Beta Galactosidase, Leukocytes
| 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. Beta Galactosidase, Leukocytes | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
BGAL
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Yellow top (ACD) tube: Whole Blood
Collection Volume:
6.0 mL
Minimum Volume:
5.0 mL
Storage:
Refrigerated
Availability:
Sent to reference lab; tested Tues
Methodology:
Fluorometric
Special Instructions:
Deliver to lab promptly.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)
Lab/Phone:
330-543-8418
TAT:
8 days
Additional Info:
Reference range: > or =1.56 nmol/min/mg
CPT Code:
82657
