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. Galactosylceramide Beta Galactosidase, WBC
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
GBG
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Yellow top (ACD) tube: Whole Blood
Alternate Tube Type:
Lavender Top- EDTA
Collection Volume:
6.0 mL
Minimum Volume:
2.0 mL
Cause for Rejection:
A frozen specimen; Gross Hemolysis
Storage:
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 must arrive within 72 hours of draw to be stabilized. Draw MonThurs only and not the day before a holiday. Specimen should be drawn and packaged as close to shipping time as possible.
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 must arrive within 72 hours of draw to be stabilized. Draw MonThurs only and not the day before a holiday. Specimen should be drawn and packaged as close to shipping time as possible.
