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# A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

There are currently 25 names in this directory beginning with the letter D.

Dabigatran

Synonyms Pradaxa® (Dabigatran Etexilate) Expected Turnaround Time 4 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents For more information, please view the literatre below. Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium Sample Report Specimen Requirements Specimen Plasma Volume 1 mL Minimum Volume 0.5 mL (Note: This volume does not allow for repeat testing.) Container Blue-top (sodium citrate) tube (preferred), lavender-top (EDTA) tube, or green-top (heparin) tube Collection Transfer plasma to a plastic transport tube. Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 7 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Test Details Use Measurement of drug level in order to monitor therapeutic level and/or diagnose under-dosage or potential toxicity. Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS) Additional Information Dabigatran etexilate mesylate (Pradaxa®) is a selective, reversible, direct thrombin inhibitor that has been approved for thromboprophylaxis to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.1-4 Dabigatran etexilate is a prodrug that is administered orally and has a bioavailability of 6.5%. After absorption into the bloodstream, the prodrug is converted by ubiquitous esterases to the active drug, dabigatran. Approximately one third of circulating dabigatran is bound to plasma proteins.5 Maximum serum concentrations are reached between 1.5 and 3 hours after dosing.6,7 Pharmacokinetic studies reveal an interindividual coefficient of variation of approximately 30%.6 Dabigatran is widely distributed through the bloodstream but does not cross the blood-brain barrier to an appreciable extent.8 Repeated administration in patients with normal renal function is 14 to 17 hours permitting a once daily administration of the drug.6 Approximately 80% of the dabigatran in the blood is eliminated unchanged through renal excretion.9 As a consequence, there is a risk of drug accumulation in patients with renal impairment.4,10 Renal function should be evaluated before prescribing dabigatran.11,12 The FDA-approved 150-mg twice-daily dabigatran for patients with normal renal function and 75-mg twice-daily for patients with impaired renal function (ie, a creatinine clearance 20 to 50 mL/minute). Renal function should be assessed on a regular basis in situations in which decline anticipated and at least yearly for patients older than 75. Because dabigatran is not metabolized by cytochrome P450 isoenzymes, it has few major interactions with other drugs;9 however, drugs that either induce or inhibit P-glycoprotein can affect the absorption of the drug in the gut.9 There is no reversal agent for dabigatran, although hemodialysis can be employed for rapid removal of the drug in life-threatening circumstances.13 A procoagulant, such as recombinant-activated factor VII, can also be employed in the management of severe bleeding associated with dabigatran.13 Routine therapeutic monitoring of dabigatran levels is not required because of the drug's relatively wide therapeutic index. Despite the use of fixed doses of dabigatran, determination of the amount of drug present in a given individual may be valuable in several clinical situations. Measurement of levels can inform clinicians with concerns regarding patient compliance and adherence to therapy.14 Dabigatran is transported across the intestinal wall by P-glycoprotein, and drugs that induce or inhibit P-glycoprotein activity may decrease or increase the levels of dabigatran, respectively.4 Therapeutic monitoring can help the clinician assess the potential cause of bleeding or thrombosis while on therapy. Determination of levels may also be useful in preparation for surgery or an invasive procedure. Also, drug level measurement can be valuable in determining drug accumulation in situations of renal or hepatic failure and when administered with other drugs that may alter metabolism or clearance. Total dabigatran, ie, the sum of dabigatran and its pharmacologically active glucuronides,15 is measured after complete alkaline cleavage of the glucuronide conjugates present in the samples using a validated liquid chromatography/mass spectrometry (LC/MS-MS) method. Use of liquid LC/MS-MS provides highly accurate measurement of dabigatran concentrations without the variable interferences associated with traditional clot-based and chromogenic assays.16,17 In fact, studies performed using the LabCorp LC/MS-MS method indicate the assayed drug recovery was unaffected by the presence of lupus anticoagulants or heparin administration. Factor VIII deficiency and multiple factor deficiency associated with coumadin treatment had no effect on the recovery of drug.

