Supply Form
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Supply Form

Supplies


As a convenience to our clients, you may now order supplies on-line. This will accurately expedite the shipping of your requested supplies. If preferred, you can print out the supply order and complete by hand to be sent by fax or specimen shipment.
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FORMS & LABELS
TUBES
NEEDLES
TRANSPORT
MICROBIOLOGY
DRUG SCREEN
MOLECULAR
CHARGEABLE ITEMS
MISCELLANEOUS
*Compliance Notice*

*The office of the Inspector General through its "special fraud alerts" to the Health Care Industry has identified a possible violation of the Fraud and Abuse Laws. This abuse arises when the Reference Laboratory provides bulk supplies, ie, tubes, needles, media, etc. to the referring client and those supplies are used by the client for testing performed in the Laboratory. This is then viewed as a benefit to the provider and the anti-kickback statute is implicated. 4ZCFR1001.952(H)(3)(iii). By pushing submit, I certify that the supplies requested on this form are solely for the purpose of collecting specimens for referral to Kansas Pathology Services LLC. *