Ordering Supplies

Please complete the form below to order any materials you may need. Should you have any questions or an item not be listed, please contact Client Services at 415-353-7270.


First time ordering supplies / using our service?
Provider Contact
Provider Name *
Provider Name
Attn:
Attn:
Office Address *
Office Address
Have you moved?
Phone *
Phone
Fax
Fax
Oral Pathology Kits
PLEASE USE THE PROVIDED FIELD TO INDICATE THE QUANTITY NEEDED.
For Oral Surgeons, DDS, etc. Each Oral Pathology Kit includes:
  • 1 Requisition Form & Oral Diagram
  • 1 Med 20ml Specimen Container
  • 1 Biohazard Specimen Bag
  • 1 FedEx Clinical Pak & Canister
  • 1 FedEx Pre-Printed Airbill

  • Biopsy Supplies
    Please use the provided field to indicate the quantity needed.
    Please check this box if your office uses an EMA Interface (250/pack)
    *Please note that we are currently unable to ship 7ml Specimen Containers outside of California. Please select either 20ml Containers or call us at 415-353-7270. Thank you.
    Due to the shorter t1⁄2 of Michel's Transport Medium, we are limiting orders to ≤10 vials per order. Should you require >10 vials, please contact Client Services at 415-353-7270.
    Shipping Supplies
    Other: