Email Us Your Order

Instead of faxing in your order, fill out the form provided and we'll email you a copy of the Purchase Order for your records.

Shipping is FOB Lake Villa Net 30 Days.

Sales tax will be added on dependant on the state it is shipped to.

Email Address
Email Address To Send You A Copy
Full Name
Company Name
Ship To Address
Bill To Address
Telephone Number
Account Number
5-HOLE FOAM INSERT (INF-FI-5)	Case Qty.
BIOSORB POWDER 16 OUNCE BOTTLES (INFBIO-16)	Bottle Qty.
BIOSORB POWDER 16 OUNCE BOTTLES (INFBIO-16)	Bottle Qty.
BIOSORB POWDER 2 OUNCE BOTTLES (INFBIO-20)	Case Qty.
BIOSORB POWDER 8 OUNCE (INFBIO-80)	Case Qty.
BIOSORB STRIPS BY THE CASE (INFBIOS-425225-2) - $370.00	Case Qty.
BIOSORB STRIPS (INFBIOS-425225-1)	Pack Qty.
DIAGNA-PAK 95 KPA BAG (INFDIAG-95)	Case Qty.
DIAGNA-PAK AMB (INFDIAG-AMB-1)	Case Qty.
DIAGNA-PAK 17B (INFDIAG-17B)	Case Qty.
DIAGNA-PAK 20B (INFDIAG-20B)	Case Qty.
SMC-7 SINGLE MAILING CASE (INFSMC-7)	Case Qty.
SMC-10 SINGLE MAILING CASE (INFSMC-10)	Case Qty.
INFEKTA-PAK 1 (INF-1)	Case Qty.
INFEKTA-PAK 1 - 4-Pack (INF-1-4)	Case Qty.
INFEKTA-PAK 2 (INF-2)	Case Qty.
Class 6 Infectious Substance (IPIL-1-BK-6)	Pack Qty.
UN 3373 Diagnostic Specimen (IPIL-3)	Pack Qty.
UN 3373 Diagnostic Specimen (IPIL-2)	Pack Qty.