Mayo_Collaborative_Services_SOW.pdf

STATEMENT OF WORK FOR MAYO COLLABORATIVE SERVICES

Mayo Collaborative Services, LLC d/b/a Mayo Medical Laboratories ("Contractor") shall perform the following reference laboratory testing upon request:

Test Name Test# Test Name Fee

GHBP Growth Horm Bind Prot Referral Dept can assist as needs arise

Cortisol Binding Globulin ZW59 Corticosteroid Binding Globulin

(CBG)

Plasma Renin Activity PRA Renin Activity, Plasma

CBG with Free Cortisol SALCT Cortisol, Saliva

Cortisol, Free CORTF Cortisol, Free, Serum

Cortisol, Saliva SALCT Cortisol, Saliva

Cortisol, Urine CORTU Cortisol, Free, Urine 24 Hour

DHEA-serum DHEA_ Dehydroepiandrosterone (DHEA), Serum

Testosterone, Total & Free TGRP Testosterone, Total & Free, Serum

Testosterone, Free TGRP Testosterone, Total & Free, Serum

Testosterone, Total only TTST Testosterone, Total Only & Free, Serum

Andostenedione, Serum ANST Androstenedione, Serum

IGF Binding Prot, 1 FIGBP IGF Binding Protein-1 (IGFBP-1)

IGFBP*3, S IGFB3 Insulin-Like Growth Factor Binding Protein-3, Serum

Sex Hormone Binding Glob SHBG Sex Hormone Binding Globulin (SHBG), Serum

Leptin FLEP Leptin

Estrone, Serum El Estrone, Serum

Vitamin D, 1525*Dihydroxy DHVD 1,25-Dihydroxyvitamin D, Serum

Renin PRA Renin Activ ity, Plasma

Renin Esoterix PRA Renin Activity, Plasma

Renin Plasma PRA Renin Activity, Plasma

Renin Activity, Plasma PRA Renin Activi ty, Plasma

21 Hydroxylase Ab, S OH21 21-Hydroxylase Antibody, Serum

Bone Alkaline Phosphatase BAP Bone Alkaline Phosphatase, Serum

17 Hydroxyprogesterone OHPG 7-Hydroxyprogesterone, Serum

Estradiol, Enhanced, S EEST Estradiol, Mass Spectrometry, Serum

17 Hydroxy-Pregnenolone 170HP 17-Hydroxypregnenolone, Serum

Aldosterone, Serum ALDS Aldosterone, Serum

Estrone> Serum El Estrone, Serum

Quant, each specimen Need more information

Creatinine, Urine CTU Creatinine, 24 Hour, Urine

Adrenal AB OH21 21-Hydroxylase Antibody, Serum

I I Desoxycortisol DCORT 11-Deoxycortisol, Serum

Dexamenthasone SGSS Synthetic Glucocorticoid Screen, Serum

Histamine Blood NMHIN N-Methylhistamine, Urine

Pyridinoln+Deoxypyrid, Ur NTXPR NTX-Telopeptide, Urine

Bone Alkaline Phospatase BAP Bone Alkaline Phosphatase, Serum

Somatostatin, Plasma FSOMA

Growth Hormone-Releasing Hormone (GH-RH)

FIRGH

Antimullerian Hormone (AMH), Serum

AMH

Chromogranin A, Serum CGAK

Inhibin B, Serum INHB

SOHB, SOHC, SOHO Gene Panel

SOHP

RET Proto-Oncogene, Full Gene Analysis

RETZ

VHL (Von Hippel-Lindau) Gene, Full Gene Analysis

VHLZ

*Tests identified with an asterisk are not performed by Contractor and are forwarded on to a non-Mayo laboratory ("Referral Tests"). Charges for Referral Tests are subject to change without notification. Contractor does not guarantee the fee charged will not change over the course of the SOW, nor does Contractor provide any warranties of any kind of the performance of any referral laboratory performing such Referral Tests.

The NIH Clinical Center Department of Laboratory Medicine (DLM) will receive, accession, and process NICHD patient blood specimens for clinical laboratory testing, using the DLM central accessioning group and the on-site Mayo Collaborative Services staff to process these samples, Specimens shall be picked up from the Department of Laboratory Medicine on the 2nd floor of the Clinical Center of the NIH daily.

Patient Assays shall be performed and the results reported to the NIH in accordance with turnaround times in the then current MML Test Catalog.

The Contractor shall be available for discussion of assay results and problems.

Deliverables/Reporting Requirements

I. Results from the analysis of samples from humans shall be provided to DLM daily via the on-site Mayo Collaborative Services staff, and will become available to the individual ordering physicians via the CRIS system.

2. The contractor will maintain information on the patient medical record number, requesting physician, assay requested, test name, time-points and date, if such information is available on the transmittal paperwork.