Skip to content
LOG IN
SCHEDULE
Patients
Pharmacogenomics (PGx)
Order a PGx Test
Covid 19
PGx FAQ
Providers
PGx for Facilities
Facility Sign Up
Covid 19
Testing Services
PGx
Covid 19
About Us
Contact
Patient Consent Form
Order Supplies
Order Supplies
Date
(Required)
MM slash DD slash YYYY
Name
(Required)
First
Last
Customer Name
(Required)
Customer Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Attention
(Required)
Customer Phone
(Required)
Contact Email
(Required)
If you want this order to be sent to a sales rep, please list their name and address below:
Hidden
TOXICOLOGY
Standard Specimen Cup (Temp strips included on cup)
Price:
$0.00
Quantity:
Yellow Vacutainer Cup *Note: Urine collection only. Never submit samples in this cup*
Price:
$0.00
Quantity:
*Order two (2) urine tubes per yellow cup*
Urine Tube No Additive (100/pack)
Price:
$0.00
Quantity:
Oral Tox Swabs
Price:
$0.00
Quantity:
Urine Hats
Price:
$0.00
Quantity:
Quantity for Tox Reqs
Price:
$0.00
Quantity:
Hidden
STI
COPAN E Swab – White top (480C/Female Anatomy)
Price:
$0.00
Quantity:
COPAN E Swab – Blue top (482C/Male Anatomy)
Price:
$0.00
Quantity:
STI Urine Kits (Urine Transfer Device, Preservative Tube)
Price:
$0.00
Quantity:
Hidden
BLOOD
Gold Top Serum Separator Tubes (5 mL)
Price:
$0.00
Quantity:
Lavender Top Whole Blood Tubes (4 mL)
Price:
$0.00
Quantity:
Green Top Tubes Lithium Heparin (6mL)
Price:
$0.00
Quantity:
*Note: Lithium-hep tubes are only for TB
Blood Serum Tube (6mL)
Price:
$0.00
Quantity:
Eclipse Straight Needle 21G x 1-1/4" w/ Guard
Price:
$0.00
Quantity:
Butterfly Needle Kit- Push Button 23g
Price:
$0.00
Quantity:
Tourniquets
Price:
$0.00
Quantity:
Gauze
Price:
$0.00
Quantity:
Bandages
Price:
$0.00
Quantity:
Alcohol Pads (100/pack)
Price:
$0.00
Quantity:
Small Shipping Cooler (Individual) (Comes with 1 Freezer Pack)
Price:
$0.00
Quantity:
*UN3373 labels will be shipped out automatically with blood coolers* *Coolers are for blood only*
Shipping Tape for Coolers
Price:
$0.00
Quantity:
Pipettes
Price:
$0.00
Quantity:
Aliquoting Tubes
Price:
$0.00
Quantity:
Blood Requisitions
Price:
$0.00
Quantity:
Blood Requisitions
Price:
$0.00
Quantity:
INFECTIOUS DISEASE/UPPER RESPIRATORY/COVID-19
Nasal Swab Covid Kit
Price:
$0.00
Quantity:
Saliva Covid Kit
Price:
$0.00
Quantity:
PHARMACOGENOMICS
PGx Req Forms
Price:
$0.00
Quantity:
PGx Collection Kit
Price:
$0.00
Quantity:
OTHER
Patient Consent Card
Price:
$0.00
Quantity:
SHIPPING SUPPLIES
FedEx Envelope
Price:
$0.00
Quantity:
FedEx Label
Price:
$0.00
Quantity:
MARKETING SUPPLIES
Aura PGx Poster
Price:
$0.00
Quantity:
Patient Brocures
Price:
$0.00
Quantity:
Brocure Holder
Price:
$0.00
Quantity:
Total