Dehydroepiandrosterone (DHEA)

Synonyms DHEA Unconjugated DHEA Expected Turnaround Time 4 - 6 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Multiple-specimen Testing Related Documents For more information, please view the literature below. Adrenal Steroid Response to ACTH: Pediatrics Sample Report Specimen Requirements Specimen Serum Volume 1 mL Minimum Volume 0.5 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube or gel-barrier tube Collection If a red-top tube is used, transfer separated serum to a plastic transport tube. Storage Instructions Refrigerate Stability Requirements Temperature Period Room temperature 6 hours Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Test Details Use Evaluate adrenal carcinomas that frequently secrete large amounts of DHEA Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Deoxypyridinoline (Dpd) Cross-links (Serial Monitor)

Test Includes Long-term serial monitoring of results; color graphic summary report Special Instructions The account must submit the patient' s Social Security number to monitor. Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Expected Turnaround Time 2 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine Volume 10 mL Minimum Volume 1 mL Container Plastic urine container, no preservative Collection Collection before 10 AM is recommended (eg, first morning void). Do not add preservative. Storage Instructions Refrigerate. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Blood contamination Test Details Use The Dpd test can be used as a tool to assess bone resorption rates in healthy individuals and in patients with enhanced risk of developing metabolic bone disease. Significantly high levels of Dpd are found in children, in postmenopausal women due to estrogen deficiency, and in patients with diseases that have high bone turnover rates. Dpd can be used to monitor antiresorptive therapies in postmenopausal women and in individuals diagnosed with osteoporosis. Limitations This test has not been established to predict development of osteoporosis or future fracture risk. Methodology Immunochemiluminometric assay (ICMA) Reference Interval • Pediatric:1 − Prepubertal (Tanner Stage I): <41.8 nmol Dpd/mmol creatinine − Pubertal (Tanner Stage II to IV): <83.5 nmol Dpd/mmol creatinine • Adults: 2.3−7.4 nmol Dpd/mmol creatinine Additional Information Bone is constantly undergoing a process of remodeling that consists of degradation, or resorption, mediated by osteoclasts and rebuilding mediated by osteoblasts. This process is tightly coupled in individuals with healthy bone metabolism. In certain conditions, the rate of resorption exceeds the rate of rebuilding resulting in a net loss of bone. Deoxypyridinoline (Dpd) is a crosslink of type 1 collagen that provides tensile strength to the collagen matrix of bone. Dpd is released into circulation during bone resorption and is excreted unmetabolized into urine. Since Dpd levels are not affected by diet or physical exercise, urinary Dpd concentrations reflect the true rate of bone turnover.

Dermatophagoides farinae

Dermatophagoides microceras

Expected Turnaround Time 2 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Individual Allergens Related Documents Sample Report Specimen Requirements Specimen Serum Volume 0.2 mL Minimum Volume 0.1 mL Container Red-top tube or gel-barrier tube Storage Instructions Room temperature Test Details Use Detect possible allergic responses to Dermatophagoides microceras, a house dust mite. Quantitative allergen-specific IgE test is indicated: • To determine whether a patient has elevated allergen-specific IgE antibodies • If specific allergic sensitivity is needed to allow immunotherapy to be initiated • When testing patients for agents that may potentially cause anaphylaxis • When evaluating patients who are taking medications (eg, long-acting antihistamines) that interfere with other testing modalities (eg, skin testing) • If immunotherapy or other therapeutic measures based on skin testing results have not led to a satisfactory remission of symptoms • When a patient is unresponsive to medical management where identification of offending allergens may be beneficial Methodology Thermo Fisher ImmunoCAP®

Dermatophagoides pteronyssinus

Desomorphine, Screen and Confirmation, Urine

Synonyms Permonid® Test Includes Desomorphine Expected Turnaround Time 7 - 21 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Acetylmorphine, Urine Specimen Requirements Specimen Urine (random) Volume 10 mL Minimum Volume 3 mL Container Plastic urine container without preservative Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Causes for Rejection Urine in preservative tube Test Details Use Detect the presence of desomorphine (dihydrodesoxymorphine) a highly addictive opioid derivative of codeine. Methodology Initial presumptive testing by liquid chromatography tandem mass spectrometry (LC/MS-MS) at a testing threshold of 1.0 ng/mL; presumptive positives confirmed by definitive liquid chromatography tandem mass spectrometry (LC/MS-MS) at a testing threshold of 1.0 ng/mL

