Transcript

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12 X 18

LONG TERM CARE BAG

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PK

BX

BX

BX

CASE

EA

EA

EA

EA

EA

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C) KIT

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

ACCOUNT NAME ACCT. NO. ROUTE

DATE RECEIVEDRECEIVED BY (CLIENT SIGNATURE)

BLOOD COLLECTION TUBES

GLUCOSE TOL. BEVERAGE

BAGS

MISCELLANEOUS

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

CYTO / HISTO / HPV SUPPLIES

SHARPS CONTAINERS

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197925

48197923

36996023CA

36996023CA

36996023CA

SUPPLY ORDER

RETURN THE TOP 3 COPIES TO DMC UNIVERSITY LABORATORIES326430EC (4/06)

MIDSTREAM KIT(UA AND CULTURE TUBE)MIDSTREAM KIT(UA TUBE ONLY)

MICROBIOLOGY SUPPLIES

FOR ITEMS NOT LISTED ON THE SUPPLY ORDER FORM, PLEASE CONTACT YOUR SALES REPRESENTATIVE FOR AVAILABILITY.

PLEASE ALLOW 5-7 DAYS FOR DELIVERY

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

ORDER DATE FILL DATE

BY: BY:

SPECIMEN CONTAINERS

FORMALIN BIOPSY BOTTLESSIZE: 20ML

PEDIATRIC TUBES

TOXICOLOGY SUPPLIES

LABELS

URINE-STERILE, 4OZ. (HANDI-PAK)

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

4201 St. Antoine, Detroit MI, 48201-2194

PINK TOP 6ML - K2EDTA(BLOOD BANK)

REQUISITIONS AND FORMS

EA

EA

EA

36812056CA

36812070CA

36812007CA

LARGE

MEDIUM

WALL MOUNT (SMALL)

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

THIN PREP VIALSCYTOBRUSHES & SPATULAS

REVIEWED BY DATE

REQUEST REQUEST PRODUCTNUMBER ISSUEDUNITISSUEDPRODUCT

NUMBERUNITISSUEDPRODUCTNUMBERUNITREQUEST

ROYAL BLUE TOP 7ML-NO ADDITIVE

ORDERS ARE FILLED BASED ON PREVIOUS TEST VOLUMES AND SUPPLY REQUESTS

BLOOD CULTURE VIALANAEROBIC

BLOOD CULTURE VIALAEROBIC

CHLAMYDIA/GC AMP PROBETEC - FEMALECHLAMYDIA/GC AMP PROBETEC - MALECHLAMYDIA CULTUREFLEX TRANS

DIAMONDS MEDIA(TRICHOMONAS)ENTERIC TRANS MEDIA(STOOL CULTURE)

MYCOPLASMA TRANSPORTMEDIUM

VIRAL TRANSPORT(HERPES CULTURE)

COAGULATION TEST

CYTOGENETICS TEST

CYTOLOGY/HISTOLOGY TEST

ESOTERIC TEST

LONG TERM CARE TEST

ROUTINE TEST

TOXICOLOGY TEST

Digicomp Lockup Info
Plate: Black
Digicomp Lockup Info
Page: 1 Plate: PANTONE 301 U Stub: Left Lockup: Continuous Top: 0.25" Middle(v): 0.542" Bottom: 0.386" Left: 0.25" Middle(h): 0" Right: 0.242"
Digicomp Lockup Info
Page: 1 Plate: PANTONE Warm Red U Stub: Left Lockup: Continuous Top: 2.727" Middle(v): 0" Bottom: 8.201" Left: 0.266" Middle(h): 2.351" Right: 2.63"

LARGE

MEDIUM

WALL MOUNT (SMALL)

