March 2026: New Chemistry Standard Transport Tube

Special Communication

New Chemistry Standard Transport Tube

Effective March 9, 2026.

New Chemistry Standard Transport Tube Implemented for All Cleveland Clinic Locations

A new standard transport tube will be implemented for all Cleveland Clinic locations and clients on March 9, 2026. This new tube will replace the existing transport tube (Sarstedt product number 62.612) for most specimens that need to be aliquoted. The existing transport tube will no longer be accepted after March 31. Please refer to the test directory or procedure catalog for test-specific requirements.

March 2025: Test Changes to Oxidized Low-Density-Lipoprotein & Lipoprotein-associated Phospholipase A2 Activity

Special Communication

Test Changes – Oxidized Low-Density-Lipoprotein (OXLDL) & Lipoprotein-associated Phospholipase A2 Activity (PLAA2)

Effective March 18, 2025.

Starting March 18, 2025, Oxidized Low-Density-Lipoprotein (OXLDL) & Lipoprotein-associated Phospholipase A2 Activity (PLAA2) will be sent to a different performing reference laboratory (LabCorp).

Refer to the table below for an outline of testing changes.

Please contact Client Services with any questions or for assistance.

Test Change Overview

Lipoprotein-associated Phospholipase A2 Activity (Lp-PLA2 Activity) (PLAA2)

New Test

Old Test

Performing Laboratory

LabCorp

Cleveland HeartLab

Methodology

Spectrophotometric/Enzymatic assay

Enzymatic assay

Specimen Collection

Serum, 0.5 mL

Gold Serum Separation Tube (SST)

Serum

Minimum Volume

0.2 mL

0.5 mL

Transport Temperature

Refrigerated

Refrigerated

Reference Interval

<225 nmol/min/mL

≤123 nmol/min/mL

Please note the change in units and reference interval.

Turnaround Time

3-5 days

4-5 days

Oxidized Low-Density-Lipoprotein (OXLDL)

New Test

Old Test

Performing Laboratory

LabCorp

Cleveland HeartLab

Methodology

Enzyme-Linked Immunosorbent Assay (ELISA)

Enzyme-Linked Immunosorbent Assay (ELISA)

Specimen Collection

Plasma, 0.5 mL

Lavender K2EDTA Tube

Plasma

Lavender K2EDTA Tube

Minimum Volume

0.2 mL

0.2 mL

Transport Temperature

Critical frozen

Refrigerated

Reference Interval

10-170 ng/mL

<60 U/L

Please note the change in units and reference interval.

Turnaround Time

4-6 days

2-6 days

October 2024: Stool Testing Universal Laboratory (STUL) Kit for Microbiology

Special Communication

Stool Testing Universal Laboratory (STUL) Kit for Microbiology

Effective October 1, 2024.

The Stool Testing Universal Laboratory (STUL) Kit for Microbiology contains the collection and transport items necessary for most stool testing.

Place all (3) vials into the white STUL Kit bag or a large biohazard bag with Beaker labels attached externally.

All vials remain at Main Campus for add-on testing, stability permitting. Refer to the Microbiology Collection & Transport Guide: Stool Collection Devices for specific test and item information.

September 2024: Test Update – Vasoactive Intestinal Polypeptide (VIP), Plasma

Special Communication

Test Update – Vasoactive Intestinal Polypeptide, Plasma (VIP)

Effective October 8, 2024.

Beginning October 8, 2024, Vasoactive Intestinal Polypeptide, Plasma (VIP) will return to the previous reference lab following the resolution of the reagent shortage.

Refer to the table below for an outline of testing changes.

Please contact Client Services with any questions or for assistance.

Test Change Overview

Vasoactive Intestinal Polypeptide, Plasma (VIP)

For specimens collected between 9/17/24 and 10/8/24, the VIP order will be canceled and replaced by a MISC1 test due to the test at Mayo being discontinued as of 9/17/24 with no advance notice.  The specimen will be sent to ARUP and results will be uploaded as a PDF when they are received.

