Blood and CSF collection supplies have expiration dates determined by the manufacturer. Please limit requests to kits you will use within 2-3 months. Please provide your preferred email address to receive notifications about this request
*
000 - PCM 701- Massachusetts General Hospital 702- Houston Methodist 706- Henry Ford Health 708- Columbia University 709- Dartmouth Hitchcock 710- Duke University Medical Center 711- Emory University 713- Johns Hopkins University 718- Mayo Clinic, Jacksonville 723- University of California, San Francisco 741- Washington University in St. Louis 744- Indiana University ALS Center at IU Health 753- Georgetown University 754- University of California, San Diego 762- Ohio State University 763- Providence Brain and Spine Center 765- Pennsylvania State Medical Center 769- Texas Neurology 777- University of California, Irvine 779- University of Colorado Denver 784- University of Michigan 796- University of Utah 798- University of Washington 812- Northwestern University 816- Universidad de Puerto Rico 833- Hospital for Special Care 839- Nebraska Medicine ALS Treatment Center 844- Barrow Neurological Institute 892- Virginia Commonwealth University 907- Temple University 929- Saint Alphonsus 946- University of Minnesota 936 - Our Lady of the Lake Regional Medical Center 959- University of Alabama, Birmingham
000 - PCM
[site contact]
[shipping address]
[phone number]
[email]
844- Barrow Neurological Institute
Kathleen Nagaran Hildebrand
240 W Thomas Rd
Ste 400
Phoenix, AZ 85013
602-406-7031
kathleen.nagaranhildebrand@dignityhealth.org
nicole.turcotte@dignityhealth.org
708- Columbia University
Benn Hoover
710 W 168TH ST
NI-11-1112
New York, NY 10032
646-574-7399
bnh2119@cumc.columbia.edu
709- Dartmouth Hitchcock
Kevin A. Cornell
Borwell 550W, 1 Medical Center Drive
Lebanon, NH 03756
603-650-6496
Kevin.A.Cornell@hitchcock.org
710- Duke University Medical Center
Emma Ward
932 Morreene Rd
Durham, NC 27705
919-600-3626
emma.ward@duke.edu
711- Emory University
Jen Taylor
101 Woodruff Cir.
Suite 6000
Atlanta, GA 30322
404-251-5365
jennifer.aran.taylor@emory.edu
753- Georgetown University
Brent Harris
Pasquerilla Healthcare Center, 7th Floor
3800 Reservoir Road, NW
Washington, DC 20007
202-687-5345
bth@georgetown.edu
706- Henry Ford Health
Beverley Duthie
[shipping address]
[phone number]
[email]
833- Hospital for Special Care
Sabine Lebel-Hardenack
2150 Corbin Avenue
New Britain, CT 06053
(860)827-1958
SHardenack@HFSC.org
702- Houston Methodist
Delrose Vernon
[shipping address]
[phone number]
[email]
744- Indiana University ALS Center at IU Health
Angela Micheels
355 West 16th Street
Suite 3222
Indianapolis, IN 46202
317-963-7385
amicheel@iu.edu
713- Johns Hopkins University
Betsy Mosmiller
855 N. Wolfe St.
Rm 248
Baltimore, MD 21205
410-502-0495
emosmil1@jhmi.edu
701- Massachusetts General Hospital
Rachel Freedman/Courtney Uek
165 Cambridge Street, Floor 6
Boston, MA 02114
617-724-3268
rfreedman3@mgh.harvard.edu
cuek@mgb.org
718- Mayo Clinic, Jacksonville
Megan Donahue
4500 San Pablo Rd
Jacksonville, FL 32224
904-953-3647
donahue.megan@mayo.edu
839- Nebraska Medicine ALS Treatment Center
Katelyn Hilz
988840 Nebraska Medical Center
Oma, NE 68198
405-559-4504
[email]
812- Northwestern University
Arleen Matos
710 N. Lake Shore Dr.
Chicago, IL 60611
312-503-0748
arleen.matos@northwestern.edu
762- Ohio State University
Carly Failor
2006 Kenny Rd.
Columbus, OH 43221
614-293-4973
Carly.Failor@osumc.edu
936 - Our Lady of the Lake Regional Medical Center
Micah L Klumpp, PhD
[shipping address]
[phone number]
[email]
765- Pennsylvania State Medical Center
Michele Hare
30 Hope Drive
Building B, Suite 1300
Hershey, PA 17033
717-531-0003 (x282351)
mhare@pennstatehealth.psu.edu
763- Providence Brain and Spine Center
Ashley Adamo
5050 NE Hoyt Street
Suite 315
Portland , OR 97213
503-962-1171
ashley.adamo@providence.org
929- Saint Alphonsus
Stacy Smith
1055 North Curtis Road
Boise, ID 83706
208-367-2233
Stacy.Smith@saintalphonsus.org
907- Temple University
John Furey
3401 N Broad St
Philadelphia, PA 19140
267-694-0573
tuf40109@temple.edu
769- Texas Neurology
Haley Rucker
6080 North Central Expressway
Suite 100
Dallas, TX 75206
214-827-3610
hrucker@texasneurology.com
816- Universidad de Puerto Rico
Frances Aponte Caraballo
CHALS-CCT, Biomedical Studies Building II/ACTU
Suite 100, PR Medical Center grounds
San Juan, PR 00935
787-507-0609
frances.aponte2@upr.edu
Internal Note: Please include pre-filled FedEx air waybills in kits for this site.
