Piedmont Pathology Associates, Inc.
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   Lab Supplies Order Form
PPA provides, free of charge, supplies that our clients require to collect specimens to be sent to PPA for analysis.

Please provide your account information:

Account Name:  
Contact Name:  
Phone Number:  

Please provide the following ordering information:

   Test Request Forms
QTY DESCRIPTION
Urology
Biopsy
Non-Gyn (Cytology)
   Tissue Containers
QTY DESCRIPTION
Pre-filled formalin 5ml
Pre-filled formalin 20ml
Pre-filled formalin 40ml
Pre-filled formalin 60ml
Pre-filled formalin 120ml
Plastic Container with Lid 8oz
Plastic Container with Lid 16oz
Plastic Container with Lid 32oz
Plastic Container with Lid 65oz
Plastic Container with Lid 92oz
Plastic Container with Lid 165oz
   Cytology
QTY DESCRIPTION
Cytology Fixative
30ml Cytolyt Vials
30ml Cytolyt Cups
Lg Cardboard Slide Holder
Sm Cardboard Slide Holder
Prostate Biopsy Kits
Slides (box)
   Bags
QTY DESCRIPTION
Bags - 6 x 9 Transport w/ Pouch
Bags - Large Biohazard
   Miscellaneous
QTY DESCRIPTION
Supply Request Forms
Other -
   Other Supplies
QTY DESCRIPTION
Other -
Other -
Other -
Other -

Si necesita asistencia, llame al 828-267-3543
© 2008 Piedmont Pathology Associates, Inc
1899 Tate Boulevard SE - Suite 1105 - Hickory - North Carolina - 28602
Phone: (828) 322-3821 - Toll Free (888) 339-8147 - Fax: (828) 322-1122
Billing Phone: (828) 322-3572 - Billing Toll Free (866) 520-9915 - Billing Fax: (828) 322-6697