Centralized Core Laboratory - Mayo Clinic Laboratories :
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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. Galactose 1 Phosphate, RBC
2.
3.
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5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
G1P
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Alternate Tube Type:
Green top (Sodium Heparin) tube: Whole Blood
Collection Volume:
3.0 mL
Minimum Volume:
2.0 mL
Cause for Rejection:
Gross hemolysis
Storage:
Critical Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Specimen only stable for 72 hours.
Please refer to Reference Lab Website for Specimen Processing Instructions.
Lab/Phone:
330-543-8418
TAT:
8-14 days
Additional Info:
Reference range is available on patient report
CPT Code:
84378
Galactose 1 Phosphate, RBC
Test ID/Workstation :
G1P
Specimen Type:
Whole Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Collection Volume:
3.0 mL
Cause for Rejection:
Gross hemolysis
Storage:
Critical Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Specimen only stable for 72 hours.
Please refer to Reference Lab Website for Specimen Processing Instructions.
Lab/Phone:
330-543-8418
TAT:
8-14 days
Additional Info:
Reference range is available on patient report
CPT Code:
84378
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