Cortisol, Saliva

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. Cortisol, Saliva
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

SALCT

Test Workstation :

MAYO

Specimen Type:

Saliva

Tube Type:

Cortisol, Saliva Collection Kit (T514)

Collection Volume:

1.5 mL

Minimum Volume:

0.6mL

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

liquid Chromatography - tandem Mass Spectrometry (LC-MS/MS)

Special Instructions:

Collect between 11pm and midnight, and record collection time. To use the Salivette: remove top cap of container to expose swab. Place swab directly into mouth by tipping container so swab falls into mouth. Do not touch swab with fingers. Keep swab in mouth for approximately 2 minutes. Roll swab in mouth, do not chew swab. Place swab back in its container without touching, and replace the cap. Record collection time and label specimen. Can also collect 7am to 9am or 3pm to 5pm, however 11pm to midnight is preferred. Record collection time. If multiple specimens are collected, submit each vial under a separate order.

Lab/Phone:

330-543-8418

TAT:

2-4 days

Additional Info:

See reference lab report

CPT Code:

82533

Synonyms:

Nighttime Salivary Cortisol Salivary Cortisol Salivary Cushings Salivary Hydrocortisone

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Cortisol, Saliva

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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