We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Mitotane

Centralized Core Laboratory : Chemistry

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. Mitotane
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

MIT2 MAYO

Specimen Type:

Blood

Tube Type:

Green top (sodium heparin)tube - Plasma

Collection Volume:

5.0 mL (minimum 1.0 mL)

Storage:

Refrigerated

Availability:

Sent to Reference Laboratory

Methodology:

Gas Chromatography/Flame Ionization Detection (GC-FID)

Special Instructions:

Draw blood in a green-top (sodium heparin) tube. Lab - Spin down and send sodium heparin plasma refrigerated in a plastic vial.

Lab/Phone:

330-543-8418

TAT:

5-9 days

Additional Info:

Reference range available on patient report

CPT Code:

80375

Synonyms:

Lysodren

While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. It brings the entire family together for emotional support and understanding across multiple locations to reach you in the community where you live. Learn more...