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12x18

LONG TERM CARE BAGS

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

36812056CA

36812070CA

36812007CA

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

1

1

1

1

1

1

1

1

50

50

50

100

100

1

1

200

72

1

200

1

1

1

1

1

200

PRODUCTNUMBER UNIT Q/UNIT

1

5

5

12

12

12

12

12

4

4

4

1

2

1

1

1

2

10

1

2

1

2

2

1

1

LIMIT

CHLAMYDIA/GC AMPPROBETEC - MALE

CHLAMYDIA/GC AMPPROBETEC - FEMALE

PRODUCTNUMBER UNIT Q/UNIT LIMIT

1

1

1

100

100

1

50

1

1

20

1

1

1

1

50

1

50

50

25

100

100

1

1

1

1

20

24

25

100

100

50

50

100

1

1

1

1

1

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PKG

BX

BX

BX

CASE

EA

EA

EA

EA

EA

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197923

48197925

36996023CA

36996023CA

36996023CA

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

PRODUCTNUMBER UNIT Q/UNIT LIMIT

4

4

4

4

2

4

25

4

10

10

4

4

4

2

2

2

2

2

2

1

1

4

4

4

2

4

25

2

1

1

5

1

20

5

100

100

100

100

100

100

1

100

1

1

100

100

100

100

100

100

100

100

100

50

50

48

48

200

100

50

1

250

250

100

100

1000

1

20

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

MYCOPLASMA TRANSPORTMEDIUM

20

10

10

1

1

20

4

24

10

1

20

10

10

10

1

20

2

1

4

2

1

1

24

24

20

20

5

4

4

1

2

1

4

4

2

20

10

6

6

6

ROUTINE TEST

CYTOLOGY/HISTOLOGY TEST

COAGULATION TEST

CYTOGENETICS TEST

ESOTERIC TEST

TOXICOLOGY TEST

LONG TERM CARE TEST

URINE-STERILE, 4OZ. (HANDI-PAK)

DIAMONDS MEDIA(TRICHOMONAS)

BLOOD CULTURE VIALANAEROBIC

ENTERIC TRANS MEDIA(STOOL CULTURE)

MIDSTREAM KIT(UA TUBE ONLY)

MIDSTREAM KIT(UA AND CULTURE TUBE)

FORMALIN BIOPSY BOTTLESSIZE: 20ML

BLOOD CULTURE VIALAEROBIC

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

CHLAMYDIA CULTUREFLEX TRANS

THIN PREP VIALS, CYTOBRUSHES& SPATULAS

ROYAL BLUE TOP 7ML-NO ADDITIVES

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C.) KIT

PINK TOP 6ML - K2EDTA(PINK TUBE)

TOXICOLOGY SUPPLIES

MISCELLANEOUS

SPECIMEN CONTAINERS

LABELS

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

CYTO / HISTO / HPV SUPPLIESBAGS

GLUCOSE TOL. BEVERAGEPEDIATRIC TUBES

BLOOD COLLECTION TUBES MICROBIOLOGY SUPPLIES SHARPS CONTAINERS

REQUISITIONS AND FORMS

VIRAL TRANSPORT(HERPES CULTURE)

Digicomp Lockup Info
Page: 2 Plate: Black Stub: Left Lockup: Continuous Top: 2.5" Middle(v): 0" Bottom: 0.998" Left: 0.25" Middle(h): 0.115" Right: 0.232"

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12 X 18

LONG TERM CARE BAG

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PK

BX

BX

BX

CASE

EA

EA

EA

EA

EA

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C) KIT

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

ACCOUNT NAME ACCT. NO. ROUTE

DATE RECEIVEDRECEIVED BY (CLIENT SIGNATURE)

BLOOD COLLECTION TUBES

GLUCOSE TOL. BEVERAGE

BAGS

MISCELLANEOUS

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

CYTO / HISTO / HPV SUPPLIES

SHARPS CONTAINERS

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197925

48197923

36996023CA

36996023CA

36996023CA

SUPPLY ORDER

RETURN THE TOP 3 COPIES TO DMC UNIVERSITY LABORATORIES326430EC (4/06)

MIDSTREAM KIT(UA AND CULTURE TUBE)MIDSTREAM KIT(UA TUBE ONLY)

MICROBIOLOGY SUPPLIES

FOR ITEMS NOT LISTED ON THE SUPPLY ORDER FORM, PLEASE CONTACT YOUR SALES REPRESENTATIVE FOR AVAILABILITY.

