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. Insulin Antibodies
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
INSAB
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
4.0 mL (minimum 2.5 mL)
Cause for Rejection:
Gross hemolysis, Grossly lipemia, Gross icterus
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Radioimmunoassay (RIA)
Special Instructions:
Do not administer isotopes 24 hours prior to collection.
TAT:
3-9 days
Additional Info:
Reference range: < or = 0.02 nmol/L
CPT Code:
86337
Synonyms:
Human Insulin Antibodies
Insulin Antibodies
Test ID/Workstation :
INSAB
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
4.0 mL (minimum 2.5 mL)
Cause for Rejection:
Gross hemolysis, Grossly lipemia, Gross icterus
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Radioimmunoassay (RIA)
Special Instructions:
Do not administer isotopes 24 hours prior to collection.
TAT:
3-9 days
Additional Info:
Reference range: < or = 0.02 nmol/L
CPT Code:
86337
Synonyms:
Human Insulin Antibodies
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There are 10 nurses in the picture.
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The five differences are:
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The two matching doctors are 9 and 14.
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The correct path:
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