Please include the following information with all anatomic pathology specimens.

Patient information

All patient information (full legal name, date of birth, insurance, etc.) is required prior to testing. You must provide complete information, even if previously given.

Client information

We are required to know the pathology lab that is sending us material, even if the request for testing originates from an outside source. Please provide us with the name and NPI number of either the referring pathologist or the ordering physician. We send results reports based on this information.

Billing classification is also required prior to testing and needs to be included with the submission.

Consultation request

Complete all relevant information and attach supporting documents if appropriate.

Specimen type

Indicate specimen type(s), number included, and date of archive removal. Label the specimen container with patient identifiers.

Tissue source

Indicate source(s), collection date, accession number, and test(s)/workup(s) desired.

Pertinent clinical history and findings

Include any available information, including any previous test results, that may be relevant to the current medical problem.

Medical necessity

List all applicable codes (use complete codes; do not truncate), not descriptions.

Consultations should be addressed to:

The University of Chicago Medicine
UChicago Medical Laboratories-Client Services
Room J-601/MC6101
5841 S. Maryland Ave.
Chicago, IL 60637
Phone: 773.702.8287
Fax: 773.702.9903

Please include pertinent clinical history and cytology/surgical pathology report(s).