PLEASE ALLOW 5-7 DAYS FOR DELIVERY

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

ORDER DATE FILL DATE

BY: BY:

SPECIMEN CONTAINERS

FORMALIN BIOPSY BOTTLESSIZE: 20ML

PEDIATRIC TUBES

TOXICOLOGY SUPPLIES

LABELS

URINE-STERILE, 4OZ. (HANDI-PAK)

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

4201 St. Antoine, Detroit MI, 48201-2194

PINK TOP 6ML - K2EDTA(BLOOD BANK)

REQUISITIONS AND FORMS

EA

EA

EA

36812056CA

36812070CA

36812007CA

LARGE

MEDIUM

WALL MOUNT (SMALL)

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

THIN PREP VIALSCYTOBRUSHES & SPATULAS

REVIEWED BY DATE

REQUEST REQUEST PRODUCTNUMBER ISSUEDUNITISSUEDPRODUCT

NUMBERUNITISSUEDPRODUCTNUMBERUNITREQUEST

ROYAL BLUE TOP 7ML-NO ADDITIVE

ORDERS ARE FILLED BASED ON PREVIOUS TEST VOLUMES AND SUPPLY REQUESTS

BLOOD CULTURE VIALANAEROBIC

BLOOD CULTURE VIALAEROBIC

CHLAMYDIA/GC AMP PROBETEC - FEMALECHLAMYDIA/GC AMP PROBETEC - MALECHLAMYDIA CULTUREFLEX TRANS

DIAMONDS MEDIA(TRICHOMONAS)ENTERIC TRANS MEDIA(STOOL CULTURE)

MYCOPLASMA TRANSPORTMEDIUM

VIRAL TRANSPORT(HERPES CULTURE)

COAGULATION TEST

CYTOGENETICS TEST

CYTOLOGY/HISTOLOGY TEST

ESOTERIC TEST

LONG TERM CARE TEST

ROUTINE TEST

TOXICOLOGY TEST

Digicomp Lockup Info
Plate: Black
Digicomp Lockup Info
Page: 1 Plate: PANTONE 301 U Stub: Left Lockup: Continuous Top: 0.25" Middle(v): 0.542" Bottom: 0.386" Left: 0.25" Middle(h): 0" Right: 0.242"
Digicomp Lockup Info
Page: 1 Plate: PANTONE Warm Red U Stub: Left Lockup: Continuous Top: 2.727" Middle(v): 0" Bottom: 8.201" Left: 0.266" Middle(h): 2.351" Right: 2.63"

LARGE

MEDIUM

WALL MOUNT (SMALL)

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12x18

LONG TERM CARE BAGS

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

36812056CA

36812070CA

36812007CA

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

1

1

1

1

1

1

1

1

50

50

50

100

100

1

1

200

72

1

200

1

1

1

1

1

200

PRODUCTNUMBER UNIT Q/UNIT

1

5

5

12

12

12

12

12

4

4

4

1

2

1

1

1

2

10

1

2

1

2

2

1

1

LIMIT

CHLAMYDIA/GC AMPPROBETEC - MALE

CHLAMYDIA/GC AMPPROBETEC - FEMALE

PRODUCTNUMBER UNIT Q/UNIT LIMIT

1

1

1

100

100

1

50

1

1

20

1

1

1

1

50

1

50

50

25

100

100

1

1

1

1

20

24

25

100

100

50

50

100

1

1

1

1

1

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PKG

BX

BX

BX

CASE

EA

EA

EA

EA

EA

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197923

48197925

36996023CA

36996023CA

36996023CA

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

PRODUCTNUMBER UNIT Q/UNIT LIMIT

4

4

4

4

2

4

25

4

10

10

4

4

4

2

2

2

2

2

2

1

1

4

4

4

2

4

25

2

1

1

5

1

20

5

100

100

100

100

100

100

1

100

1

1

100

100

100

100

100

100

100

100

100

50

50

48

48

200

100

50

1

250

250

100

100

1000

1

20

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

MYCOPLASMA TRANSPORTMEDIUM

20

10

10

1

1

20

4

24

10

1

20

10

10

10

1

20

2

1

4

2

1

1

24

24

20

20

5

4

4

1

2

1

4

4

2

20

10

6

6

6

ROUTINE TEST

CYTOLOGY/HISTOLOGY TEST

COAGULATION TEST

CYTOGENETICS TEST

ESOTERIC TEST

TOXICOLOGY TEST

LONG TERM CARE TEST

URINE-STERILE, 4OZ. (HANDI-PAK)