New Test

Old Test

Performing Laboratory

ARUP

Mayo Clinic Laboratories

Methodology

Enzyme-linked immunosorbent assay (ELISA)

Enzyme-linked immunosorbent assay (ELISA)

Specimen Collection

Plasma, 2 mL

Lavender K2EDTA tube

Plasma, 1 mL

Lavender K2EDTA tube

Minimum Volume

0.5 mL

0.5 mL

Transport Temperature

Critical frozen

Critical frozen

Reference Interval

0-89.1 pg/mL

0-36 pg/mL

Turnaround Time

4-8 days

6-10 days

Vendor Test Information

TEST ID : FVIP2

Sept 2024: Immediate Test Change – Testosterone, Free and Total

Immediate Test Change

Test Update – Testosterone, Free and Total (TFTEST)

Effective September 12, 2024.

Beginning September 12, 2024, Testosterone, Free and Total (TFTEST) will be sent to a different reference laboratory due to an emergency inactivation at the current reference laboratory because of reagent problems.

This follows an extended test delay since April of this year.

Please contact Client Services with any questions or for assistance.

For specimens ordered and collected before September 12, 2024, but not received by Mayo before September 12, 2024, Mayo will send them to LabCorp for testing. When available, those results will be uploaded as scanned documents to the lab order.

Test Change Overview

Testosterone, Free and Total (TFTEST)

As part of this change, the test’s name has been modified to clarify its contents and how it is performed. Test name changes for the other testosterone assays are planned for later this fall.

New Test

Old Test

Test Name

Testosterone, free and total, by equilibrium ultrafiltration mass spectrometry

Testosterone, Free and Total

Performing Laboratory

LabCorp

Mayo Clinic Laboratories

Methodology

Equilibrium ultrafiltration; Liquid chromatography/tandem mass spectrometry

Equilibrium dialysis; Liquid chromatography/tandem mass spectrometry

Specimen Collection

Serum, 2.2 mL

Red (No Additive) Tube

Serum, 2.5 mL

Red (No Additive) Tube

Minimum Volume

1.8 mL

1 mL

Transport Temperature

Ambient

Refrigerated

Turnaround Time

5-7 days

4-8 days (delay as of April 19, 2024)

Vendor Test Information

June 2024: Test Update – Vasoactive Intestinal Polypeptide (VIP), Plasma

Immediate Test Change

Test Update – Vasoactive Intestinal Polypeptide, Plasma (VIP)

Effective June 27, 2024.

Beginning June 27, 2024, Vasoactive Intestinal Polypeptide, Plasma (VIP) will be sent to a different reference laboratory due to issues with the current reagent manufacturer.

Refer to the table below for an outline of testing changes.

Please contact Client Services with any questions or for assistance.

Test Change Overview

Vasoactive Intestinal Polypeptide, Plasma (VIP)

Additional patient preparation information for the new test:
Patients must fast for 10-12 hours and avoid antacid medications or medications that affect intestinal motility for at least 48 hours before collection.

New Test

Old Test

Performing Laboratory

Mayo Clinic Laboratories

ARUP

Methodology

Enzyme-linked immunosorbent assay (ELISA)

Radioimmunoassay (RIA) 

Specimen Collection

Plasma, 1 mL

Lavender K2EDTA tube

Plasma, 1 mL

PPACK tube

Minimum Volume

0.5 mL

0.5 mL

Transport Temperature

Critical frozen

Frozen

Reference Interval

0-36 pg/mL

0-60 pg/mL 

Turnaround Time

6-10 days

4-8 days 

Vendor Test Information

November 2023: Product Discontinuation – BD CultureSwab™

Immediate Test Change

Product Discontinuation: BD CultureSwab™ Liquid Amies Double Swab

Effective November 14, 2023.

Replacements: eSwab™ or Cepheid Collection Device

The eSwab™ (Copan Diagnostics) collection device—utilized by Cleveland Clinic for 8+ years—will now be the primary swab for bacteriology.

