How to Order a Test
Requisition Form (does not contain price or CPT code information)
The form includes the following information:
- Page 1-2 - Patient and Specimen information.
- Page 3 - Payment/Billing Information
Informed consent laws for genetic testing differ between countries and states. It is your responsibility as the referring provider/lab to obtain proper informed consent from patients as required by your state/country. A generalized consent form is provided here for your convenience.
We can accept institutional billing, self pay by credit card, and private insurance. Unfortunately, we cannot bill Medicaid and Medicare directly at this time.
The prices on our requisition form are subject to change, please make sure you are using the most current form from the web site when you order a test.
For volume pricing and other questions about billing, please contact the lab at 503 418-2535.
Use an EDTA (lavender top) tube.
For adults, please send 3-5 mL.
For infants, please send 1-2 mL.
We accept extracted DNA for any test.
Please send a minimum of 10 µg.
Please contact us to confirm whether a saliva sample is suitable for the test you wish to order. If you have additional specimen questions, please call the lab directly at 503 418-2535.
Amniotic Fluid – Cell Culture: Send cultured amniocytes at room temperature: two T25 flasks, filled with media for shipment. Please continue to maintain the cell culture as a backup until results are reported.
Amniotic Fluid – Direct: For faster results, if you have enough fluid for both cell culture and direct, you may send two (2) samples of direct amniotic fluid, 15–20 ml each, in sterile, securely capped plastic tubes. For third trimester samples, send a total of 45–50 ml of direct fluid. Transport promptly at room temperature. Please establish a cell culture before sending direct fluid; maintain the cell culture as a backup until results are reported. If the sample size is small, the cell culture takes precedence over the direct specimen.
CVS – Cell Culture: Send cultured cells at room temperature: two T25 flasks, filled with media for shipment. Please continue to maintain the cell culture as a backup until results are reported.
CVS – Direct: For faster results, only if you have enough tissue for both cell culture and direct, you may send a direct CVS specimen: at least 10–15 mg of tissue in physiologic buffered saline (PBS) in a sterile, securely capped plastic container or centrifuge tube. Clean the tissue and transport promptly at room temp. Please establish a cell culture before sending direct tissue; maintain the cell culture as a backup until results are reported. If the sample size is small, the cell culture takes precedence over the direct specimen.
Maternal Cell Contamination Study (MCC): We test for maternal cell contamination, test #7, with all prenatal testing – whether amnio or CVS, whether direct or cultured specimens. If a fetal sample is contaminated with maternal cells, interpretation will be inconclusive. Please provide a maternal blood sample, 2–3 ml, either before or with the fetal sample. Send a separate 4-page Order Form for the maternal sample, and include Test #7, MCC on both the maternal and fetal Order Forms. If a maternal DNA sample is already stored in our laboratory, please contact us to ask if we need an additional specimen.
Shipping InformationSpecimens should be received within 72 hours of collection if possible – maximum five days. Store specimen at ambient room temperature or refrigerate until you send; do not freeze.
Our laboratory is closed on Saturdays and Sundays, and on certain holidays. Please call ahead if you believe a sample might arrive on a weekend or holiday.
Please ship specimens to:
CEI Molecular Diagnostics Laboratory
3375 SW Terwilliger Blvd, Rm 3110
Portland, OR 97239