DIAMONDS MEDIA(TRICHOMONAS)

BLOOD CULTURE VIALANAEROBIC

ENTERIC TRANS MEDIA(STOOL CULTURE)

MIDSTREAM KIT(UA TUBE ONLY)

MIDSTREAM KIT(UA AND CULTURE TUBE)

FORMALIN BIOPSY BOTTLESSIZE: 20ML

BLOOD CULTURE VIALAEROBIC

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

CHLAMYDIA CULTUREFLEX TRANS

THIN PREP VIALS, CYTOBRUSHES& SPATULAS

ROYAL BLUE TOP 7ML-NO ADDITIVES

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C.) KIT

PINK TOP 6ML - K2EDTA(PINK TUBE)

TOXICOLOGY SUPPLIES

MISCELLANEOUS

SPECIMEN CONTAINERS

LABELS

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

CYTO / HISTO / HPV SUPPLIESBAGS

GLUCOSE TOL. BEVERAGEPEDIATRIC TUBES

BLOOD COLLECTION TUBES MICROBIOLOGY SUPPLIES SHARPS CONTAINERS

REQUISITIONS AND FORMS

VIRAL TRANSPORT(HERPES CULTURE)

Digicomp Lockup Info
Page: 2 Plate: Black Stub: Left Lockup: Continuous Top: 2.5" Middle(v): 0" Bottom: 0.998" Left: 0.25" Middle(h): 0.115" Right: 0.232"

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12 X 18

LONG TERM CARE BAG

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PK

BX

BX

BX

CASE

EA

EA

EA

EA

EA

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C) KIT

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

ACCOUNT NAME ACCT. NO. ROUTE

DATE RECEIVEDRECEIVED BY (CLIENT SIGNATURE)

BLOOD COLLECTION TUBES

GLUCOSE TOL. BEVERAGE

BAGS

MISCELLANEOUS

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

CYTO / HISTO / HPV SUPPLIES

SHARPS CONTAINERS

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197925

48197923

36996023CA

36996023CA

36996023CA

SUPPLY ORDER

RETURN THE TOP 3 COPIES TO DMC UNIVERSITY LABORATORIES326430EC (4/06)

MIDSTREAM KIT(UA AND CULTURE TUBE)MIDSTREAM KIT(UA TUBE ONLY)

MICROBIOLOGY SUPPLIES

FOR ITEMS NOT LISTED ON THE SUPPLY ORDER FORM, PLEASE CONTACT YOUR SALES REPRESENTATIVE FOR AVAILABILITY.

PLEASE ALLOW 5-7 DAYS FOR DELIVERY

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

ORDER DATE FILL DATE

BY: BY:

SPECIMEN CONTAINERS

FORMALIN BIOPSY BOTTLESSIZE: 20ML

PEDIATRIC TUBES

TOXICOLOGY SUPPLIES

LABELS

URINE-STERILE, 4OZ. (HANDI-PAK)

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

4201 St. Antoine, Detroit MI, 48201-2194

PINK TOP 6ML - K2EDTA(BLOOD BANK)

REQUISITIONS AND FORMS

EA

EA

EA

36812056CA

36812070CA

36812007CA

LARGE

MEDIUM

WALL MOUNT (SMALL)

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

THIN PREP VIALSCYTOBRUSHES & SPATULAS

REVIEWED BY DATE

REQUEST REQUEST PRODUCTNUMBER ISSUEDUNITISSUEDPRODUCT

NUMBERUNITISSUEDPRODUCTNUMBERUNITREQUEST

ROYAL BLUE TOP 7ML-NO ADDITIVE

ORDERS ARE FILLED BASED ON PREVIOUS TEST VOLUMES AND SUPPLY REQUESTS

BLOOD CULTURE VIALANAEROBIC

BLOOD CULTURE VIALAEROBIC

CHLAMYDIA/GC AMP PROBETEC - FEMALECHLAMYDIA/GC AMP PROBETEC - MALECHLAMYDIA CULTUREFLEX TRANS

DIAMONDS MEDIA(TRICHOMONAS)ENTERIC TRANS MEDIA(STOOL CULTURE)

