Supply requests

Client Account Number (on the left of test request forms, six digits)

Sub-client account number

Account name

First name

Last name

Address

City

State

Zip code

Country

Phone

Preferred delivery date

Canisters

Canister	Tube type	Specimen Type	Test(s)	Quantity
AFAFP only	1 - 3ml clear, flat-bottomed test tube	Amniotic Fluid	AFAFP	afafp_only
Amniocentesis w/ AFP	2 - 15ml orange screw-top tubes 1 - 3ml clear, flat-bottomed tube	Amniotic Fluid	Chromosomes, AFAFP	Amniocentesis w/ AFP
Amniocentesis, AFAFP, InSight®	2 - 15ml orange screw-top tubes 1 - 3ml clear, flat-bottomed tube 1 - 15ml blue screw-top tube	Amniotic Fluid	Chromosomes, AFAFP, InSight®	Amniocentesis W AFAFP InSight
Blood Cytogenetics - Adult w/ or w/o FISH	2 - 6ml sodium heparin (green top) tubes	Blood	Chromosomes, FISH	Blood Cytogenetics Adult
Blood Cytogenetics - Pediatric w/ or w/o FISH	2 - 4ml sodium heparin (green top) tubes	Blood	Chromosomes, FISH	Blood Cytogenetics Pediatric
Cystic Fibrosis	1 - 8.5ml ACD-A (yellow-top) tube	Blood	Cystic Fibrosis, CFTR Intron 8 poly(T)	Cystic Fibrosis
Chorionic Villi Sampling	Call Client Services to obtain media
Fragile X	2 - 8.5ml ACD-A (yellow-top) tubes	Blood	Fragile X Syndrome, Fragile X Carrier Test	Fragile X
Maternal Serum Screening (SST)	1 - 9.5ml serum separator tube	Blood	Afp4®, MSAFP, FirstScreen℠, IntegratedScreen®, SequentialScreen℠, SerumIntegratedScreen®	Maternal Serum Screening SST
Maternal Serum Screening (Serum Only)	2 - 3ml clear flat-bottomed tubes	Blood	Afp4®, MSAFP, FirstScreen ℠, IntegratedScreen®, SequentialScreen℠, SerumIntegratedScreen®	Maternal Serum Screening Serum Only
Maternal Serum Screening & Cystic Fibrosis	2 - 8.5ml ACD-A (yellow-top) tubes 1 - 9.5ml serum separator tube	Blood	Afp4®, MSAFP, FirstScreen℠, IntegratedScreen®, SequentialScreen℠, SerumIntegratedScreen®	Maternal Serum Screening Cystic Fibrosis
Molecular Container	3 - 8.5ml ACD-A (yellow-top) tubes	Blood	Ashkenazi Jewish Carrier Screening Tests:Bloom Syndrome Canavan Disease Cystic Fibrosis Familial Dysautonomia Fanconi Anemia Group C Gaucher Disease Glycogen Storage Disease Type 1a Maple Syrup Urine Disease Mucolipidosis Type IV (MLIV) Niemann-Pick Disease Type A Tay-Sachs Disease Enzyme AnalysisTay-Sachs Disease Mutation Analysis Other (Individual) Tests: Bloom Syndrome Canavan Disease Cystic Fibrosis Familial Dysautonomia Factor II Factor V Leiden Fanconi Anemia Group C Fragile X Gaucher Disease Glycogen Storage Disease Type 1a Hemophilia A (Factor VIII)Inversion Huntington's Disease Maple Syrup Urine Disease Maternal Cell Contamination DNA Analysis Mucolipidosis Type IV (MLIV) MTHFR (C677T) Niemann-Pick Type A Rh c/E DNA Rh D Mutation Sickle Cell Anemia Spinal Muscular Atrophy Tay-SachsDisease Enzyme Analysis Tay-Sachs Disease Y Chromosome Microdeletion Analysis Zygosity	Molecular Canister
Products of Conception (POC)	Call Client Services to obtain media			Products of Conception
Spinal Muscular Atrophy	1 - 8.5ml ACD-A (yellow-top) tube	Blood	Spinal Muscular Atrophy	Spinal Muscular Atrophy

Kits

Kit	Tube Type	Specimen Type	Test(s)	Quantity
Bloodspot kit	Shipping box and canister not required. Kit includes, alcohol swab, gauze, Tenderlett, bloodspot card, biohazard Bag and envelope	Blood	FirstScreen℠, Cystic Fibrosis, CFTR Intron 8 poly(T)	Bloodspot Kit
Mouthwash	1 - 50ml orange screw-top tube 1 - Bottle of Scope®	Buccal Cells	Cystic Fibrosis, CFTR Intron 8 poly(T), Ashkenazi Jewish Carrier Screening Tests (excluding Tay Sachs), Maternal Cell Contamination	Mouthwash

Size	Quantity
2 Canister	2 Canister
2 Canister	4 Canister

Test requisitions

Test requisitions	Quantity
Molecular Genetics	Molecular Genetics
Postnatal	Postnatal
Molecular Genetics	Pregnancy Preconception
Prenatal/Cytogenetics/FISH/Microarray	Prenatal Cytogenetics FISH Microarray
Custom Requisition(s)	Custom Requisition

Patient education materials

Brochure	Quantity
Afp4® (also available in Spanish)	AFP4 Brochure
First Screen℠ (also available in Spanish)	FirstScreen Brochure
Integrated Screen℠ (also available in Spanish)	Integrated Screen Brochure
Sequential Screen℠ (also available in Spanish)	SequentialScreen Brochure
SerumIntegrated Screen ℠ (also available in Spanish)	SerumintegratedScreen Brochure
Amniocentesis (also available in Spanish)	Amniocentesis Brochure
Chorionic Villi Sampling (also available in Spanish)	Chronic Villi Sampling Brochure
Ashkenazi Jewish Carrier Testing	Ashkenazi Jweish Carrier Testing Brochure
Cystic Fibrosis (CF) (also available in Spanish)	Cyctic Fibrosis Brochure
Fragile X (FX) (also available in Spanish)	Fragile X Brochure
Spinal Muscular Atrophy (SMA) (also available in Spanish)	Spinal Muscular Atrophy Brochure
Common Genetic Diseases (CF, FX, and SMA combined)	Common Genetics Diseases CF FX SMA Brochure
Genetic Screening Question Pads	Genetic Screening Question Pads Brochure

Other Supplies

Item	Quantity
Tube Labels	Tube Labels
Bags (Two-Sided Local Courier)	Bags Two Sided Local Courier
Tube Labels	Paper Work