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Device Order Form

Fields with * are required
*Company Name:
*Contact Name:
*Address 1:
Address 2:
*City:
*State:
Province:
*Postal Code:
*Email:
*Phone:
DEA Number:

The sale of these items is subject to strict regulation by the U.S. Food and Drug Administration as well as state and local regulatory agencies. Do not purchase items unless you are an authorized purchaser. We will verify your status as an authorized purchaser of restricted items before shipping if a DEA number is not provided. Authorization verification may delay shipment of your order.

By supplying a DEA number you agree to let Northeast Scientific, Inc. verify your approval to purchase FDA regulated items. DEA numbers will not be held on file, however a record of approval will be retained for future purchases.

Ethicon Trocars & Cannula
Model
Size
Style
Price Per Unit
Quantity To Order
B5ST 5x75mm Stability qty:
CB5LT 5x100mm Stability Cannula Only qty:
B5LT 5x100mm Stability qty:
B5LP 5x100mm Smooth qty:
B5LPH 5x100mm Smooth w/Handle qty:
B5XT 5x150mm Stability qty:
B8LT 8x100mm Stability qty:
CB11LT 11x100mm Stability Cannula Only qty:
B11LT 11x100mm Stability qty:
B11LTH 11x100mm Stability w/Handle qty:
CB12LT 12x100mm Stability Cannula Only qty:
B12LT 12x100mm Stability qty:
H12LP 12x100mm Smooth w/Anchor qty:
B15LT 15x100mm Stability qty:

*Shipping:
Ground: | Overnight
Preferred Shipper:
Shipping Account Number:

Buyers are responsible for all shipping costs.
Preferred shipper and shipper account number are optional.


Please note: you only need to click the "Submit" button one time. You will see a confirmation page once the form has been submitted successfully.