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.

Venoms Allergen Profile

Centralized Core Laboratory : Immunology

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. Venoms Allergen Profile
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

INSEC MAYO

Specimen Type:

Blood

Tube Type:

Red top ( no anticoagulant) tube

Collection Volume:

1.5 mL

Storage:

Refrigerated

Availability:

Sent to mayo Medical Laboratory

Methodology:

Fluorescence Enzyme Immunoassay (FEIA)

Lab/Phone:

330-543-8418

Additional Info:

Reference range is available on patient report

CPT Code:

86003

Panel Includes:

Honeybee venom IgE,Yellow Faced Hornet IgE, Yellow Jacket Venom IgE, Wasp Venom, IgE, White Faced Hornet Venom IgE

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