Testosterone, Free

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. Testosterone, Free
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

TESFR

Test Workstation :

MAYO

Specimen Type:

Blood

Tube Type:

Serum Red Top Tube(no anticoagulant)

Collection Volume:

7.5 mL

Minimum Volume:

2.5mL

Cause for Rejection:

Grossly hemolyzed, Gross icterus, Gross lipemia, serum separator tube or serum gel.

Storage:

Refrigerated

Availability:

Sent to Reference Laboratory

Methodology:

Testosterone Free - Equilibrium Dialysis/Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Testosterone Total - Liquid Chromatography-Tandem Mass Spectrometry

Lab/Phone:

330-543-8418

TAT:

3-7 days

Additional Info:

Reference range available on patient report

CPT Code:

84402, 88403

Panel Includes:

Testosterone, Free and Total

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Testosterone, Free

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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