Lakeland Health Care

Email Forms Manager

**Note:  Federal regulations enable us to supply only those materials necessary to submit specimens to our facility for testing.**

* Indicates required information
Lakeland Laboratory Urinalysis Supplies Order Form 
Date *  (mm/dd/yyyy)
Client Name * 
Client Address * 
Urinalysis Supplies 
Antiseptic Towelette 
Kit: Straw, 1 gray/culture 
Urine Cup with integrated sampling device 
Urine Culture Perservative Tube (gray top) 
Urine Transfer Tube (tiger top preservative) 
Urine Transfer Tube (yellow top) 
24 Hour Urine Containers with Labels and Instructions 
Collection Hats 
Authentication * 

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    Center for Outpatient Services, St. Joseph  
    Hospice at Home Lakeland HealthCare Affiliate  
    Lakeland Community Hospital, Niles  
    Lakeland Community Hospital, Watervliet  
    Lakeland Regional Medical Center, St. Joseph  
    Lakeland Specialty Hospital, Berrien Center  
 
    Lakeland HealthCare Affiliate Physician Practices    
         
         
© 2014   Lakeland HealthCare   1234 Napier Avenue   St. Joseph, Michigan 49085   1-800-968-0115
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