Diabetes Autoimmune Profile

Expected Turnaround Time 8 - 15 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Serum, frozen Volume 2.5 mL Minimum Volume 1.0 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube or gel-barrier tube Collection Transfer specimen to a plastic transport tube before freezing. To avoid delays in turnaround time when requesting multiple test on frozen samples, please submit separate frozen specimens for each test requested. Storage Instructions Freeze. Stable at room temperature or refrigerated for one day. Stable frozen for seven days. Freeze/thaw cycles: stable x3. Causes for Rejection Gross hemolysis; lipemic specimen; EDTA plasma Test Details Use Diabetes autoantibodies assessment is helpful in identifying and managing patients at risk for development of type 1 diabetes. Published positivity rates for diabetes autoantibodies in new-onset type 1 diabetes patients listed below are based on the combined analysis of GAD-65, ICA 512, insulin antibodies, and ZnT8 antibodies. The combined analysis has a 98% autoimmunity detection rate, with 1.8% diabetic individuals remaining as autoantibody-negative. fewer than 3% of type 2 diabetics have positive antibodies.1 Positive rate in new-onset type 1 diabetes patients: • GAD-65 antibodies = 68% positive • ICA 512 antibodies = 72% positive • Insulin antibodies = 55% positive • ZnT8 antibodies = 63% positive An increase in the number of positive antibodies is associated with a higher likelihood of type 1 diabetes. Methodology Enzyme-linked immunosorbent assay (ELISA), radioimmunoprecipitation

Diabetes Comorbidity Assessment

Special Instructions State patient's age and sex on the request form. Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents For more information, please view the literature below. Prediabetes Clinician Booklet Prediabetes Q&A for Clinicians Sample Report Specimen Requirements Specimen Serum (preferred) or plasma and random urine Volume 3 mL serum or plasma and 10 mL urine Minimum Volume 1 mL serum or plasma and 2 mL urine Container Red-top tube, gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube and plastic urine container Collection Separate serum or plasma from cells within 45 minutes of collection. Lipid panels are best avoided for up to three months following acute myocardial infarction, although cholesterol can be measured in the first 24 hours. Collect random urine without preservatives. pH must be 4 to 8. Storage Instructions Maintain specimens at room temperature. Stability Requirements Temperature Period Room temperature 3 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x2 Patient Preparation Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen. Causes for Rejection Specimen with greatly elevated triglycerides (>400 mg/dL); improper labeling; hemolysis Test Details Use This test is intended to help inform the clinician about the presence of hyperlipidemia as an index to cardiovascular disease and to identify patients with chronic kidney disease. Limitations LDL cholesterol cannot be calculated if triglyceride is >400 mg/dL. Methodology Lipid Profile With Non‐HDL Cholesterol: See individual tests. Kidney Profile ‐ creatinine: kinetic jaffe. Albumin: immunoturbidimetric Additional Information The relationship between diabetes, cardiovascular disease, and chronic kidney disease is widely recognized. Among individuals with type 2 diabetes, cardiovascular disease is the leading cause of morbidity and mortality. Chronic kidney disease occurs in 20% to 40% of patients with diabetes and may be present at the time of diagnosis. While not considered to be a clinical entity itself, individuals with prediabetes are at increased risk for diabetes and cardiovascular disease. Additionally, observational evidence has linked prediabetes with early nephropathy, chronic kidney disease, small fiber neuropathy, diabetic retinopathy, and increased risk of macrovascular disease.

