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MICROBIAL DISEASES LABORATORY

 MDL Form 402 - Mycobacteriology-Specimens for Isolation and Culture Electronic Submittal Form Instructions

Electronic Submittal Form Instructions

Use Lab Form 402 - Mycobacteriology-Specimens for Isolation and Culture to submit specimens. Use the following steps to enter information for the submission of each specimen.

NOTE: We are unable to process samples with inadequate information.

1. On page 1, under “Select Test Requisition”, use the pull-down menu to select Lab Form “Mycobacteriology-Specimens for Isolation and Culture-402”. Provide all necessary information on page 1. For directions on how to fill out the fields on page 1, please refer to the "General Specimen Submission Page 1 Instructions" page.


2. For MDL form 402, it is REQUIRED that the following fields be filled in:

2.1. Field 40 (Submitter’s identification of Organisms).

2.2. Field 41 (Clinical History).

3. Follow the instructions below to provide additional information on page 2 “Mycobacteriology-Specimens for Isolation and Culture-402 – Additional Information": 

3.1. Date MGIT from processed specimen, if applicable.

3.2. Date specimen or MGIT sent to State.


4. Print the completed Lab Form 402 front to back. The document is formatted for 2-sided printing.


5. Packaging and shipping: The submitter is responsible for making sure that all samples are packaged and shipped according to the current federal and state packaging and shipping regulations for “Infectious substance, Category A” and/or “Biological substance, Category B”.


6. Additional considerations when submitting samples:

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

6.2. Label 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 402 and all attachments between the inner and outer shipping containers.

6.5. Follow all other submission guidelines as described 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 – 510-412-370


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