Centralized Core Laboratory - Mayo Clinic Laboratories :
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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. Interleukin-2
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
INTL2
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant), gold top (SST gel-tube), or green top (lithium heparin) tube
Collection Volume:
2.5 mL (minimum 1.0 mL)
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Quantitative Multiplex Bead Assay
Special Instructions:
Place specimen on ice after collection. Centrifuge specimen and freeze aliquot within 2 hours of collection.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
1-12 days
Additional Info:
Reference range: 2.1 pg/mL or less
CPT Code:
83520
Interleukin-2
Test ID/Workstation :
INTL2
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant), gold top (SST gel-tube), or green top (lithium heparin) tube
Collection Volume:
2.5 mL (minimum 1.0 mL)
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Quantitative Multiplex Bead Assay
Special Instructions:
Place specimen on ice after collection. Centrifuge specimen and freeze aliquot within 2 hours of collection.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
1-12 days
Additional Info:
Reference range: 2.1 pg/mL or less
CPT Code:
83520
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