Company/Facility Name (required) Address (required) City (required) Phone(required) Fax(required) State(required) —Please choose an option—ChicagoArizona BLOOD COLLECTION PK BLUE LTPK GRAYPK SST (TIGER TOPS_8.5ML)PK PLAIN RED ( NO ADDITIVE)PK LAVENDER (4ML)PK GREEN (NA/HEPARIN)PK DK BLUE (METAL FREE)PK DK BLUE (EDTA) CULTURES EA BACTERIAL CULTURE SWABS AEORBIC/ANAEROBIC)EA NUNS CAPS SPECIMEN COLLECTORSEA URINE COMPLETE CUP KITSEA STERILE CUPS (URINE,STOOL,SPUTUM)EA URINE CUPSEA URINALYSIS TRANSFER TUBE RED/YELLOWEA URINE C/S GREY TRANSFER TUBEEA URINE TRANSFER STRAWS PHLEBOTOMY SUPPLIES BX 21 G VACUTAINER SAFETY NEEDLES22 G VACUTAINER SAFETY NEEDLESBX 23 G BUTTERFLY SAFETY NEEDLESBX 21 G BUTTERFLY SAFETY NEEDLESBX VACUTAINER HOLDERS (100)BX 5 ML SYRINGES MISC EA TOURNIQUETSBX BAND-AIDSBX COBANPK GUAZE PADSBX ALCOHOL WIPESBX SHARPS CONTAINER 8 QUARTEA SHARPS CONTAINER 1.5 QUARTEA GLOVES SM. LATEX POWDER FREEEA GLOVES MED. LATEX POWDER FREEGLOVES LG. LATEX POWDER FREEPK SPECIMEN BAGS
