Dermatopathology Supply Form

Full Name

First Name

Last Name

Mailing Address

Email Address

Formalin

7ml (100 bottles per case)

20ml (96 bottles per case)

40ml (96 bottles per case)

60ml (96 bottles per case)

20ml (500 bottles per case)

Michel's Transport Medium

for Immunoflourescense studies (bottles)

Biohazardous specimen bags

(30 bags per bundle)

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