Everolimus, 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. Everolimus, Blood
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

EVERB

Test Workstation :

MAYO

Specimen Type:

Whole Blood

Tube Type:

EDTA Purple Top Tube

Collection Volume:

3.0 mL

Minimum Volume:

1.0 mL

Cause for Rejection:

Clotted specimens

Storage:

Refrigerated

Availability:

Sent to Reference Laboratory

Methodology:

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Special Instructions:

Draw Blood immediately before next scheduled dose. Do not centrifuge. Send specimen in original tube.

Lab/Phone:

330-543-8418

TAT:

1-2 days

Additional Info:

Reference range available on patient report

CPT Code:

80169

Synonyms:

Afintor Evero Zortress

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Everolimus, Blood

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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