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. Fibroblast Culture-Mayo Clinic Sendout
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
FIBR
Test Workstation :
MAYO
Specimen Type:
Skin biopsy- sterile container with standard cell culture media
Tube Type:
Fibroblast transport media (T115). (Obtain from CCL-Sendouts)
Collection Volume:
Skin section 4 mm in diameter
Cause for Rejection:
Specimen dry, not in sterile container, QNS
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Cell Culture
Special Instructions:
4 mm punch skin biopsy in Fibroblast transport media (T115).
Obtain media from CCL(Sendouts). Sterile technique essential for noncontamination of specimen.
Lab/Phone:
330-543-4853
TAT:
41-42 Days
Additional Info:
Growth of cells depends largely on specimen quality.
CPT Code:
Fibroblast Culture CPT 88233 Cryopreservation of Fibroblast cells CPT 88240
Panel Includes:
Fibroblast Culture
Cryopreservation of Fibroblast cells.
Synonyms:
Skin fibroblast
Fibroblast Culture-Mayo Clinic Sendout
Test ID/Workstation :
FIBR
Specimen Type:
Skin biopsy- sterile container with standard cell culture media
Tube Type:
Fibroblast transport media (T115). (Obtain from CCL-Sendouts)
Collection Volume:
Skin section 4 mm in diameter
Cause for Rejection:
Specimen dry, not in sterile container, QNS
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Cell Culture
Special Instructions:
4 mm punch skin biopsy in Fibroblast transport media (T115).
Obtain media from CCL(Sendouts). Sterile technique essential for noncontamination of specimen.
Lab/Phone:
330-543-4853
TAT:
41-42 Days
Additional Info:
Growth of cells depends largely on specimen quality.
CPT Code:
Fibroblast Culture CPT 88233 Cryopreservation of Fibroblast cells CPT 88240
Panel Includes:
Fibroblast Culture
Cryopreservation of Fibroblast cells.
Synonyms:
Skin fibroblast
By using this site, you consent to our use of cookies. To learn more, read our
privacy policy.
