Inhalant 24 Allergen Panel

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. Inhalant 24 Allergen Panel
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

INHAL

Test Workstation :

MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

7.5 mL

Minimum Volume:

6.3 ml

Storage:

Refrigerated

Availability:

Sent to Mayo Medical Laboratory

Methodology:

Fluorescence Enzyne Immunoassay ( FEIA)

Lab/Phone:

330-543-8418

TAT:

1-3 days

Additional Info:

Reference range is available on patient report

CPT Code:

86003

Panel Includes:

Alternaria Tenuis IgE, Aspergillus Fumigatus IgE, Bermuda Grass IgE, Box Elder/Maple,S IgE, Cat Epithelium IgE, Cladosporium IgE, Cocklebur IgE, Cockroach IgE, Cottonwood IgE, Dog Dander IgE, Eastern Sycamore IgE, Elm IgE, House Dust Mites/ D.F. IgE, House Dust Mites/D.P. IgE, Johnson Grass IgE, June Grass IgE, Lamb's Quarter IgE, Mugwort IgE, Nettle IgE, Oak IgE, Rough Marsh Elder IgE, Silver Birch IgE, Short Ragweed IgE, Walnut Tree IgE, White Ash IgE

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Inhalant 24 Allergen Panel

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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