Supply Order Form

Please submit orders to PeaceHealth Laboratories by 5 p.m. Friday for delivery the following Wednesday.

  Ordered by: 
Phone#: 
E-mail address: 
Physician/Client: 
QtyMICROBIOLOGY
Culturette II
Mini-Tip
Culturette
Urine Culture Kit
(box of 50)
Stool Culture Kit
Ova & Parasite Kit
Blood Culture
Bottle Set
Chlamydia/GC
ProbeTec-Female
Chlamydia/GC
ProbeTec-Male
Herpes/Chlamydia/
Viral Culture
Transport Media
(M4)
QtySYRINGE/NEEDLES
Multi Draw Needles 21 g
(box of 100)
Multi Draw Needles 22 g
(box of 100)
Syringes - 5cc
Syringes - 10cc
Syringe Needles 21 g
(box of 100)
Syringe Needles 22 g
(box of 100)
Syringe Needles 23 g
(box of 100)
QtyVACUTAINERS
SST - 5 mL
(pkg of 100)
Lavender - 4 mL
(pkg of 100)
Lavender - 3 mL
(pkg of 100)
Red - 10 mL
(pkg of 100)
Blue (coag) - 4.5 mL
(pkg of 100)
Royal Blue - 7 mL
Na Hep-(pkg of 100)
Royal Blue - 7 mL
Plain-(pkg of 100)
Tan -3 mL
EDTA-(pkg of 100)
Grey - 7 mL
(pkg of 100)
ACD - A 10 mL
(pkg of 100)
QtyMISCELLANEOUS
Glucola - 50g
Glucola - 100g
Zip Lock Bags
Stool Container
(72 hr Fecal Fat)
Plastic Aliquot Tubes
(bag of 1000)
Metal Free Tubes
(MAYO)
QtyREQUISITIONS
NWRL - Laboratory
(pkg of 100)


QtyURINE
Sterile Plastic
Specimen Container
24 hr Urine
Collection Container
QtyPt Protect. *
Pt Protect Pain Mgt Requisition#419955
Noble Split Spec. Cups #420080
Temperature Strip Urine Cups #110658

These supplies ship from
Oregon so please allow
7-10 days for processing
and shipping.
* For PtProtect Pain Management Clients only. To sign up for this program, please call
360-788-6330, x2937 or x2980.


Other :