Infliximab QN with Reflex to Ab
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Infliximab QN with Reflex to Ab | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
INFXR
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant)tube
Collection Volume:
2.5 mL (minimum 1.5 mL)
Cause for Rejection:
Grossly hemolyzed, grossly icteric or collected in Plasma, whole blood, SST tubes.
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
INFX: Selective Reaction Monitoring LC-MS/MS
INXAB: Electrochemiluminescent Bridging Immunoassay with Acid Dissociation
Special Instructions:
Draw blood immediately before next scheduled dose (trough specimen).
For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.
Lab/Phone:
330-543-8418
TAT:
3-6 days
Additional Info:
Reference range available on patient report.
CPT Code:
80230
82397- if appropriate