Diazepam, Serum or Plasma

Synonyms Diastat® Diastat® AcuDial™ Diazepam Intensol™ Valium® Test Includes Diazepam; nordiazepam (diazepam metabolite) Expected Turnaround Time 2 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum or plasma Volume 1 mL Minimum Volume 0.4 mL Container Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant. Collection Transfer separated serum or plasma to a plastic transport tube. Oral: peak: one hour after dose; IV: peak: 15 minutes after dose. Storage Instructions Refrigerate. Causes for Rejection Gel-barrier tube Test Details Use Diazepam is effective in the management of generalized anxiety disorder and panic disorder in appropriately selected patients. Its use prior to endoscopy or cardioversion relieves anxiety and diminishes the patient's recall of the procedure. Preoperative use relieves anxiety and tension and may provide anterograde amnesia. Additional uses include the treatment of skeletal muscle spasms due to inflammation or trauma, spasticity (eg, multiple sclerosis, cerebral palsy, paraplegia, stiff-man syndrome), seizure disorders (eg, status epilepticus, febrile seizures), and alleviation of abstinence symptoms during alcohol withdrawal. Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS) Reference Interval Therapeutic: diazepam + nordiazepam: 0.2−2.5 μg/mL Critical Value Potentially toxic: >5.0 μg/mL Additional Information Diazepam is a muscle relaxant and antianxiety drug. Peak blood levels are achieved within an hour after oral dose. Half-life in adults is 21 to 37 hours. The major metabolite (nordiazepam) has a half-life in adults of 50 to 99 hours. It is the major metabolite also of clorazepate and prazepam. Minor active metabolites of diazepam are temazepam (3-hydroxydiazepam) and oxazepam (3-hydroxy-N-diazepam).1,2 Diazepam may exhibit synergism with barbiturates, tricyclic antidepressants, and amine oxidase inhibitors. Toxicity may be additive with other central nervous system depressants, and ethanol enhances the absorption of diazepam itself. Many cases of overdose are seen but few fatalities result from use of this drug alone. A frequent finding is a combination of this drug and ethanol.

Digoxin, Random

Synonyms Lanoxin® Special Instructions Be sure patient is not on digitoxin. This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample. Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 0.8 mL Minimum Volume 0.3 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube or gel-barrier tube Collection If a red-top tube is used, transfer separated serum to a plastic transport tube. Random collection is for those cases in which a digoxin is collected at a time other than the ideal collection time. Ideally, blood specimen is drawn six to eight hours after the administration of the last dose (levels drawn earlier than six hours after a dose will be artificially elevated). Collect specimen just before dose if steady-state estimate is needed. The steady-state is usually attained in five days. Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Citrate plasma specimen; improper labeling Test Details Use Diagnose and prevent digoxin toxicity; prevent underdosage; monitor therapeutic drug level; prevention and therapy of cardiac arrhythmias Limitations Digoxin should not be confused with digitoxin. The elimination half-life in normal subjects is 37 hours. Patients with renal failure may have an endogenous digoxin-like material in their serum which makes digoxin measurements unreliable. Methodology Kinetic interaction of microparticles in solution (KIMS)

Digoxin, Unbound, Serum or Plasma

Synonyms Digitek® Digox® Lanoxin® Expected Turnaround Time 2 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Serum or plasma Volume 3 mL Minimum Volume 1.2 mL Container Red-top tube or green-top (heparin) tube Collection Serum or plasma should be separated from cells within two hours of venipuncture. Submit serum or plasma in a plastic transport tube. Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Specimen is stable for three days at room temperature, for two weeks refrigerated, and for six months frozen. Causes for Rejection Gel-barrier tubes Test Details Use Therapeutic drug management; management of digoxin overdose post Digibind® Methodology Ultrafiltration; immunoassay (IA) Reference Interval 0.3−1.5 ng/mL

Dihydrolipoamide Dehydrogenase (DLD)

