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.
IMPORTANT: Please make sure to properly submit your order by clicking the "Submit Order" button at the bottom of this page.

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

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 SWABS AND TUBES This question requires a valid number format.

Each (100 unit minimum)

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; COVID, RSV, RP2, Flu, and Pertussis) 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)

IMPORTANT! Please make sure to click the "Submit Order" button only once, and do not close the browser or navigate away from this page until the form is finished submitting (you will see a Thank You page and receive an email receipt of your order when properly submitted). All required field errors must be corrected for your order to be processed.