MYCOPLASMA TRANSPORTMEDIUM

VIRAL TRANSPORT(HERPES CULTURE)

COAGULATION TEST

CYTOGENETICS TEST

CYTOLOGY/HISTOLOGY TEST

ESOTERIC TEST

LONG TERM CARE TEST

ROUTINE TEST

TOXICOLOGY TEST

Digicomp Lockup Info
Plate: Black
Digicomp Lockup Info
Page: 1 Plate: PANTONE 301 U Stub: Left Lockup: Continuous Top: 0.25" Middle(v): 0.542" Bottom: 0.386" Left: 0.25" Middle(h): 0" Right: 0.242"
Digicomp Lockup Info
Page: 1 Plate: PANTONE Warm Red U Stub: Left Lockup: Continuous Top: 2.727" Middle(v): 0" Bottom: 8.201" Left: 0.266" Middle(h): 2.351" Right: 2.63"

LARGE

MEDIUM

WALL MOUNT (SMALL)

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12x18

LONG TERM CARE BAGS

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

36812056CA

36812070CA

36812007CA

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

1

1

1

1

1

1

1

1

50

50

50

100

100

1

1

200

72

1

200

1

1

1

1

1

200

PRODUCTNUMBER UNIT Q/UNIT

1

5

5

12

12

12

12

12

4

4

4

1

2

1

1

1

2

10

1

2

1

2

2

1

1

LIMIT

CHLAMYDIA/GC AMPPROBETEC - MALE

CHLAMYDIA/GC AMPPROBETEC - FEMALE

PRODUCTNUMBER UNIT Q/UNIT LIMIT

1

1

1

100

100

1

50

1

1

20

1

1

1

1

50

1

50

50

25

100

100

1

1

1

1

20

24

25

100

100

50

50

100

1

1

1

1

1

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PKG

BX

BX

BX

CASE

EA

EA

EA

EA

EA

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197923

48197925

36996023CA

36996023CA

36996023CA

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

PRODUCTNUMBER UNIT Q/UNIT LIMIT

4

4

4

4

2

4

25

4

10

10

4

4

4

2

2

2

2

2

2

1

1

4

4

4

2

4

25

2

1

1

5

1

20

5

100

100

100

100

100

100

1

100

1

1

100

100

100

100

100

100

100

100

100

50

50

48

48

200

100

50

1

250

250

100

100

1000

1

20

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

MYCOPLASMA TRANSPORTMEDIUM

20

10

10

1

1

20

4

24

10

1

20

10

10

10

1

20

2

1

4

2

1

1

24

24

20

20

5

4

4

1

2

1

4

4

2

20

10

6

6

6

ROUTINE TEST

CYTOLOGY/HISTOLOGY TEST

COAGULATION TEST

CYTOGENETICS TEST

ESOTERIC TEST

TOXICOLOGY TEST

LONG TERM CARE TEST

URINE-STERILE, 4OZ. (HANDI-PAK)

DIAMONDS MEDIA(TRICHOMONAS)

BLOOD CULTURE VIALANAEROBIC

ENTERIC TRANS MEDIA(STOOL CULTURE)

MIDSTREAM KIT(UA TUBE ONLY)

MIDSTREAM KIT(UA AND CULTURE TUBE)

FORMALIN BIOPSY BOTTLESSIZE: 20ML

BLOOD CULTURE VIALAEROBIC

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

CHLAMYDIA CULTUREFLEX TRANS

THIN PREP VIALS, CYTOBRUSHES& SPATULAS

ROYAL BLUE TOP 7ML-NO ADDITIVES

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C.) KIT

PINK TOP 6ML - K2EDTA(PINK TUBE)

TOXICOLOGY SUPPLIES

MISCELLANEOUS

SPECIMEN CONTAINERS

LABELS

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

CYTO / HISTO / HPV SUPPLIESBAGS

GLUCOSE TOL. BEVERAGEPEDIATRIC TUBES

BLOOD COLLECTION TUBES MICROBIOLOGY SUPPLIES SHARPS CONTAINERS

REQUISITIONS AND FORMS

VIRAL TRANSPORT(HERPES CULTURE)

