Galactose 1 Phosphate, RBC
| 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. Galactose 1 Phosphate, RBC | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
G1P
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Alternate Tube Type:
Green top (Sodium Heparin) tube: Whole Blood
Collection Volume:
3.0 mL
Minimum Volume:
2.0 mL
Cause for Rejection:
Gross hemolysis
Storage:
Critical Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Specimen only stable for 72 hours.
Please refer to Reference Lab Website for Specimen Processing Instructions.
Lab/Phone:
330-543-8418
TAT:
8-14 days
Additional Info:
Reference range is available on patient report
CPT Code:
84378