Synonyms Lipoamide Dehydrogenase (LAD) Special Instructions If cultured cells are needed, an additional 7-12 days may be required. Additional culture fee may be included. Expected Turnaround Time 7 - 15 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Whole blood, amniotic fluid, chorionic villus sample (CVS) (Submission of maternal blood is required for fetal testing.), or LabCorp buccal swab kit (Buccal swab collection kit contains instructions for use of a buccal swab.). Volume 7 mL whole blood, 10 mL amniotic fluid, 20 mg CVS, or LabCorp buccal swab kit Minimum Volume 3 mL whole blood, 5 mL amniotic fluid, 10 mg CVS, or two buccal swabs Container Lavender-top (EDTA) tube, yellow-top (ACD) tube, sterile plastic conical tube or two confluent T-25 flasks for fetal testing, or LabCorp buccal swab kit Storage Instructions Maintain specimen at room temperature. Test Details Use Detect dihydrolipoamide dehydrogenase deficiency (DLD) Methodology DNA analysis Additional Information Dihydrolipoamide dehydrogenase deficiency (DLD), also known as lipoamide dehydrogenase deficiency (LAD), is an autosomal-recessive disorder that occurs at an increased frequency in individuals of Ashkenazi Jewish descent, with a carrier frequency of 1 in 96. DLD presents as persistent lactic acidosis with recurrent episodes of vomiting and abdominal pain. There is progressive neurological impairment, hepatomegaly, cortical blindness, stupor, and coma. Mortality is high. Couples who are planning a pregnancy or who are already pregnant may decide to have testing to find out whether they are carriers and at risk of having a baby with DLD. DLD mutation analysis tests for two mutations for a 95% carrier detection rate in the Ashkenazi Jewish population.

Dilute Prothrombin Time

Synonyms Tissue Thromboplastin Inhibition Test Includes Dilute prothromboplastin time (dPT) Expected Turnaround Time 2 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents For more information, please view the literature below. Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium Sample Report Specimen Requirements Specimen Plasma, frozen Volume 1 mL Container Blue-top (sodium citrate) tube Collection Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (ie, "butterfly"), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp No. 49482). Freeze immediately and maintain frozen until tested. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume. Storage Instructions Freeze. Patient Preparation Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to the test and heparin, direct Xa, and thrombin inhibitor therapies for about three days prior to testing. Do not draw from an arm with a heparin lock or heparinized catheter. Causes for Rejection Severe hemolysis; improper labeling; clotted specimen; specimen diluted with IV fluids; samples thawed in transit; improper sample type; sample out of stability Test Details Use Qualitative detection of lupus anticoagulants (LA) in plasma6 Limitations Improper preparation of the platelet-poor plasma at collection reduces the sensitivity of this assay for LA.6,7 The screening assay can be prolonged in patients with congenital or acquired factor deficiency and will be elevated in individuals on warfarin therapy.7 The reagent contains agents that neutralize unfractionated heparin at plasma levels up to 1.0 unit/mL.7 Samples with levels higher than this can produce anomalous results.7 No single LA test can detect all LA-positive patients. The ISTH recommends that any sample suspected of having LA be tested using two or more LA screening tests.6 Methodology Clotting time is measured using a dilute prothrombin time (dPT) reagent consisting of a unique formulation of relipidated recombinant tissue factor and calcium.8 Samples with extended dPT are tested in a confirmatory assay including excess phospholipid. The sample is considered to be positive for lupus anticoagulant when the dPT ratio (ie, dPT:confirm) is >1.15. Additional Information Lupus anticoagulants are antibodies which inhibit one or more of the in vitro phospholipid-dependent tests of coagulation (eg, APPT, KCT, dRVVT, dPT). Recently, the SCC Subcommittee for the Standardization of Lupus Anticoagulants provided guidelines for the laboratory diagnosis of LA.6 No single screening test can detect all LA-positive patients. The ISTH recommends that any sample suspected of having LA be tested using two or more LA screening tests.6,9 The other screening tests commonly used to detect LA assess inhibitors of the intrinsic pathway (aPTT-LA) and the common pathways (dRVVT). The dPT assay screens for the phospholipid-dependent inhibitors of a different part of the coagulation cascade, the extrinsic pathway.10 The standard prothrombin time (PT) is usually normal in patients with LA because the thromboplastin reagent used in this assay typically contains a high concentration of phospholipids;11 however, in the dPT assay, the thromboplastin reagent is diluted, increasing assay sensitivity for phospholipid-dependent inhibitors of the extrinsic pathway.11 Several reports have suggested that a dPT assay using recombinant tissue factor and synthetic phospholipids can be sensitive for LA.11,12 The use of a higher phospholipid concentration confirmatory test allows for determination of the phospholipid dependence of the inhibitor.6

