Client Lab Supply Order Form

Rady Children's Hospital Laboratory Department | For questions call: (858) 576-1700 ext. 5629
Requests received by 12 midnight Monday will deliver Wednesday.

1. Please enter your contact information below:

Client Name *This question is required. (Start typing then select name from pop-up choices OR type in if not listed)

Contact Name *This question is required.

Contact Email Address: *This question is required. This question requires a valid email address.

Back Line Phone Number *This question is required.

Delivery Address *This question is required. Please include Mailcodes (MC) in this field.

City *This question is required.

State *This question is required.

Zip *This question is required.

Questions/Comments:

BAG SPECIMEN LAB RADY CHILDREN'S HOSPITAL
Stock #:46434 | Catalog #:46434 This question requires a valid number format.

Packages (100 units/pk)

BAG PLASTIC RECLOSABLE 8 IN X 10 IN
Stock #: 50160 | Catalog #: ACB525185010 This question requires a valid number format.

Packages (100 units/pk)

BAG PLASTIC RECLOSABLE 18 X 20
Stock #: 43256 | Catalog #: F21820 This question requires a valid number format.

Packages (100 units/pk)

KIT COLLECTION UVE BD MAX
Stock #: 86349 | Catalog #: 443376 This question requires a valid number format.

Each (1 unit/ea)

CONTAINER SPECIMEN W/LID 4 OZ URINE CUP
Stock #: 26920 | Catalog #: 4937 This question requires a valid number format.

Each (1 unit/ea)

FIXATIVE MICROSET OVA PARASITE - O AND P KIT
Stock #: 50320 | Catalog #: 037-24 This question requires a valid number format.

Each (1 unit/ea)

KIT SPECIMEN COLLECTION GRAY KIT
Stock #: 39737 | Catalog #: 364953 This question requires a valid number format.

Boxes (50 units/box)

KIT SPECIMEN COLLECTION STRAW
Stock #: 39736 | Catalog #: 364943 This question requires a valid number format.

Boxes (50 units/box)

KIT URINE COLLECTION SPECIMEN
Stock #: 22000 | Catalog #: 4625 This question requires a valid number format.

Each (1 unit/each)

PINWORM PREP TUBE COLLECTOR
Stock #: 52643 | Catalog #: T1329-10 This question requires a valid number format.

Each (1 unit/each)

SWAB CULTURETTE II RED TOP
Stock #: 50550 | Catalog #: 220109 This question requires a valid number format.

Each (1 unit/ea)

SWAB MINI TIP GREEN
Stock #: 52060 | Catalog #: 220133 This question requires a valid number format.

Each (1 unit/ea)

TAPE EVIDENCE
Stock #: 46503 | Catalog #: 66671 This question requires a valid number format.

Each (1 unit/ea)

TIP MICROTAINER CAPILLARY
Stock #: 50590 | Catalog #: 365956 This question requires a valid number format.

Bags (50 units/BG)

TUBE CULTURE MEDIA PORT A CUL (E-SWAB)
Stock #: 50050 | Catalog #: C8851-2 This question requires a valid number format.

Each (1 unit/ea)

U-BAG PEDIATRIC URINE BAG
Stock #: 37600 | Catalog #: 7513 This question requires a valid number format.

Each (1 unit/ea)

PAN SPECIMEN COLLECTION (HATS)
Stock #: 32710 | Catalog #: DYND36605 This question requires a valid number format.

Each (1 unit/ea)

MEDIA ANAEROBIC BACTEC YELLOW BLOOD CULTURE BOTTLE
Stock #: 51930 | Catalog #: 4402191 This question requires a valid number format.

Each (1 unit/ea)

MEDIA PEDS PLUS PINK BLOOD CULTURE BOTTLE
Stock #: 51920 | Catalog #: 4402194 This question requires a valid number format.

Each (1 unit/ea)

MICROTAINER CAPILLARY GREEN
Stock #: 50610 | Catalog #: 365958 This question requires a valid number format.

Bags (50 units/BG)

MICROTAINER CAPILLARY LAVEN
Stock #: 50600 | Catalog #: 365974 This question requires a valid number format.

Bags (50 units/BG)

SET BLOOD COLLECTION ADAPTER FOR BUTTERFLY
Stock #: 82116 | Catalog #: 367290 This question requires a valid number format.

Packs (100 units/PK)

SET COLLECTION BUTTERFLY 23G
Stock #: 33550 | Catalog #: 367297 This question requires a valid number format.

Each (1 unit/ea)

SET COLLECTION BUTTERFLY 25G
Stock #: 33560 | Catalog #: 367298 This question requires a valid number format.

Each (1 unit/ea)

VACUTAINER 3ML HEPARIN GREEN GEL
Stock #: 50640 | Catalog #: 367960 This question requires a valid number format.

Boxes (100 units/box)

VACUTAINER 3ML LIQUID LAVENDAR
Stock #: 50660 | Catalog #: 367856 This question requires a valid number format.

Boxes (100 units/box)

VACUTAINER 3ML TAN TOP FOR LEAD
Stock #: 39235 | Catalog #: 367855 This question requires a valid number format.

Boxes (100 units/box)

VACUTAINER 4ML RED TOP
Stock #: 50620 | Catalog #: 367613 This question requires a valid number format.

Boxes (100 units/box)

SCM TO OBTAIN FROM LAB

COLLECTION KIT FOR PERTUSSIS TEST This question requires a valid number format.

Each (1 unit/ea)

TUBE VIRAL MEDIA LESION LARGE TIP This question requires a valid number format.

Each (1 unit/ea)

TUBE VIRAL MEDIA NASOPHARYNGEAL SMALL TIP This question requires a valid number format.

Each (1 unit/ea)

COVID DRY COLLECTION SWAB This question requires a valid number format.

Each (1 unit/ea)

COVID DRY COLLECTION TUBE This question requires a valid number format.

Each (1 unit/ea)

LAB REQUEST FORM - IMPRINTED WITH PHYSICIAN OFFICE NAME This question requires a valid number format.

Each (1 unit/ea)

COLLECTION KIT FOR RESPIRATORY PATHOGENS (VTM) This question requires a valid number format.

Each (1 unit/ea)

SYNETHIC FLOCK SWAB This question requires a valid number format.

Each (1 unit/ea)

SPECIMEN LOCK BOX WITH 2 KEYS This question requires a valid number format.

Each (1 unit/ea)