LAB INFO | 2019 LABORATORY INFORMATION GUIDE SEPTEMBER 2019 aruplab.com Information in this brochure is current as of September 2019. All content is subject to change. Please contact ARUP Client Services at 800-522-2787 with any questions or concerns. ARUP LABORATORIES As a nonprofit, academic institution of the University of Utah and its Department We believe in of Pathology, ARUP believes in collaborating, sharing knowledge, and contributing to laboratory science in ways that benefit our clients and their patients. collaborating, Our test menu is one of the broadest in the industry, encompassing more sharing than 3,000 tests, including highly specialized and esoteric assays. We offer comprehensive testing in the areas of genetics, molecular oncology, pediatrics, knowledge, and and pain management, among others. contributing ARUP’s clients include many of the nation’s university teaching hospitals to laboratory and children’s hospitals, as well as multihospital groups, major commercial laboratories, and group purchasing organizations. We do not compete with our science in ways clients for physician office business, choosing instead to support clients’ existing test menus by offering highly complex assays and accompanying consultative that provide support so clients can provide exceptional patient care in their local communities. the best value Offering analytics, consulting, and decision support services, ARUP provides clients with the utilization management tools necessary to prosper in this time of for the patient. value-based care. Our UM+ program helps clients control utilization, reduce costs, Together, and improve patient care. In addition, ARUP is a worldwide leader in innovative laboratory research and development, led by the efforts of the ARUP Institute for ARUP and ® Clinical and Experimental Pathology . its clients will ARUP’s reputation for quality is supported by our ability to meet or exceed the requirements of multiple regulatory and accrediting agencies and organizations. improve patient ARUP participates in the CAP laboratory accreditation program and has CLIA care today and certification through the Centers of Medicare and Medicaid Services. In December 2016, ARUP earned accreditation to the ISO 15189:2012 standard under CAP. in the future. patients. answers. results.® A laboratory test is more than a number; it is a person, an answer, a diagnosis.® . TABLE OF CONTENTS CHEMISTRY DIVISION ..................... 1–7 Molecular Genetics. .24 Analytic Biochemistry. 1 Molecular Oncology . 25 Automated Core . 1 Supplemental Newborn Screening. 25 Calculi and Manual Chemistry . 2 Clinical Toxicology I. 2 ARUP INSTITUTE FOR CLINICAL & Clinical Toxicology II . .3 EXPERIMENTAL PATHOLOGY® ........... 26–27 Clinical Toxicology III. 3 Research and Development. 26 Automated Endocrinology . 4 Specialized Technologies and Manufacturing . 26 Endocrinology/Electrophoresis. 4 Technology Transfer. 27 Hemostasis/Thrombosis . 5 Manual Endocrinology I . 5 TECHNICAL SUPPORT .................. 28–29 Mass Spectrometry I and II. .6 Automated Specimen Management (ASM). 28 Special Chemistry. .6 Infectious Disease Processing . .28 Trace and Toxic Elements . 7 Integrated Oncology and Genetics Services . .29 Description . 29 IMMUNOLOGY DIVISION ................. 8–11 Specimen Processing . 29 Autoimmune Immunology I . 8 Autoimmune Immunology II. 8 TRANFUSION MEDICINE .................... 30 Cellular and Innate Immunology . 9 Blood Services. .30 Immunologic Flow Cytometry. 9 Immunohematology Reference Laboratory (IRL) 30 Immunology Core . 10 Transfusion Services. 30 Microbial Immunology I. .10 Microbial Immunology II. .10 UNIVERSITY OF UTAH HEALTH ............... 31 Protein Immunology. 11 University Hospitals and Clinics, Clinical Lab. 31 Serologic Hepatitis/Retrovirus . 11 CLIENT COMMITMENT ...................... 31 INFECTIOUS DISEASE. 12–17 Client Commitment Statement . 31 Bacteriology. .12 Infectious Disease Antigen Testing . .12 Microbial Amplified Detection . 13 Molecular Hepatitis/Retrovirus . 13 Molecular Infectious Disease . 14 Mycology AFB . .14 Parasitology and Fecal Testing . 15 Sequencing Infectious Disease. 15 Special Microbiology. 16 Virology. .16 INTEGRATED ONCOLOGY AND GENETICS 17–25 Anatomic Pathology. 17 Biochemical Genetics . 17 Cytogenetics and Genomic Microarray. 18 Cytopathology . .18 Fragment Analysis. 19 Genetics Sequencing . .20 Genomics . .21 Hematologic Flow Cytometry . 22 Special Hematology . 22 Histology. 