Diphtheria Antitoxoid Antibodies

Synonyms Diphtheria Antibodies Diphtheria Toxin Antibodies Expected Turnaround Time 1 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 0.5 mL Minimum Volume 0.25 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube or gel-barrier tube Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen Unstable Causes for Rejection Gross hemolysis; lipemia; bacterial contamination Test Details Use Assess immunity against diphtheria by determining levels of circulating antibodies to diphtheria toxin or to measure the immune response, postvaccination, in individuals suspected of immunodeficiency disorders Limitations This procedure is rarely used for confirmation of diphtheria infection; it cannot accurately discriminate antibodies between 0.10 IU/mL and 0.01 IU/mL. Immunity declines with age. This procedure may be considered by Medicare and other carriers as investigational and, therefore, may not be payable as a covered benefit for patients. Methodology Enzyme immunoassay (EIA)

Diuretic Analysis, Urine

Test Includes Benzthiazide; bumetanide; chlorothiazide; chlorthalidone; furosemide; hydrochlorothiazide; hydroflumethiazide; metolazone Expected Turnaround Time 10 - 14 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine (random) Volume 10 mL Minimum Volume 1.2 mL Container Plastic urine container without preservative Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Causes for Rejection Urine from a preservative tube Test Details Use Detect presence of diuretic class drugs Methodology High-pressure liquid chromatography with ultraviolet detection (HPLC/UV)

Dockweed, Yellow

Synonyms Yellow Dockweed Expected Turnaround Time 3 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Individual Allergens Related Documents Sample Report Specimen Requirements Specimen Serum Volume 0.2 mL Container Red-top tube or gel-barrier tube Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 3 months Freeze/thaw cycles Stable x3 Test Details Methodology Thermo Fisher ImmunoCAP®

Drug Abuse Profile (DOT), Urine (9 Drugs) (MS Confirmation Included at an Additional Charge)

Synonyms Drug Abuse Screen (DOT), Urine (9 Drugs) confirmation included at an additional charge Special Instructions Initial testing uses immunoassay with mass spectrometry (MS) confirmation. Testing may vary depending upon a number of variables, including the need for compliance with The Department of Transportation (DOT), company guidelines, collective bargaining agreements, or other guidelines. It is the responsibility of the client to confirm applicable requirements. Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine Volume 30 mL (primary), 15 mL (split) Container Collection kit that meets DOT guidlines. Collection kits are available by request from the laboratory. Collection Chain-of-custody is initiated through the use of special request forms and packaging materials and by following the special packaging instructions supplied by the laboratory. Chain-of-custody is included at no charge in all DOT drug abuse tests. Storage Instructions Maintain specimen at room temperature. If arrival at the lab will extend beyond 7 days then refrigerate. Test Details Methodology Initial testing by immunoassay; confirmation of positives by mass spectrometry (MS)

Drug Abuse Profile (Routine), Urine (Seven Drugs) (MS Confirmation Included)

Test Includes Amphetamines; barbiturates; benzodiazepines; cannabinoids (THC); cocaine metabolite; opiates (codeine, morphine only); phencyclidine (PCP) Special Instructions Whenever positive results from preliminary testing are obtained, confirmation by mass spectrometry (MS) is automatic. The components of profiles for employment/preëmployment testing may vary depending upon a number of variables, including the need for compliance with company guidelines, collective bargaining agreements, or state or local guidelines. It is the responsibility of the client to confirm applicable requirements. “Chain-of-custody” handling is initiated through the use of our special request forms and packaging materials and by following the special packaging instructions supplied by the laboratory. Expected Turnaround Time 1 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine (random) Volume 30 mL Container Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory. Collection Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes. Storage Instructions Maintain specimen at room temperature. If arrival extends beyond seven days, then refrigerate. Causes for Rejection Quantity not sufficient for analysis; improper specimen (serum, plasma, blood); incomplete chain-of-custody documentation; incomplete specimen identification; improper or missing tamper-evident seals Test Details Use Detect the presence of prescribed and illicit drugs Methodology Initial test by immunoassay (IA); confirmation of positives by mass spectrometry (MS)

