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. Alpha -1-Antitrypsin, Stool (Mayo)
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
A1ANT
Test Workstation :
MAYO
Specimen Type:
Stool
Tube Type:
Stool container
Collection Volume:
Random stool collection 5 grams
Minimum Volume:
1 gram
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Nephlometry
Lab/Phone:
330-543-8418
TAT:
1-2 days
Additional Info:
Send frozen in containers supplied. This test is for RANDOM samples ONLY. For 24hr collections please order on a manual requisition and also send 1mL serum (SST tube).
CPT Code:
82103
Alpha -1-Antitrypsin, Stool (Mayo)
Test ID/Workstation :
A1ANT
Specimen Type:
Stool
Tube Type:
Stool container
Collection Volume:
Random stool collection 5 grams
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Nephlometry
Lab/Phone:
330-543-8418
TAT:
1-2 days
Additional Info:
Send frozen in containers supplied. This test is for RANDOM samples ONLY. For 24hr collections please order on a manual requisition and also send 1mL serum (SST tube).
CPT Code:
82103
By using this site, you consent to our use of cookies. To learn more, read our
privacy policy.