23 Immunohistochemistry . .23 CHEMISTRY DIVISION ANALYTIC BIOCHEMISTRY Description This technical section primarily uses high-performance liquid chromatography (HPLC) combined with various detection systems, including mass spectrometry (MS), electrochemical, UV, and fluorometric. Testing is focused on nutritional assessment, pophyrins, and biogenic amines. Testing Areas • 5-HIAA • Porphyrins • Vitamin B6 • Catecholamines • Serotonin • Vitamin C • Coenzyme Q10 • Sulfate, Supersaturation • Vitamin E • Fractionated Carotenes • Vitamin A • Vitamin K • HVA • Vitamin B1 • VMA • Metanephrines • Vitamin B2 Methodologies Spectrophotometry, chromatography, mass spectrometry, and fluorometry Instrumentation HPLC, MS, electrochemical detector (ECD), UV detector, spectrophotometer, and fluorometer AUTOMATED CORE Description This technical section primarily uses high-throughput automated analyzers. Test selection is focused on assays requiring no manual manipulation. The lab currently performs more than 20 percent of all testing performed at the central facility. Testing Areas 200 different assays performed on various types of samples (serum, urine, CSF, and amniotic fluid), including: • Drugs of abuse screening by immunoassay • Endocrine testing: T3, T4, TSH, testosterone, SHBG, ferritin, folate, B12, insulin, PTHI, and thyroglobulin • General chemistries: electrolytes, enzymes, BUN, creatinine, and glucose • Maternal serum screen: alpha fetoprotein, hCG, estriol, and inhibin A • Tumor markers: CA 125, CA 15-3, CA 19-9, CEA, PSA, AFP TM, and hCG Methodologies Ion-selective electrode/enzymatic, chemiluminescent immunoassay, electrochemiluminescent immunoassay, immunoturbidimetric, spectrophotometry Instrumentation Ortho Clinical Diagnostics, Beckman Coulter, and Roche Diagnostics analyzers 1 CHEMISTRY DIVISION CALCULI AND MANUAL CHEMISTRY Description This technical section primarily uses Fourier-transform infrared spectroscopy (FT-IR) for calculi analysis. Testing specializes in calculi (stone) analysis, calculi photomicrographs, calculi risk assessments, visocometry assessment, and nutritional status. Testing Areas • Calculi • Calculi risk assessments • Calculi photomicrographs • Carotenes • Sulfate • Viscosity • Supersaturation risk calculations Methodologies FT-IR, FT-IR microscopy, polarizing microscopy, photomicroscopy, spectrophotometry, viscometry Instrumentation FT-IR, FT-IR microscope, stereomicroscope, spectrophotometer, cone-plate viscometer CLINICAL TOXICOLOGY I Description This laboratory analyzes urine, serum, and plasma to detect drugs of abuse for treatment-rehabilitation centers, pain management clinics, and hospitals. No chain of custody, employment, or forensic sample testing is performed. Testing Areas Qualitative and quantitative testing for commonly abused prescription and illicit drugs. Screens with reflex to confirmation and confirmation-only testing are available. Drug testing is designed to support clinical applications, including: • Compliance testing for pain management clinics • Qualification for patients for surgery or other interventions • Verification of drug abstinence • Confirmation of previously obtained screening results Methodologies GC-MS, LC-MS/MS Instrumentation Agilent Technologies, AB Sciex, and Waters mass spectrometry systems 2 CHEMISTRY DIVISION CLINICAL TOXICOLOGY II Description This laboratory performs approximately 40 quantitative assays for more than 100 drugs. Comprehensive screening is also performed to detect the presence of up to 250 drugs, including over-the-counter and prescription drugs, as well as some drugs of abuse. Testing Areas • Anticonvulsant drugs • Antidepressant drugs • Antifungal drugs • Antipsychotic drugs • Cardiac drugs • Immunosuppressant drugs Methodologies Spectrophotometric assays, immunoassay (ELISA), GC-MS, LC-MS/MS Instrumentation Agilent Technologies, AB Sciex, and Waters mass spectrometry systems CLINICAL TOXICOLOGY III Description This laboratory analyzes serum, plasma, meconium, and umbilical cord tissue to detect drugs of abuse for hospitals, pain management clinics, and treatment-rehabilitation centers. No chain of custody, employment, or forensic sample testing is performed. Testing Areas Qualitative and quantitative testing for commonly abused prescription and illicit drugs. Screens with reflex to confirmation and confirmation-only testing are available. Drug testing is designed to support clinical applications, including: • Identification of in utero drug exposure • Compliance testing for pain management clinics • Qualification for patients for surgery or other interventions • Verification of drug abstinence • Confirmation of previously obtained screening results Methodologies ELISA, GC-MS, LC-MS/MS Instrumentation Agilent Technologies, AB Sciex, and Waters mass spectrometry systems 3 CHEMISTRY DIVISION AUTOMATED ENDOCRINOLOGY Description This technical section primarily uses high-throughput automated analyzers. Test selection is focused on assays not fitting into the Automated Core Lab that may require limited manual manipulation prior