Drug Abuse Profile (Without THC), Urine (Eight Drugs)

Synonyms Immunoassay Nine With Reflex to Confirmation Test Includes Amphetamines; barbiturates; benzodiazepines; cocaine (metabolite); creatinine; dilution detection; methadone screen; opiates; oxycodone/oxymorphone; pH; phencyclidine (PCP); propoxyphene. This profile contains expanded benzodiazepine confirmation on reflex of positive screen. Opiate confirmation of positive screen includes hydrocodone, hydromorphone, codeine, and morphine. Expected Turnaround Time 3 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine Volume 30 mL Container Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory. Storage Instructions Maintain specimen at room temperature. If arrival at the lab will extend beyond seven days, then refrigerate. Test Details Use Detect the presence of prescribed and illicit drugs Methodology Initial testing by immunoassay (IA); confirmation of positives by mass spectrometry (MS)

Drug Abuse Profile, Urine (Seven Drugs + Alcohol)

Test Includes Amphetamines; barbiturates; benzodiazepines; cannabinoids (THC); cocaine; ethanol; opiates (codeine, morphine only); phencyclidine (PCP) Special Instructions Confirmation by mass spectrometry (MS) is included at an additional charge. Expected Turnaround Time 2 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine (random) Volume 30 mL Container Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory. Collection Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes. Storage Instructions Maintain specimen at room temperature. If arrival extends beyond seven days, then refrigerate. Test Details Use Detect the presence of prescribed and illicit drugs, including ethanol Methodology Initial test by immunoassay (IA); confirmation of positives by mass spectrometry (MS)

Drug Analysis Profile, Comprehensive, Urine

CPT: 80307; 80326; 80331; 80334; 80337; 80338; 80341; 80344; 80346; 80348; 80353; 80354; 80355; 80357; 80358; 80359; 80360; 80361; 80364; 80365; 80366; 80367; 80368; 80370; 80371; 80372; 80373; 80377; 83992 Include LOINC® in print Test Includes Alcohol; amphetamines; analgesics/NSAIDS; anesthetics (local); anticonvulsants; antidepressants; antihistamines; antipsychotics; barbiturates; benzodiazepines; buprenorphine; cannabinoids (THC); cocaine metabolite; creatinine; fentanyl and analogues; methadone; muscle relaxants; opiates; other hallucinogens; other opioids; oxycodone; sedatives/hypnotics; sympathomimetics; tapentadol; and miscellaneous drugs. For a complete list of profile components, see Drug Analysis Profile, Comprehensive (791194), under Related Documents. Expected Turnaround Time 5 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents For more information, please view the literature below. Drug Analysis Profile, Comprehensive, Urine (791194) Specimen Requirements Specimen Urine (random or spot collection) Volume 30 mL Minimum Volume 3 mL Storage Instructions Room temperature is acceptable for shipping and/or short-term storage (three days); specimen may also be refrigerated or frozen. Causes for Rejection Incorrect sample type; name discrepancy; no name on sample; no name on test request form Test Details Use Detect the presence of abused, prescribed, and over-the-counter drugs in urine Methodology Immunoassay (IA) and liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Drug Screen and Confirmation (10 Drug Classes), Meconium

Test Includes Amphetamines; barbiturates; benzodiazepines; cocaine and metabolites; methadone; opiates; oxycodones; phencyclidine (PCP); propoxyphene; tetrahydrocannabinol (THC) Expected Turnaround Time 3 - 6 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Meconium Volume 5 Grams Minimum Volume 1 Gram Container Meconium Collection Kit (PeopleSoft N° 96663) or clean, leakproof polypropylene container. Collection Specimens from different voidings may be pooled if necessary. For step-by-step instructions for collecting and preparing meconium specimens, see Meconium Testing Collection Instructions. Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Test Details Use Detect fetal exposure to controlled drugs Methodology Initial presumptive testing by immunoassay at the following testing thresholds: amphetamines, 100 ng/gm; barbiturates, 100 ng/gm; benzodiazepines, 100 ng/gm; cocaine and metabolites, 50 ng/gm; methadone, 50 ng/gm; opiates, 50 ng/gm; oxycodones, 50 ng/gm; phencyclidine (PCP), 25 ng/gm; propoxyphene, 100 ng/gm; tetrahydrocannabinol (THC), 25 ng/gm; presumptive positives confirmed by definitive chromatography mass spectrometry (GC/MS or LC/MS-MS).

