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   Lab-In-A-Box®, Kits & Supplies Ordering Form

Lab-In-A-Box® Kits   Lab-In-A-Box® Supplies
Lab-In-A-Box®, Adult  Kit Qty   Veni-Packs  $2.95 each
Lab-In-A-Box®, Pediatric  Kit Qty   Culturette Swabs
Lab-In-A-Box®, Blood Culture  Kit Qty   Urine Packs
Lab-In-A-Box®, Trace Metal  Kit Qty    
Multi-Packs, Adult  Kit Qty    
Multi-Packs, Pediatric  Kit Qty    
For training material, contact Cinda Moss   at 615-472-9013 or email cmoss@hhla.com

Company Information
*Company Name
*Company Branch
*Contact Name
*Contact Email
*Contact Phone Number  999-999-9999
*Street Address
*City
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*Zip Code
Date Needed By  mm-dd-yyyy
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