No change to the swabbing collection process is needed when using an eSwab™.

Although typically tissue or fluid is a superior quality sample for bacteriology, collecting a swab is often more feasible. The eSwab™ uses a patented flocked swab, which enables the elution of the primary sample into 1 mL of liquid contained within the collection tube. The bacteriology laboratory then uses this liquid for testing.

Swab discontinued by the manufacturer.

Choose the appropriate collection device: 

eSwab™

Use for:
Group A Strep PCR GASPCR

Fungal Screen for Candida FUNGSC

Bacteriology cultures:
• Abscess & Wound Culture WCUL
• Anaerobe Culture ANACUL
• Cystic Fibrosis Respiratory Culture CFRCUL
• Ear Culture & Stain EARCSM
• Eye Culture & Stain EYECSM
• MRSA culture screen MRSASC
• MRSA/S. aureus culture screen SANSAL
• Throat Culture THRCUL
• VRE Culture VRESC

Cepheid Collection Device

Use for:
Routine Prenatal Group B PCR GBPCR

S. aureus PCR SAPCR

November 2023: Test Update – Chromogranin A, New Assay

Immediate Test Change

Test Update – Chromogranin A (CHROMA), New Assay

Effective November 9, 2023.

Chromogranin A (CHROMAwill be updated to a new assay effective November 9, 2023.

The results of the current and new tests are not interchangeable. Due to a reagent shortage, the laboratory will not be able to undergo a rebaseline/parallel testing process.

Please contact Client Services for laboratory assistance with interpreting results in patients undergoing serial monitoring.

Test Change Overview

Chromogranin A (CHROMA)

Update?

Details

Methodology

Yes

New Assay:
Immunoassay, BRAHMS CGA II Kryptor Kit

Discontinued:
Cisbio CGA II, ELISA

The results in the new assay are, on average, 20% lower than the previous assay. The bias is more pronounced at concentrations below 200 ng/mL, where the observed bias is 30%.

Test Code

No

Specimen

No

Type
Serum

Container
Gold Serum Separator Tube, or
Red Plain (No Additive) Tube

Stability

Yes

Ambient:
48 hours

Refrigerated:
48 hours

Frozen:
3 months

Transport samples frozen.

Days Performed

Yes

Days Performed
Tuesday, Friday

Reported
1-4 days

Reporting

Yes

Reference Interval
<187 ng/mL

The results of the new and old assays will not trend together in the laboratory information system (e.g., Beaker/EPIC).

November 2023: Test Delay – Oxalate, Plasma and Oxalate, 24-hour Urine

Immediate Test Change

Test Delay – Oxalate, Plasma (OXLATE) and Oxalate, 24-hour Urine (UOXALD)

Effective November 6, 2023.

Oxalate, Plasma (OXLATE) and Oxalate, 24-hour Urine (UOXALD) will be delayed effective November 6, 2023, due to a global reagent shortage.

Currently, there are no alternative testing options available.

The vendor expects the reagent to be available in late November/December 2023.

For Existing Orders/Specimens
Specimens will be stored frozen, pending the arrival of the reagent. However, if specimens exceed validated stability (4 weeks for plasma specimens, 7 days for urine specimens), testing will be canceled.

Questions?
Please contact Client Services for assistance.

September 2023: Changes to Reference Ranges – Catecholamines, Fractionated, Plasma (PLCAT)

Special Communication

Changes to Reference Ranges – Catecholamines, Fractionated, Plasma (PLCAT)

Effective October 2, 2023.

Catecholamines, Fractionated, Plasma (PLCAT)

Epinephrine (18 years and older)
Seated (15 min): Less than or equal to 330 pmol/L
Supine (30 min): Less than or equal to 265 pmol/L

Norepinephrine (18 years and older)
Seated (15 min): 1050-4800 pmol/L
Supine (30 min): 680-3100 pmol/L

Dopamine (18 years and older)
Seated (15 min): Less than or equal to 240 pmol/L
Supine (30 min): Less than or equal to 240 pmol/L