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Consumables order form version française  english version
SAMPLING EQUIPMENT REQUEST
Date   / / (DD/MM/YYYY)  *
Customer reference *
Laboratory Name *

 
Name    *
Last name  *
Address    *
Phone   *  
Fax   *  
E-mail   *  

(*) All these points have to be completed before sending your request
  • Serum tubes (box of 30 bags))
  • Urine collection cup (box of 24 cups)
  • Aprotinin tubes
  • Kit mail return
  • ACD tubes sol. A
  • ACD Tubes sol. B
  • Direct screen Kit Syva microtrack : HSV1 / HSV2
  • Chlamydia trachomatis
  • Culture Kit/ PCR pour HSV, CMV, HPV, Chlamydiae, Virus  
  • Culture Kit for Mycoplasma ureaplasma
  • Pyruvate Kit
  • Helicobacter Pylori Kit (test respiratoire 13C)
  • Narcotics Kit : Individual
  • Anaphylactic Kit choc anaphylactic - choc bag
  • Shirmer's sampling pick
  • Liquid bases cytology monolayer Kit
  • Pap smear Kit
  • Booklet of Sampling Materials Request Forms
  • Booklet of Test Order Forms
  • Yellow sticks for mixes files
 • Transparent bags for room temperature samples
  • Blue bags for frozen samples
  • Green bags for refrigereted samples
  • Information sheets of Down's Syndrome
  • Others : (You have to precise)


    

 

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