3 Methylglutaconic Acid, Blood

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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. 3 Methylglutaconic Acid, Blood
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

3META

Test Workstation :

MAYO

Specimen Type:

EDTA, Plasma

Tube Type:

Purple Top (EDTA)

Collection Volume:

5.0 mL

Minimum Volume:

1.5 mL

Storage:

Strict Frozen

Availability:

Sent to Reference Lab

Methodology:

Gas Chromatography Kennedy Kreiger Institute

Special Instructions:

For outpatients, send specimen by courier STAT to hospital laboratory.

Lab/Phone:

330-543-8418

TAT:

1-2 weeks

Additional Info:

Reference range available on patient report

Misc. Referral Test. Gokey ZW175; Referral Code 7

CPT Code:

83921

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3 Methylglutaconic Acid, Blood

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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