959- University of Alabama, Birmingham
Melanie Benge
1720 7th Avenue South
SC 420B
Birmingham, AL 35233
205-975-0445
melaniebenge@uabmc.edu
777- University of California, Irvine
Veronica Martin
3800 W. Chapman Ave
Ste 7400
Orange, CA 92868
714-456-7760
vero@hs.uci.edu
754- University of California, San Diego
Thaine Ross
9452 Medical Center Drive
Suite 2W-108, MC0886
La Jolla, CA 92037
858-534-2555
thross@health.ucsd.edu
723- University of California, San Francisco
Bradley Bedell
400 Parnassus Ave
San Francisco, CA 94143
415-501-0671
Bradley.Bedell@ucsf.edu
779- University of Colorado Denver
Alexis Shepardson
12631 E 17th Ave. B185
Rm 5510
Aurora, CO 80045
303-724-7248
Alexis.Shepardson@cuanschutz.edu
784- University of Michigan
Jayna Duell
300 N. Ingalls St.
Room NI 3D02
Ann Arbor, MI 48109
734-936-8776
jkballar@med.umich.edu
946- University of Minnesota
Valerie Ferment
420 Delaware St SE, MMC295
Minneapolis, MN 55455
612-301-1535
ferm0016@umn.edu
796- University of Utah
Scott Redlin
20 South 2030 East
Room 580
Biopolymer Medical Research Bldg
Salt Lake City, UT 84132
801-581-7437
scott.redlin@utah.edu
798- University of Washington
Kinsey Chapman
1959 NE Pacific St
Seattle, WA 98195
206-543-0081
kinseyc@uw.edu
892- Virginia Commonwealth University
Brianna Schibley-Laird
11958 W Broad St 4th Floor
Henrico, VA 23233
315-651-9378
brianna.schibleylaird@vcuhealth.org
741- Washington University in St. Louis
Nathan Budde
660 S. Euclid Ave
MSC 8111-0181-301
St. Louis, MO 63110
314-362-9895
budden@wustl.edu
Is the contact information above all correct?
*
Yes
No
Which information needs to be corrected?
*
Today M-D-Y
View equation
Which kits or supplies are you requesting?
This request will be delivered to your site by ______ .
Please note in Comments if you need this order to arrive sooner . Include date of visit.
*
How many Baseline/Screening Blood Collection Kit (s) do you need for CASE participants?
*
How many Baseline/Screening Blood Collection Kit (s) do you need for CONTROL participants?
*
How many Longitudinal Blood Collection Kit (s) do you need for CASE participants?
*
How many Longitudinal Blood Collection Kit (s) do you need for CONTROL participants?
*
How many CSF Collection Kit (s) do you need?
*
Preferred Sprotte® Needle Gauge (in LP trays)
*
22G
24G
Internal Note: Printed labels should say ASSESS. Include expiration date label on kit bags (blood and CSF). Be sure to double check that the correct CASE or CONTROL labels were used on the kits.
Baseline/Screening Blood Collection Kit
Blood Collection Kit Contents: 2 - EDTA tube (10ml), plastic
1- NaHep PBMC tube (10ml) 2- Red-top Serum tube (10ml) plastic 2 - EDTA tube for whole blood (3ml) 20 - Purple-capped cryovial (Sarstedt), 2ml 2 - Clear-capped cryovial (Sarstedt), 2ml 20 - Red-capped cryovial (Sarstedt), 2ml 3 - Disposable transfer pipette (3ml)
1- Case/Control Neon Label
1 - 81-Slot Cryobox 2 - Biohazard bag w/ absorbent sheet (1 large, 1 small)
1 - Ambient Mailer Kit
1 - ClinPak 2 - UPS Airbill Sleeve 1 - Shipping box/Styrofoam container 1 - UN3373 label 1 - Fragile label 1 - Dry ice label 2 - Bubble sleeves for tubes 50 - Cryohold specimen labels-- Kit numbers
Annual Blood Collection Kit
Blood Collection Kit Contents: 2 - EDTA tube (10ml), plastic 2- Red-top Serum tube (10ml) plastic 2 - EDTA tube for whole blood (3ml) 20 - Purple-capped cryovial (Sarstedt), 2ml 2 - Clear-capped cryovial (Sarstedt), 2ml 20 - Red-capped cryovial (Sarstedt), 2ml 2 - Disposable transfer pipette (3ml)
1 - 81-Slot Cryobox 2 - Biohazard bag w/ absorbent sheet (1 large, 1 small) 1 - UPS Airbill Sleeve 1 - Shipping box/Styrofoam container 1 - UN3373 label 1 - Fragile label 1 - Dry ice label 2 - Bubble sleeves for tubes 50 - Cryohold specimen labels-Kit numbers
Each CSF Collection Kit
30 - Clear-capped cryovial, 2ml (Sarstedt) 2 - 15ml Centrifuge tube, individually wrapped 2 - 50ml Centrifuge tube, individually wrapped 1 - Medication Transfer Filter Straw 1 - LP tray with ______ gauge Sprotte® needle