A signed informed consent in the patient's medical record is required. The consent should not be sent to the laboratory. The link to the Genetic Testing Consent Form is provided as a convenience for the providers and genetic counselors within the order.
The assay tests for the following genes and star alleles: CYP2B6*9, CYP2C19*2, CYP2C19*3, CYP2C19*4, CYP2C19*5, CYP2C19*6, CYP2C19*8, CYP2C19*17, CYP2C9*2, CYP2C9*3, CYP2C9*5, CYP2C9*6, CYP2C9*8, CYP2C9*11, CYP2D6*2 (*34), CYP2D6*2 (*39), CYP2D6*3, CYP2D6*4, CYP2D6*6, CYP2D6*10, CYP2D6*17, CYP2D6*41, CYP3A5*3, DPYD D949V, DPYD*2A, DPYD*13, SLCO1B1*5, TPMT*2, TPMT*3B, TPMT*3C, TPMT*4, UGT1A1*80 as well as provides the information of the CYP2D6 copy number. The Go4PGx PDF based report includes additional diplotype-phenotype information as well as gene-phenotype-drug recommendations based on CPIC guidelines.
Testing is performed Mon-Fri; results are reported within 7-10 days.
Pharmacogenomic (PGx) testing is performed at the MHealth Fairview Molecular Diagnostic Laboratory. It uses targeted genotyping technology to evaluate the presence of DNA variants tht affect the metabolism of certain medications, Whole blood and buccal swab samples are acceptable DNA sources for PGx testing.
Blood (ACD or EDTA) (preferred)
or Buccal swab of cheek.
Blood ACD or EDTA: 10 mL (preferred)
OR
Two Genotek OraCollect-DX (OCD-100) buccal swabs
Blood ACD or EDTA: 3 mL
OR
One OraCollect buccal swab
Do not process. Store at room temperature.
Blood samples tested in hematology using automated instrumentation not accepted. DNA extracted at a non-CLIA certified (or equivalent) lab.
Ship at room temperature.
5 days at room temperature.
Yellow (ACD, Solution A) Tube, available from laboratory
Purple (EDTA)
Yellow (ACD, Solution B) Tube, available from laboratory
Buccal Swab
By report.
| Requester | Contact Information |
| Patient and UMP/FV Care Team | Fairview Consumer Line at 612-672-1048 |
| MRL Outreach Client | DEPT-MRL-CLIENT-MANAGEMENT@Fairview.org |
| Research | research@fairview.org |
| CPT | Qty | HC Hospital | PR Clinic | Note |
| 81418 | 1 | 3008141801 | 8141801 | HC PGX DRUG METABOLISM VERSION 1 6+ PANEL |
| G0452 | 1 | 971G045201 | G045201 | HC MOLECULAR INTERP PF |
SNP Genotyping of selected drug-metabolizing enzymes using Fluidigm BioMark HD and Life Technologies TaqMan®
| Test Name | Component | Required | Description | Type | LOINC |
| LAB8161 | Pharmacogenomics Profile | Orderable | |||
| SPT_1097 | Y | Specimen type: | Prompt | ||
| SRC_1000 | Y | Specimen source: | Prompt | ||
| 1230003559 | Results Molecular | Result | |||
| 1230005210 | Signout Location if Remote | Result | 90119-9 | ||
| 1238000018 | PGX Variants | Result | |||
| 1238000019 | About the PGX test | Result | |||
| 1238000030 | Methodology | Result | |||
| 1238000040 | Limitations | Result | |||
| 1238000050 | Disclaimer | Result | |||
| 1238000060 | Comments | Result |
| Ordering |
A signed informed consent in the patient's medical record is required. The consent should not be sent to the laboratory. The link to the Genetic Testing Consent Form is provided as a convenience for the providers and genetic counselors within the order.
The assay tests for the following genes and star alleles: CYP2B6*9, CYP2C19*2, CYP2C19*3, CYP2C19*4, CYP2C19*5, CYP2C19*6, CYP2C19*8, CYP2C19*17, CYP2C9*2, CYP2C9*3, CYP2C9*5, CYP2C9*6, CYP2C9*8, CYP2C9*11, CYP2D6*2 (*34), CYP2D6*2 (*39), CYP2D6*3, CYP2D6*4, CYP2D6*6, CYP2D6*10, CYP2D6*17, CYP2D6*41, CYP3A5*3, DPYD D949V, DPYD*2A, DPYD*13, SLCO1B1*5, TPMT*2, TPMT*3B, TPMT*3C, TPMT*4, UGT1A1*80 as well as provides the information of the CYP2D6 copy number. The Go4PGx PDF based report includes additional diplotype-phenotype information as well as gene-phenotype-drug recommendations based on CPIC guidelines.
Testing is performed Mon-Fri; results are reported within 7-10 days.
Pharmacogenomic (PGx) testing is performed at the MHealth Fairview Molecular Diagnostic Laboratory. It uses targeted genotyping technology to evaluate the presence of DNA variants tht affect the metabolism of certain medications, Whole blood and buccal swab samples are acceptable DNA sources for PGx testing.
| Collection & Processing |
Blood (ACD or EDTA) (preferred)
or Buccal swab of cheek.
Blood ACD or EDTA: 10 mL (preferred)
OR
Two Genotek OraCollect-DX (OCD-100) buccal swabs
Blood ACD or EDTA: 3 mL
OR
One OraCollect buccal swab
Do not process. Store at room temperature.
Blood samples tested in hematology using automated instrumentation not accepted. DNA extracted at a non-CLIA certified (or equivalent) lab.
Ship at room temperature.
5 days at room temperature.
| Containers |
Yellow (ACD, Solution A) Tube, available from laboratory
Purple (EDTA)
Yellow (ACD, Solution B) Tube, available from laboratory
Buccal Swab
| Result Interpretation |
By report.
| Administrative |
| Requester | Contact Information |
| Patient and UMP/FV Care Team | Fairview Consumer Line at 612-672-1048 |
| MRL Outreach Client | DEPT-MRL-CLIENT-MANAGEMENT@Fairview.org |
| Research | research@fairview.org |
| CPT | Qty | HC Hospital | PR Clinic | Note |
| 81418 | 1 | 3008141801 | 8141801 | HC PGX DRUG METABOLISM VERSION 1 6+ PANEL |
| G0452 | 1 | 971G045201 | G045201 | HC MOLECULAR INTERP PF |
SNP Genotyping of selected drug-metabolizing enzymes using Fluidigm BioMark HD and Life Technologies TaqMan®
| Interface Mapping |
| Test Name | Component | Required | Description | Type | LOINC |
| LAB8161 | Pharmacogenomics Profile | Orderable | |||
| SPT_1097 | Y | Specimen type: | Prompt | ||
| SRC_1000 | Y | Specimen source: | Prompt | ||
| 1230003559 | Results Molecular | Result | |||
| 1230005210 | Signout Location if Remote | Result | 90119-9 | ||
| 1238000018 | PGX Variants | Result | |||
| 1238000019 | About the PGX test | Result | |||
| 1238000030 | Methodology | Result | |||
| 1238000040 | Limitations | Result | |||
| 1238000050 | Disclaimer | Result | |||
| 1238000060 | Comments | Result |
| Private Details |
