About Us

Client Supply Request

• Please note: For critical supply needs, Genzyme clients will receive a minimum shipment via FedEx Priority Overnight®. Remainder of shipment will be sent via FedEx Ground®. Order limits are per shipment. If supply quantities beyond the order limits are needed, please call Client Services to discuss - 800-357-5744 Please correct the form fields below.
• Client Account Number (on the right of your test requisition form)^*
• Sub-Client Account Number (on the right of your test requisition form)^*
• Account Name^*
• Your Name^*
• Contact Name (who will receive supplies)^*
• Shipping Address 1^*
• Shipping Address 2
• City^*State^* -- Select -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code^*
• Country^* -- Please Select -- Argentina Australia Austria Belgium Brazil Bulgaria Canada Chile China Colombia Costa Rica Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary India Ireland Israel Italy Japan Korea Malaysia Mexico Netherlands Norway Poland Portugal Romania Russia Singapore South Africa Spain Sweden Switzerland Taiwan Turkey United Arab Emirates United Kingdom United States Venezuela
• Telephone^*
• Email^*
• Confirm Email^*
• Preferred Delivery Date (mm/dd/yyyy)^*

• Select Canisters Required

  Canister	Tube Type	Specimen Type	Test/s	Qty
  AFAFP only	1 - 3ml clear, flat-bottomed test tube	Amniotic Fluid	AFAFP	100 Max
  Amniocentesis w/ AFP	2 - 15ml orange screw-top tubes 1 - 3ml clear, flat-bottomed tube	Amniotic Fluid	Chromosomes, AFAFP	100 Max
  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®	100 Max
  Blood Cytogenetics - Adult w/ or w/o FISH	2 - 6ml sodium heparin (green top) tubes	Blood	Chromosomes, FISH	100 Max
  Blood Cytogenetics - Pediatric w/ or w/o FISH	2 - 4ml sodium heparin (green top) tubes	Blood	Chromosomes, FISH	100 Max
  Cystic Fibrosis	1 - 8.5ml ACD-A (yellow top) tube	Blood	Cystic Fibrosis, CFTR Intron 8 poly(T)	100 Max
  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	100 Max
  Maternal Serum Screening (SST)	1 - 9.5ml serum separator tube	Blood	Afp4®, MSAFP, FirstScreen®, IntegratedScreen®, SequentialScreenSM, SerumIntegratedScreen®	100 Max
  Maternal Serum Screening (Serum Only)	2 - 3ml clear, flat-bottomed tubes	Serum	Afp4®, MSAFP, FirstScreen®, IntegratedScreen®, SequentialScreenSM, SerumIntegratedScreen®	100 Max
  Maternal Serum Screening & Cystic Fibrosis	2 - 8.5ml ACD-A (yellow top) tubes 1 - 9.5ml serum separator tube	Blood	Afp4®, MSAFP, FirstScreen®, IntegratedScreen®, SequentialScreenSM, SerumIntegratedScreen®, Cystic Fibrosis	100 Max
  Molecular Canister	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 Analysis Tay-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-Sachs Disease Enzyme Analysis Tay-Sachs Disease Y Chromosome Microdeletion Analysis Zygosity	100 Max
  Products of Conception (POC)	Call Client Service to obtain media
  Spinal Muscular Atrophy	1 - 8.5ml ACD-A (yellow top) tube	Blood	Spinal Muscular Atrophy	100 Max

• Select Kits Required

  Kit	Tube Type	Specimen Type	Test/s	Qty
  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)	100 Max
  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	100 Max

• Select Boxes Required

  Shipping box (includes shipping box, cold pack, FedEx air bill & diagnostic bag) - Comes in two sizes
  Size	Quantity
  2 Canister	100 Max
  4 Canister	100 Max

• Select Test Requisitions Required

  Shipping box (includes shipping box, cold pack, FedEx air bill & diagnostic bag) - Comes in two sizes
  Test Requisitions	Quantity
  Pregnancy/Preconception	100 Max
  Cytogenetics/FISH/Array CGH	100 Max
  Molecular Genetics	100 Max
  Custom Requisition(s)	100 Max

• Select Patient Education Brochures Required

  Brochure	Quantity
  Afp4®*	100 Max
  FirstScreen®*	100 Max
  IntegratedScreenSM*	100 Max
  SequentialScreenSM*	100 Max
  SerumIntegratedScreenSM*	100 Max
  Amniocentesis*	100 Max
  Chorionic Villi Sampling*	100 Max
  Ashkenazi Jewish Carrier Testing	100 Max
  Cystic Fibrosis (CF)*	100 Max
  Fragile X (FX)*	100 Max
  Spinal Muscular Atrophy (SMA)*	100 Max
  Common Genetic Diseases (CF, FX and SMA combined)	100 Max
  Genetic Screening Question Pads	100 Max
  * - Also available in Spanish

• Select Other Supplies Required

  Item	Quantity
  Tube Labels	100 Max
  Bags: Two-Sided Local Courier	100 Max
  Paper Work	100 Max

• Submit