Digicomp Lockup Info
Page: 2 Plate: Black Stub: Left Lockup: Continuous Top: 2.5" Middle(v): 0" Bottom: 0.998" Left: 0.25" Middle(h): 0.115" Right: 0.232"

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12 X 18

LONG TERM CARE BAG

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PK

BX

BX

BX

CASE

EA

EA

EA

EA

EA

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C) KIT

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

ACCOUNT NAME ACCT. NO. ROUTE

DATE RECEIVEDRECEIVED BY (CLIENT SIGNATURE)

BLOOD COLLECTION TUBES

GLUCOSE TOL. BEVERAGE

BAGS

MISCELLANEOUS

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

CYTO / HISTO / HPV SUPPLIES

SHARPS CONTAINERS

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197925

48197923

36996023CA

36996023CA

36996023CA

SUPPLY ORDER

RETURN THE TOP 3 COPIES TO DMC UNIVERSITY LABORATORIES326430EC (4/06)

MIDSTREAM KIT(UA AND CULTURE TUBE)MIDSTREAM KIT(UA TUBE ONLY)

MICROBIOLOGY SUPPLIES

FOR ITEMS NOT LISTED ON THE SUPPLY ORDER FORM, PLEASE CONTACT YOUR SALES REPRESENTATIVE FOR AVAILABILITY.

PLEASE ALLOW 5-7 DAYS FOR DELIVERY

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

ORDER DATE FILL DATE

BY: BY:

SPECIMEN CONTAINERS

FORMALIN BIOPSY BOTTLESSIZE: 20ML

PEDIATRIC TUBES

TOXICOLOGY SUPPLIES

LABELS

URINE-STERILE, 4OZ. (HANDI-PAK)

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

4201 St. Antoine, Detroit MI, 48201-2194

PINK TOP 6ML - K2EDTA(BLOOD BANK)

REQUISITIONS AND FORMS

EA

EA

EA

36812056CA

36812070CA

36812007CA

LARGE

MEDIUM

WALL MOUNT (SMALL)

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

THIN PREP VIALSCYTOBRUSHES & SPATULAS

REVIEWED BY DATE

REQUEST REQUEST PRODUCTNUMBER ISSUEDUNITISSUEDPRODUCT

NUMBERUNITISSUEDPRODUCTNUMBERUNITREQUEST

ROYAL BLUE TOP 7ML-NO ADDITIVE

ORDERS ARE FILLED BASED ON PREVIOUS TEST VOLUMES AND SUPPLY REQUESTS

BLOOD CULTURE VIALANAEROBIC

BLOOD CULTURE VIALAEROBIC

CHLAMYDIA/GC AMP PROBETEC - FEMALECHLAMYDIA/GC AMP PROBETEC - MALECHLAMYDIA CULTUREFLEX TRANS

DIAMONDS MEDIA(TRICHOMONAS)ENTERIC TRANS MEDIA(STOOL CULTURE)

MYCOPLASMA TRANSPORTMEDIUM

VIRAL TRANSPORT(HERPES CULTURE)

COAGULATION TEST

CYTOGENETICS TEST

CYTOLOGY/HISTOLOGY TEST

ESOTERIC TEST

LONG TERM CARE TEST

ROUTINE TEST

TOXICOLOGY TEST

Digicomp Lockup Info
Plate: Black
Digicomp Lockup Info
Page: 1 Plate: PANTONE 301 U Stub: Left Lockup: Continuous Top: 0.25" Middle(v): 0.542" Bottom: 0.386" Left: 0.25" Middle(h): 0" Right: 0.242"
Digicomp Lockup Info
Page: 1 Plate: PANTONE Warm Red U Stub: Left Lockup: Continuous Top: 2.727" Middle(v): 0" Bottom: 8.201" Left: 0.266" Middle(h): 2.351" Right: 2.63"

LARGE

MEDIUM

WALL MOUNT (SMALL)

