Myelin Basic Protein CSF

Centralized Core Laboratory - Cleveland 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. Myelin Basic Protein CSF
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

MBP

Test Workstation :

CLEVE

Specimen Type:

CSF

Tube Type:

CSF container

Collection Volume:

1.0 mL

Minimum Volume:

0.3 mL

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Enzyme Linked Immunoassay (ELISA)

Special Instructions:

If CSF is bloody, centrifuge the sample and separate supernatant from cells prior to freezing.

Lab/Phone:

330-543-8418

TAT:

2-5 days

Additional Info:

Reference range: 0.00-5.50 ng/mL

Days Performed: Mon, Wed, Fri

CPT Code:

83873

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Myelin Basic Protein CSF

Centralized Core Laboratory - Cleveland Clinic Laboratories : Send Out

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