VS 4-12 National Veterinary Services Laboratories Kit and Instru

Clear Form
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control number. The valid OMB control number for this information collection is 0579-0430. The time required to complete this information collection is estimated to average 2 minutes per
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Send comments regarding this burden statement or any other aspect of this information collection, including suggestions for reducing this burden, to [email protected].

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

OMB APPROVED
0579-0430
Exp. xx/xxxx

NATIONAL VETERINARY SERVICES LABORATORIES
KIT AND INSTRUMENT ORDER FORM

CONTACT NAME:
ORGANIZATION COMPANY:
ADDRESS (do not use a P.O. Box) CITY, STATE, ZIP CODE:
TELEPHONE NUMBER:

DATE OF REQUEST:

ITEM

QUANTITY

ITEM

BSE FRESH TISSUE

DIAGNOSTIC KITS

KIT #5 (5 red-top tubes)

LARGE

KIT #10 (10 red-top tubes)

SMALL

QUANTITY

KIT #25 (25 red-top tubes)
SCRAPIE (Formalin)

INSTRUMENTS

KIT #1 (2-180 ml jars)

SPOONS, SMALL

KIT #2 (12-180 ml jars)

SPOONS, LARGE

KIT #3 (2-90 ml jars)

FORCEPS (rat tooth)

KIT #4 (12-90 ml jars)

METZENBAUM SCISSORS (curved nose)

TB KITS

DRESSING SCISSORS (straight nose)

SLAUGHTER (black/yellow)

SCALPELS (10 per box)

DEER (orange)

RECTAL SPECULUM

MEDIA

MISCELLANEOUS KITS

TBTB 5 ml (10/box)

FADD REPLENISHMENT

TBTB 3 ml (each)
3 ml BHI BROTH (40 tubes/box; no antibiotics)

(Blue cap/plastic tube. For up to 5 swabs OP/CL swab pools from
avian spp. See NVSL WI-AV-0020 for details.)

AI KITS

5.5 ml BHI BROTH WITH ANTIBIOTICS (40 tubes/box)

(Black cap/plastic tube. For up to 11 TR/OP swab pools from
gallinaceous poultry or environmental sample collection;
Refer to NVSL WI-AV-0020 for further details.)

COLLECTION KIT (STP 210)

FORMALIN CASE SIZE

MISCELLANEOUS ITEMS

90 ml (96/case)

AI BAR CODES (4/set) (Specify roll or set)

180 ml (64/case)

BSE BAR CODES (8/set) (Specify roll or set)
TISSUE CASSETTE
BIOPSY SPONGES

Fax all supply orders to NVSL Shipping Department at 515-337-7378 or email to [email protected].
The NVSL Shipping Department may be reached at [email protected].
Safety data sheets may be obtained at
https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/sa_lab_information_services/sa_reagents/ct_safety
Please make a copy of all orders for your records.
VS FORM 4-12
FEB 2021