MOLECULAR GENETICS

SUPPLY ORDER FORM

COLA, 100 gm

LEMON LIME, 100 gm

ORANGE, 100 gm

ORANGE, 75 gm

ORANGE, 50 gm

DMCUL BAG 12x18

LONG TERM CARE BAGS

SPECIMEN TRANSPORT BAG

ANTISEPTIC TOWELETTES

AUTODIAL RESULT PAPER 1 PART

AUTODIAL PRINTER RIBBON

CENTRIFUGE

COTTON BALLS

FROSTED END SLIDES

ICE TRANSPORT

4MEDICA LABEL PAPER

4MEDICA RESULT PAPER

4MEDICA PRINTER CARTRIDGE(SPECIFY MODEL)

PATIENT LOG BOOK

PHONE REPORT PAD

SPECIMEN LOCK BOX

SPONGES 2X2

36812056CA

36812070CA

36812007CA

322560FRCT

322560FQCA

322560FBCA

322570XGPK

326430UXCA

326430ZG

326430DVCA

326430ECCA

322560FJBX

23210003CA

23210002CA

23210001CA

23210007EA

23210006EAX

36811472CA

36811471CA

48197954CA

48194743CA

322560F4CA

48490017EA

48194709CA

37137203CA

369946APCAX

321971JA

32237312EA

326430EDPD

481930BYCA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

PKG

PKG

PKG

BX

CASE

EA

EA

PKG

BX

EA

CASE

PKG

EA

EA

EA

EA

PKG

1

1

1

1

1

1

1

1

50

50

50

100

100

1

1

200

72

1

200

1

1

1

1

1

200

PRODUCTNUMBER UNIT Q/UNIT

1

5

5

12

12

12

12

12

4

4

4

1

2

1

1

1

2

10

1

2

1

2

2

1

1

LIMIT

CHLAMYDIA/GC AMPPROBETEC - MALE

CHLAMYDIA/GC AMPPROBETEC - FEMALE

PRODUCTNUMBER UNIT Q/UNIT LIMIT

1

1

1

100

100

1

50

1

1

20

1

1

1

1

50

1

50

50

25

100

100

1

1

1

1

20

24

25

100

100

50

50

100

1

1

1

1

1

EA

EA

EA

BX

BX

EA

PKG

EA

EA

BX

EA

EA

EA

EA

BX

EA

PKG

PKG

PKG

EA

BX

EA

EA

EA

EA

BX

PKG

BX

PKG

BX

BX

BX

CASE

EA

EA

EA

EA

EA

369960LGCA

37138328PK

36342006PK

481947A1CA

481947A2CA

484650CWPK

363420DHBX

363420CJPK

36342063PK

363420A1PK

484900BVPK

363450Z1BX

363420CGPK

37137239CAX

48156607CA

363420EQPK

481581E5BG

38977111PK

38977106CA

48341655CA

48197109CA

34582207CAX

358830AGCA

369960LCCA

37137237CA

481376EP

3634511PCA

369960BLBG

36996076CA

36996008CA

36997709CA

36996005CA

48197923

48197925

36996023CA

36996023CA

36996023CA

ANAEROBIC TUBE & VIAL

CULTURE SWAB

G.C. JEMBEC PLATES

HEMOCCULT W/O DEVELOPER

HERPES I & II DIRECT

OVA & PARASITE (PARAPAK)

URINE CULTURE TRANSPORT

CERVICAL SPATULA-MILEX

CYTOLOGY BROOMS 8''

CYTOLOGY BRUSHES 6"

CYTOLOGY FIXATIVE

POLYESTER SWAB

HPV TRANSPORT MEDIA

PAP SMEAR KIT 1 SLIDE

SLIDE HOLDERS

BLOOD TRANSFER TUBE

MIDSTREAM KIT (NO TUBES)

STERILE UA CUP, 4 OZ.

U BAG NEWBORN

U BAG PEDIATRIC

URINE-BORIC ACID, 24 HR.

URINE-HCL 6N, 24 HR.

URINE-PLAIN, 24 HR.

