2.1. Field 12 (Patient Street Address).

2.2. Field 13 (City).

2.3. Field 15 (State).

2.4. Field 16 (Zip).

2.5. Field 39 (Test(s) Requested).

2.6. Field 41 (Clinical History).

3.1. Feces Appearance (if available):

3.1.1. Indicate if this is an initial specimen from a patient (“1st specimen”) or if it is a follow up specimen for clearance (“2nd” or “3rd”).

3.1.2. Check any appropriate descriptors for the fecal specimen appearance.

3.2. Culture Independent Diagnostic Test (CIDT):

3.2.1. If results for a CIDT are available, select the platform used from the drop-down list. If “Lab developed test (LDT)” is selected enter a description of the LDT in the blank to the right.

3.2.2. If the specific platform used is not listed select “Other platform” and enter the name of the platform in the blank to the right.

3.2.3. REQUIRED Check all analytes that were positive by CIDT. If the analyte(s) is not listed check “other” under bacterial and enter the analyte(s) identified; enter the information in this field regardless if the analyte is bacterial or not. Include the CT values results from the CIDT if available.

3.2 Comment

Used for other information.

6.1 Clinical specimens should be appropriately sealed to prevent leakage during transport.

6.2 Label the sample tube with at least two identifiers (i.e. the patient’s name, submitter

lab number, date of birth) and the date inoculated.

6.3 For safety, all submitted sample tubes must have a tightened screw cap secured in place using tape.

6.4 Before shipment, insert the completed Lab Form 414 and all attachments between the inner and outer shipping containers.

6.5. Follow all other submission guidelines as described in in the “General Specimen Submission Instructions ” and guides located on the MDL Services and Test Catalog website. 

6.6 If you have any questions regarding sample submission, call the MDL for guidance – 510-412-3700.