Galactose 1 Phosphate Uridyltransferase, RBC
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Galactose 1 Phosphate Uridyltransferase, RBC | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
G1PUT
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Alternate Tube Type:
Green top (Sodium Heparin) tube or Yellow Top (ACD) tube: Whole Blood
Collection Volume:
5.0 mL (minimum 2.0 mL)
Cause for Rejection:
A frozen specimen
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Enzyme Reaction followed by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Lab/Phone:
330-543-8418
TAT:
3-6 days
Additional Info:
Reference range is available on patient report
CPT Code:
82775