PRODUCTNUMBER UNIT Q/UNIT LIMIT

4

4

4

4

2

4

25

4

10

10

4

4

4

2

2

2

2

2

2

1

1

4

4

4

2

4

25

2

1

1

5

1

20

5

100

100

100

100

100

100

1

100

1

1

100

100

100

100

100

100

100

100

100

50

50

48

48

200

100

50

1

250

250

100

100

1000

1

20

BX

BX

BX

BX

BX

BX

EA

BX

EA

EA

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

BX

EA

BAG

RL

RL

RL

RL

EA

BX

48156639CA

369960ADBX

48156633CA

48156654CA

481566C1

48156638CA

481566B1BX

48156630CA

369960H6BX

369960H5BX

481566AJCA

48156620

48156641CA

48156640CA

36998511CA

48156636CA

48156638CA

48156632CA

48156622CA

48167445CA

48167485CA

48188264BX

48188278CA

48194730CA

48193486BX

48193457CA

36678140PK

48156649CA

321971APPK

321971B5RL

321971ACRL

321971AHRL

36997710CAX

36996075CA

MYCOPLASMA TRANSPORTMEDIUM

20

10

10

1

1

20

4

24

10

1

20

10

10

10

1

20

2

1

4

2

1

1

24

24

20

20

5

4

4

1

2

1

4

4

2

20

10

6

6

6

ROUTINE TEST

CYTOLOGY/HISTOLOGY TEST

COAGULATION TEST

CYTOGENETICS TEST

ESOTERIC TEST

TOXICOLOGY TEST

LONG TERM CARE TEST

URINE-STERILE, 4OZ. (HANDI-PAK)

DIAMONDS MEDIA(TRICHOMONAS)

BLOOD CULTURE VIALANAEROBIC

ENTERIC TRANS MEDIA(STOOL CULTURE)

MIDSTREAM KIT(UA TUBE ONLY)

MIDSTREAM KIT(UA AND CULTURE TUBE)

FORMALIN BIOPSY BOTTLESSIZE: 20ML

BLOOD CULTURE VIALAEROBIC

FORMALIN BIOPSY BOTTLESSIZE: 40MLFORMALIN BIOPSY BOTTLESSIZE: 90ML

CHLAMYDIA CULTUREFLEX TRANS

THIN PREP VIALS, CYTOBRUSHES& SPATULAS

ROYAL BLUE TOP 7ML-NO ADDITIVES

GRAY TOP 6ML

GREEN TOP 7ML-LITHIUM HEPARIN

GREEN TOP 10ML-SODIUM HEPARIN

LAVENDER TOP 4ML

POWDER BLUE TOP 2.7ML

PPT TUBES (HIV VIRAL LOAD)

RED TOP 10ML (PLAIN)

ROYAL BLUE TOP 7ML-EDTA

SERUM SST 8.5ML

SERUM SST GOLD TOP 5.0ML

YELLOW ACD "B" TUBES

GRAY TOP 2ML

GREEN 3ML-LITHIUM HEPARIN

LAVENDER TOP 3ML

POWDER BLUE TOP 2.7ML

RED TOP 3ML (PLAIN)

SERUM SEPARATION 4ML

BUTTERFLY 23Gx¾" 12" TUBING

BUTTERFLY 21G x ¾" 12" TUBING

MULTISAMPLE 21G 1¼"

MULTISAMPLE 22G 1¼"

ALCOHOL SWABS

BANDAIDS-REGULAR

BANDAIDS-SPOTS

TOURNIQUETS

VACUTAINER HOLDER

FROZEN

PAI LABEL NEW / CHANGE

SPECIMEN

STAT

UDS (C.O.C.) KIT

PINK TOP 6ML - K2EDTA(PINK TUBE)

TOXICOLOGY SUPPLIES

MISCELLANEOUS

SPECIMEN CONTAINERS

LABELS

BLOOD COLLECTION SUPPLIES

BLOOD COLLECTION NEEDLES

CYTO / HISTO / HPV SUPPLIESBAGS

GLUCOSE TOL. BEVERAGEPEDIATRIC TUBES

BLOOD COLLECTION TUBES MICROBIOLOGY SUPPLIES SHARPS CONTAINERS

REQUISITIONS AND FORMS

VIRAL TRANSPORT(HERPES CULTURE)

Digicomp Lockup Info
Page: 2 Plate: Black Stub: Left Lockup: Continuous Top: 2.5" Middle(v): 0" Bottom: 0.998" Left: 0.25" Middle(h): 0.115" Right: 0.232"

Top Related