Inhalant 24 Allergen Panel
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Inhalant 24 Allergen Panel | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
INHAL
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
7.5 mL
Minimum Volume:
6.3 ml
Storage:
Refrigerated
Availability:
Sent to Mayo Medical Laboratory
Methodology:
Fluorescence Enzyne Immunoassay ( FEIA)
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference range is available on patient report
CPT Code:
86003
Panel Includes:
Alternaria Tenuis IgE, Aspergillus Fumigatus IgE, Bermuda Grass IgE, Box Elder/Maple,S IgE, Cat Epithelium IgE, Cladosporium IgE, Cocklebur IgE, Cockroach IgE, Cottonwood IgE, Dog Dander IgE, Eastern Sycamore IgE, Elm IgE, House Dust Mites/ D.F. IgE, House Dust Mites/D.P. IgE, Johnson Grass IgE, June Grass IgE, Lamb's Quarter IgE, Mugwort IgE, Nettle IgE, Oak IgE, Rough Marsh Elder IgE, Silver Birch IgE, Short Ragweed IgE, Walnut Tree IgE, White Ash IgE
