Muscular Dystrophy Biopsy Sample Requirements
| Sample: | Frozen muscle (or skin for CMD or EDMD) |
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| Ship to: |
Steven A. Moore, M.D., Ph.D. University of Iowa Hospitals and Clinics Department of Pathology, 5231 RCP 200 Hawkins Drive Iowa City, IA 52242 |
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| Shipping Requirements: | Overnight delivery with hazardous material precautions. Monday through Friday delivery only, pack on 5-10 lbs. of dry ice. Samples that cannot arrive Monday through Friday should be stored at –70o C. until shipped for arrival M-F. |
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| Please include: | |
| Specimen Information: |
All information must be provided before testing is
performed Patient full name (Last, First, MI) Patient identifier Date of birth and sex Date and time of collection Ordering physician |
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| Billing Information: | Please see Billing Options |
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| Reporting Information: |
Because of confidentiality issues, the report will not be
released to any other individual or institution than is listed
on this form. Physician or institution to send report to Address to send report to Phone number of individual or institution above Fax number to send report to if desired |
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| Turn Around Time: | 7-14 days |
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| CPT Codes: | 88323 and 88346 (for each antibody utilized) |
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| Contact Information: |
UIDL Client Services Monday-Friday - 8:00 am-6:30 pm CST Saturday - 8:00 am-1:00 pm CST Phone - 866-844-2522 Fax - 319-384-7213 |