Drug Screen and Confirmation (Five Drug Classes) With Oxycodone, Meconium

Test Includes Amphetamines; cocaine metabolite; opiates; oxycodone; tetrahydrocannabinol (THC) Expected Turnaround Time 3 - 6 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Meconium Volume 5 grams Minimum Volume 1 gram Container Meconium Collection Kit (PeopleSoft No. 96663) or clean, leakproof polypropylene container Collection Specimens from different voidings may be pooled if necessary. For step-by-step instructions for collecting and preparing meconium specimens, see Meconium Testing Collection Instructions. Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Test Details Use Detect fetal exposure to controlled substances Methodology Initial presumptive testing by immunoassay at the following testing thresholds: amphetamines, 100 ng/gm; cocaine and metabolites, 50 ng/gm; opiates, 50 ng/gm; oxycodones, 50 ng/gm; tetrahydrocannabinol (THC), 25 ng/gm; presumptive positives confirmed by definitive liquid chromatography tandem mass spectrometry (LC/MS-MS).

Drug Screen, Serum and Whole Blood

Test Includes Acetone; butalbital; chlordiazepoxide; diazepam; ethanol; isopropanol; methanol; norchlordiazepoxide; nordiazepam; pentobarbital; phenobarbital; salicylates Special Instructions Sample is tested for the presence of the substances listed above (see Test Includes). Drugs will be quantitated; please indicate suspected substance, if possible. Expected Turnaround Time 3 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum and whole blood Volume 4 mL serum and 7 mL whole blood Minimum Volume 1.5 mL serum and 0.5 mL whole blood Container Red-top tube and gray-top (sodium fluoride) tube Collection Separate serum from cells and transfer to a plastic transport tube. Submit full, unopened gray-top tube for analysis of volatiles. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant. Storage Instructions Refrigerate. Causes for Rejection Gel tube; hemolysis; gross lipemia; icteric specimen Test Details Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS), gas chromatography, spectrophotometry, and immunoassay

Common Lab Tests

Complete Blood Count

This test, also known as a CBC, is the most common blood test performed. It measures the types and numbers of cells in the blood, including red and white blood cells and platelets. This test is used to determine general health status, screen for disorders and evaluate nutritional status. It can help evaluate symptoms such as weakness, fatigue and bruising, and can help diagnose conditions such as anemia, leukemia, malaria and infection.

Prothrombin Time

Also known as PT and Pro Time, this test measures how long it takes blood to clot. This coagulation test measures the presence and activity of five different blood clotting factors. This test can screen for bleeding abnormalities, and may also be used to monitor medication treatments that prevent the formation of blood clots.

Basic Metabolic Panel

This test measures glucose, sodium, potassium, calcium, chloride, carbon dioxide, blood urea nitrogen and creatinine which can help determine blood sugar level, electrolyte and fluid balance as well as kidney function. The Basic Metabolic Panel can help your doctor monitor the effects of medications you are taking, such as high blood pressure medicines, can help diagnose certain conditions, or can be part of a routine health screening. You may need to fast for up to 12 hours before this test.

Lipid

Panel

The lipid panel is a group of tests used to evaluate cardiac risk. It includes cholesterol and triglyceride levels.

Liver Panel

The liver panel is a combination of tests used to assess liver function and establish the possible presence of liver tumors.

Hemoglobin A1C

This test is used to diagnose and monitor diabetes.

Urinalysis

Often the first lab test performed, this is a general screening test used to check for early signs of disease. It may also be used to monitor diabetes or kidney disease.

Cultures

Cultures are used to test for diagnosis and treatment of infections. Illnesses such as urinary tract infections, pneumonia, strep throat, MRSA and meningitis can be detected and tested for appropriate antibiotic treatment.

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