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
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 :