Fillable Ascorbic Acid Injection (Non-Corn) (PF)* 500 mg/mL Ascorbic

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Ascorbic Acid Injection (Non-Corn) (PF)* 500 mg/mL Ascorbic

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7465 W. Sunset Road Suite 1200
Las Vegas, NV 89113
P: 800.995.4363
F: 800.238.8239
503B FDA Registered
Outsourcing Facility
Email Order to 503borders@anazaohealth.com
Office Use Order Form
CB3-020321
PF = Preservative Free **Not Available in CA and MS *Must ship on ice Monday – Thursday ONLY
Compounded items may require an attestation of clinical difference from the prescriber, practitioner administering the preparation or practitioner’s
representative prior to the order being filled.
We offer expedited service for emergencies until 2:30pm (PST) for overnight shipments or 1:30pm (PST) ground shipments in limited areas, provided these
orders can be processed in time for the carrier pick up. Rush orders will incur a $5 fee per preparation.
Commercial Products and B6 cannot ship to California.
Plaquex
®
is a registered trademark of Biorica International Corporation.
Product/Form
Size
Quantity
Ascorbic Acid Injection (Non-Corn) (PF)* 500 mg/mL
10 mL Vial
30 mL Vial
Ascorbic Acid Injection (Preserved Non-Corn) MDV* 500 mg/mL 30 mL Vial
B-Complex Injection (Thiamine HCl, Riboflavin, Pyridoxine HCl, Niacinamide,
Dexpanthenol)
30 mL Vial
B-NAD Injection (B-Nicotinamide Adenine Dinucleotide)*
4 mL Vial
Calcium Chloride Injection (Commercial Product)**
10 mL Vial
Calcium Gluconate Injection (Commercial Product)**
10 mL Vial
Compounded Plaquex
®
Injection**
50 mL Vial
Cyanocobalamin Injection (Preserved Commercial Product)**
30 mL Vial
EDTA Injection (Edetate Disodium) (PF)
10 mL Vial
Folic Acid Injection (Commercial Product) MDV**
10 mL Vial
Glutathione Injection (PF)*
10 mL Vial
Hydroxocobalamin Injection USP (Commercial Product)**
30mL vial
L-Carnitine Injection
30 mL Vial
Lipoic Acid Injection
10 mL vial
Magnesium Chloride Injection (Commercial Product)**
50 mL Vial
Methylcobalamin Injection (Vitamin B12)
10 mL Vial
10 mL Vial
M.I.C. Injection (Methionine / Inositol / Choline)
30 mL Vial
M.I.C. / Vitamin B12 Injection (Methionine / Inositol / Choline /
Cyanocobalamin)
30 mL Vial
Multitrace® -4 Pediatric Trace Elements Injection SDV
Chromium 1 mcg/mL, Copper 0.1 mg/mL, Manganese 25 mcg/mL, Zinc 5
mg/mL, (Commercial Product)**
For IV Use 3 mL Vial
Nandrolone Decanoate Injection
10 mL Vial
PlenishIV™ Nutrient Cocktail (Magnesium Chloride, Calcium Gluconate,
Thiamine, Riboflavin, Pyridoxine, Niacinamide, Dexpanthenol,
Cyanocobalamin)*
10.5 mg / 1.3 mg / 2.6 mg / 0.05 mg /
2.7 mg / 2.6 mg / 6.6 mg / 0.03 mg/mL
50 mL Vial
Sodium Bicarbonate (Commercial Product)**
50 mL Vial
Testosterone Cypionate Injection (Grape Seed Oil) 200 mg/mL
5 mL Vial
10 mL Vial
30 mL Vial
Testosterone Cypionate / Testosterone Enanthate Injection (Grape Seed Oil)
10 mL vial
TriDermaCaine™ BLT Cream (Benzocaine / Lidocaine / Tetracaine)
120 gm pump
Vitamin B6 Injection (Pyridoxine)**
30 mL Vial
Vitamin B6 / Vitamin B1 Injection (Pyridoxine / Thiamine)
30 mL Vial
Zinc Chloride Injection (Commercial Product)**
10 mL Vial
Date ordered: PO #: (If Applicable) ____________________________________________
Customer Name & Account ID: ______________________________________________________________________________________
Shipping Address: ________________________________________________________________________________________________
Prescriber Name: ________________________________________________________ DEA#: __________________________________
Order Placed By: _____________________ Email: _________________________________ Phone: _____________________________
Shipping (Check Box): FedEx Ground (Limited areas) 3
RD
DAY 2
nd
Day Overnight Priority O/N
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Ascorbic Acid Injection (Non-Corn) (PF)* 500 mgmL Ascorbic

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Completed 14 September 2021

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