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Pick up and Shipment version française  english version
CONSUMABLES REQUEST FORM
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 stickers 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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