUNT
ALIQUOT TUBES AND CAPS
(PKG OF 100)
BAG, GREEN REFRIGERATE BIOHAZARD BAG, 6 X 9
(EACH)
(PKG OF 100)
BAG, GREEN REFRIGERATE BIOHAZARD BAG, 12 X 15
(EACH)
(PKG OF 100)
BAG, BLUE FROZEN BIOHAZARD BAG, 6 X 9
(EACH)
(PKG OF 100)
BAG, BLUE FROZEN BIOHZARD BAG, 12 X 15
(EACH)
(PKG OF 100)
BAG, YELLOW ROOM TEMPERATURE BIOHAZARD BAG, 6 X9
(EACH)
(PKG OF 100)
BAG, YELLOW ROOM TEMPERATURE BIOHZARD BAG, 12 X15
EACH
(PKG OF 100)
BLOOD CULTURE BOTTLES, ADULT
(SET)
BLOOD CULTURE BOTTLES, PEDIATRIC
(EACH)
BRUSH, CYTOLOGY
(PKG OF 100)
CONTAINER, STERILE SPECIMEN (90 ML)
(EACH )
(PKG OF 100)
CULTURE SWABS
WHITE (MRSA / VRE / GRPB STREP)
(EACH)
ESWAB (BACTERIAL & FUNGAL)
(EACH)
(PKG)
GREEN (NPG OR MALE URETHRAL)
(EACH)
RED (GRP A PROBE & RAPID STREP)
(EACH)
(PKG)
 
CYTOLOGY FIXATIVE
(EACH)
CYTOLOGY PRESERVATIVE TUBES
(EACH)
DRUGS OF ABUSE COLLECTION KITS
(EACH)
FORMALIN, 40 ML
(EACH)
(PKG OF 32)
FORMALIN, 20 ML
(EACH)
(PKG OF 32)
GEN PROBE GC/CHLAMYDIA COLLECTION KITS
UNISEX SWAB (URETHRAL/ENDOCERVICAL)
(EACH)
(BOX)
GEN PROBE URINE COLLECTION KIT
(EACH)
(BOX)
 
JONES KENDRICK TRANSPORT MEDIA
(EACH)
LABELS:SPECIMEN IDENTIFICATION
LANCETS
(EACH)
MICHEL'S SOLUTION
(EACH)
NEEDLES
ECLIPSE BLOOD COLLECTION NEEDLE 22 x 1-1/4
(EACH)
(BOX OF 100)
ECLIPSE BLOOD COLLECTION NEEDLE 21 x 1/1/4
(EACH)
(BOX OF 100)
BD SAFETY-LOK BUTTERFLY COLLECTION W/HOLDER 23 GAUGE
(EACH)
(B0X OF 50)
 
PAP SMEAR KIT
(PKG of 25)
PIPETTE, TRANSFER 3 ML.
(BOX OF 500)
REQUISITIONS:
CLINICAL CUSTOMIZED
(EACH)
CYTOPATHOLOGY
(EACH)
SURGICAL PATHOLOGY
(EACH)
SLIDES, SUPERFROST 3" X 1"
(BOX of 100)
SLIDE MAILERS MAILERS:
(PKG OF 20)
STOOL TRANSPORT VIALS (CULTURE/GIARDIA EIA)
(EACH)
(BOX)
STOOL TRANSPORT VIALS (O&P)
(EACH)
(BOX)
SURE PATH ® PAP COLLECTION VIALS & BROOMS
(PKG OF 25)
SURE PATH ® PAP COLLECTION VIALS & BRUSHES/SPATULAS
(PKG OF 25)
THIN PREP® PAP COLLECTION VIALS & BRUSHES/SPATULAS
(PKG OF 25)
THIN PREP® PAP COLLECTION VIALS &BROOMS
(PKG OF 25)
TOURNIQUETS
(EACH)
TUBES, BLOOD COLLECTION
BLUE, LIGHT (COAGULATION) 2.7 ML
(EACH)
(PKG OF 100)
BLUE, DARK (STERILE) 7 ML
(EACH)
(PKG OF 100)
GRAY, 3 ML
(EACH)
(PKG OF 100)
GREEN LITHIUM HEPARIN 3 ML
(EACH)
(PKG OF 100)
GREEN SODIUM HEPARIN 3 ML
(EACH)
(PKG OF 100)
GREEN SODIUM HEPARIN 10 ML
(EACH)
(PKG OF 100)
LAVENDER (EDTA) 2 ML
(EACH)
(PKG OF 100)
PINK (EDTA - BLOOD BANK) 6 ML
(EACH)
(PKG OF 100)
RED (PLAIN) 6 ML
(EACH)
(PKG OF 100)
GOLD (SERUM SEPARATOR) 3.5 ML
(EACH)
(PKG OF 100)
TUBE, OTHER - SPECIFY:
TUBES, BLOOD COLLECTION - MICROTAINERS
AMBER (BILIRUBINS)
(EACH)
(PKG OF 50)
RED (PLAIN)
(EACH)
(PKG OF 50)
GREEN (LITHIUM HEPARIN)
(EACH)
(PKG OF 50)
YELLOW (SERUM SEPARATOR)
(EACH)
(PKG OF 50)
LAVENDER (EDTA)
(EACH)
(PKG OF 50)
URINALYSIS TRANSPORT TUBE, 8 ML
(EACH)
URINE ALIQUOT TUBE (24 HOUR), 50 ML
(EACH)
(PKG of 25)
URINE CONTAINERS (24 HOUR)
PLAIN
(EACH)
ACID ADDED
(EACH)
OTHER
EACH)
URINE CULTURE TRANSPORT TUBE
(EACH)
URINE TRANSFER STRAW
(EACH)
 
UNIVERSAL TRANSPORT MEDIA (UTM)
(EACH)
VIROLOGY/CHLAMYDIA TRANSPORT CONTAINERS
(EACH)
OTHER: