Information About Lab Requisitions, Orders and Services

The Core Laboratory at Children's Colorado offers general and specialized laboratory testing on blood, body fluids and urine 24 hours a day, 7 days a week.

The Core Laboratory consists of chemistry, hematology, coagulation and urinalysis.

Top diagnostic tests performed in the Core Lab include:

• Complete blood count (CBC)
• Comprehensive metabolic panel (CMP)
• Renal function panel (RFP)
• Allergy testing, IgE
• Basic metabolic panel (BMP)
• C-reactive protein
• TSH
• Urinalysis
• Vitamin D 25OH
• Prothrombin time (PT)

The Chemistry Laboratory performs a wide variety of tests on a STAT and routine basis. The lab can provide results for most general chemistry tests within one hour of receipt, while other tests are batched and tested daily.

Our test menu includes: electrolytes, enzymes, proteins, lipids, therapeutic drug monitoring (TDM), endocrinology and hormone tests.

Our laboratory is accredited by the Cystic Fibrosis Foundation to collect and analyze sweat for patients to rule-out or confirm a diagnosis of cystic fibrosis (CF). As a center for pharmaceutical research, our section has been integral in the development and approval of new drugs to treat CF.

The Chemistry Laboratory also helps the Inherited Metabolic Disease Clinic in the diagnosis and follow-up care for patients with phenylketonuria (PKU). We perform regular phenylalanine/tyrosine testing on children and pregnant mothers with this inherited disorder with our mass spectrophotometer.

The Hematology Laboratory performs clinical laboratory services 24/7 and can provide vital hematology test results within one hour of sample receipt.

Our Hematology Laboratory supports the Hemophilia and Thrombosis Center with a full menu of coagulation testing including:

• Factor assays
• vonWillebrand testing
• Lupus anticoagulant testing

The Children's Colorado point-of-care (POC) team ensures that all of the more than 1,500 nurses, providers and other clinical care team members performing POC testing are meeting or exceeding quality and patient safety requirements.

Most common POC tests:

• Capillary glucose level monitoring
• Blood gas testing
• Rapid macroscopic urinalysis

Contact the point-of-care team

If you have any questions on POC testing, contact the POC team by phone at 720-777-6717 or by email at poct@childrenscolorado.org.

The Blood Bank Laboratory is accredited by multiple regulatory agencies including the American Association of Blood Banks (AABB).

The Blood Bank performs patient testing and provides blood products, such as platelets, plasma and red blood cells, to all areas of Children's Colorado.

Blood products are prepared for all types of transfusions, including: traumas, scheduled surgeries, maternal intrauterine transfusions, sickle cell patients, oncology/BMT patients and other chronically transfused patients.

The Blood Bank Laboratory works closely with the Blood Donor Center to ensure the supply is always sufficient to meet the needs for all patients. Furthermore, as a level one trauma center for a seven-state region, the Blood Bank Laboratory is prepared for mass-casualty emergencies.

Commonly ordered blood tests include:

• ABO/Rh typing
• Antibody screen
• Antibody identification
• Iso-hemagglutinins
• Direct and indirect anti-globulin test
• Newborn workup
• Serological and molecular phenotyping
• Blood product residual white blood cell (WBC) testing

Working closely with the Pediatric Bone Marrow Transplant Program team, this FACT-accredited lab helps to ensure the best possible outcomes for our pediatric bone marrow transplant patients.

The Blood and Marrow Transplant Laboratory team is involved in novel cellular therapy research and clinical trials.

Top commonly ordered tests:

• Receipt, processing storage and distribution of stem cell products
• Facilitation of Busulfan pharmacokinetic testing
• Facilitation of HLA confirmatory testing for potential unrelated transplant donors
• Ficoll preparation of whole blood to "freeze and save" mononuclear cells and serum for future testing on stem cell donor and recipients

Utilizing culture, antigen detection, serology and molecular methods, The Department of Pathology and Laboratory Services’ Microbiology/Virology Laboratory diagnoses infections caused by:

• Bacteria
• Parasites
• Fungi
• Mycobacteria
• Viruses

Working closely with other teams throughout the hospital and the clinical laboratory – like the Infectious Disease, Antimicrobial Stewardship and Pharmacy teams – this lab aids in the diagnosis of infectious diseases.

We also support outbreak management initiatives in collaboration with both the Colorado Department of Public Health and Environment and the Centers for Disease Control and Prevention.

With state-of-the-art instruments and assays, we're able to provide critical, specialized services, including:

• Bacteriology
• Antibiotic susceptibilities
• Mycology
• Mycobacteriology
• Molecular microbiology
• Virology/serology
• Viral serologic testing

Microbiology learning opportunities

The Microbiology Lab is involved in teaching initiatives and welcomes:

• High school students performing shadowing projects
• College-level students seeking internships in medical laboratory science
• Medical residents
• Fellows

For further information on learning opportunities, speak with your institution or visit American Society for Microbiology.

The Anatomic Pathology Laboratory at Children's Colorado provides an array of laboratory services, including:

• Surgical pathology procedures: Our lab performs gross examination of surgical specimens with or without microscopic examination.

• Cytology services: Cytology services include histologic examination of body fluids, adequacy assessment and processing of fine-needle aspirates. Cell-block and cytospin preparation is also available for analysis of liquid specimens.

• Autopsy services: The Anatomic Pathology Lab provides post-mortem examination of deceased patients as ordered, as part of the hospital's quality initiative and to support our educational mission. Autopsy consultations are also performed for a fee, mostly originating from local hospitals, and also occasionally from local medical examiner jurisdictions.

• Histological services: We offer a full range of histological services for routine and research specimens. Using state-of-the-art technology, our histologists provide and support comprehensive diagnostic services to clinicians, hospitals and outside laboratories. As specially trained pediatric experts, we are uniquely positioned to support the diagnosis and care of pediatric patients.

  Our dedication to providing high-quality histology services with affordable, competitive pricing and rapid turn-around times makes ours one of the most reliable sources for histology services in our region.

• Flow cytometry: Our laboratory supports the Center for Cancer and Blood Disorders by offering a full range of immunophenotyping services and diagnostic testing for routine and research specimens.

  Routinely available surface marker panels include:

  • Leukemia and lymphoma phenotyping on peripheral-blood, bone marrow, fresh tissue or other body-fluid specimens
  • Lymphocyte subset analyses of peripheral blood for acquired or inherited (primary) immunodeficiencies and transplant recipients

Our Electron Microscopy Laboratory provides local, regional and national clients with a full range of diagnostic services for both adult and pediatric patients.

Our high-volume facility specializes in diagnostic ultrastructural pathology and is dedicated to quick delivery of a quality product (normally within 24 hours of specimen receipt).

Top-of-the-line laboratory equipment

The laboratory is equipped with two modern transmission electron microscopes, a JEOL JEM-1400Plus and a Hitachi H-7650, as well as a scanning electron microscope (a JEOL JSM-6010LA).

Specialized laboratory services

In addition to conventional electron microscopy, we also offer specialized diagnostic techniques such as:

• Scanning electron microscopy for hair shaft abnormalities
• Energy dispersive X-ray spectroscopy for heavy metal detection (TEM and SEM)
• Tomography for 3D reconstruction of cilia
• Whole-mount studies for platelet granule quantitation
• Direct negative staining for virus identification

Reporting capabilities
We provide technical only or complete professional services. The technical service option offers informal interpretive assistance with specimen viewing via telepathology possible. A HIPAA-compliant, web-based delivery system enables instantaneous result distribution. Pathologist interpretation is available on a fee-for-service basis, if requested.

Specimen submission requirements
Please submit tissue for conventional transmission electron microscopic examination, energy dispersive X-ray spectroscopy and most scanning electron microscopic applications in glutaraldehyde fixative.

If glutaraldehyde fixative is unavailable, please submit in a formaldehyde fixed wet tissue. Depending upon circumstances, a paraffin embedded tissue or frozen tissue that has been allowed to thaw in chilled fixative will be accepted. Ship blood, unfixed, via an overnight express carrier. You do not need to place hair specimens for scanning electron microscopic examination in fixative.

The Electron Microscopy Lab also provides fixative and express shipping upon request. Specimens must be shipped with the correct electron microscopy request forms (below). Our receiving is available 24 hours a day, as well as throughout weekends and holidays.

• Illustrative examples
• Shipping instructions
• Electron microscopy request form

Contact the Electron Microscopy Lab

Please contact us for additional technical information, advice on specimen handling or for pricing information.

Email: EMServices@childrenscolorado.org
Phone: 720-777-6171
Fax: 720-777-7119

Ship specimens to
Department of Pathology and Laboratory Medicine
Electron Microscopy Laboratory
Children’s Hospital Colorado
13123 East 16th Avenue
Aurora, CO 80045

The Biochemical Genetics Laboratory provides laboratory services for a variety of institutions throughout the country and around the world.

Our comprehensive test list allows us to provide clinical testing to diagnose and monitor treatment of many inherited metabolic disorders, such as amino acid, organic acid and fatty acid oxidation disorders.

Most commonly ordered labs for genetic testing include:

• Quantitative testing for orotic acid, methylmalonic acid or succinylacetone
• Glutaric acid and 3-hydrooxyglutaric acid
• Homovanillic acid (HVA) and vanillylmandelic acid (VMA)

With unmatched capabilities, our Biochemical Genetics Lab is the only laboratory in the country to perform:

• Trimethylamine and trimethylamine-N-oxide
• Glutaryl-CoA dehydrogenase (GAI)
• Very-long-chain acyl-CoA dehydrogenase (VL-CAD)

While our lab offers TMAu testing, an authorized provider with a state issued NPI number must order this testing. Please review the collection and handling instructions for TMA samples (.pdf) before sending in samples. If there are questions regarding testing for TMAu, please have the authorized provider contact us at LabClientServices@childrenscolorado.org or 720-777-6711.

Supporting documents for the Biochemical Genetics Lab include:

• Biochemical genetics test list (.pdf)
• Biochemical archives of GCDH mutations (.pdf)

Browse our downloadable lab requisition forms and collection instructions for our Biochemical Genetics Lab.

At Precision Diagnostics, our laboratory team provides molecular diagnostic and genetic testing. This laboratory was formed through a joining of the Denver Genetics Laboratory and the Molecular Diagnostics Laboratory to create a comprehensive molecular laboratory focused on all areas of molecular precision diagnostics. Our capabilities also cover the testing and identification of:

• Disorders causing multiple congenital anomalies
• Inborn errors of metabolism
• Autism
• Intellectual disabilities
• Skeletal disorders, including skeletal dysplasias and craniosynostoses
• Ocular disorders
• Complex analysis in oncology testing

Our molecular laboratory's resources and capabilities include next-generation sequencing (NGS), Sanger sequencing, targeted array, comparative genomic hybridization (CGH), triplet repeat primed polymerase chain reaction (PCR), bone marrow transplantation and engraftment monitoring.

Supporting documents for our molecular laboratory:

• Consent form (.pdf)
• Master list of references (.pdf)

Browse our downloadable lab requisition forms and collection instructions for our Precision Diagnostics Lab.

Our Mitochondrial Laboratory provides diagnostic testing for respiratory chain enzyme diseases. We perform spectrophotometric respiratory chain enzyme assays in all tissues and have additional testing capabilities, such as blue native PAGE analyses.

Services offered in the Mitochondrial Lab include:

• Mitochondrial respiratory chain enzyme assays:
  • Enzyme assays of complexes I, II, III, IV and II-III (combined), citrate synthase
  • Assays are available in muscle, liver, heart and fibroblast tissue
  • Enzyme activity and activity ratios (normalized to the population), facilitating diagnostic interpretation
  • Minimal sample volume required: 60mg muscle, 20mg heart and liver
  • Telephone consultation with the laboratory director available
  • Simple and graphic report form that is easy to understand
• BNPage with in-gel activity staining:
  • Complementary to the direct assay of respiratory chain enzyme activities
  • In-gel activity staining assays of complexes I, II, IV and V available in muscle, liver, heart and fibroblasts
  • Provides separate and additional information about the activity of the enzymes, including the difficult to assay complex V activity and about the assembly of the complexes
  • Provides diagnostic confirmation for difficult-to-interpret cases and provides further mechanistic information of the defect by the evaluation of the size of the assembled complexes
• Pyruvate dehydrogenase complex:
  • Assay is available in fibroblasts
  • Methodology: release of radioactive CO2 derived from 1-14C-pyruvate
• Complex 1 Assay:
  • Assay is available in fibroblasts
  • Western Blot methodology

Browse our downloadable lab requisition forms and collection instructions for our Mitochondrial Laboratory.

The Translational and Diagnostic Allergy and Immunology Laboratory supports patients within the growing clinical immunology and allergy program and diagnostic immunology at Children’s Colorado.

The laboratory provides a variety of flow cytometry assays for diagnosis and management of immunodeficiency and immune dysregulation.

Most commonly ordered tests:

• Naïve, memory and recent thymic emigrants T cell panel
• Comprehensive B cell panel
• Regulatory T cell panel
• Autoimmune lymphoproliferative syndrome (ALPS) panel
• Lymphocyte proliferation to PHA
• Perforin expression in natural killer cells and CD8 T cells
• DOCK8 in T cells, B cells and monocytes

In the pipeline:

• T follicular helper cell panel
• Th1/Th2/Th17 T cell panel

In addition to supporting diagnostic immunology, the laboratory also provides laboratory support for food allergy clinical trials and supports a variety of research efforts in applied and translational immunology. The laboratory occupies a unique space that bridges diagnostic and translational immunology, enabling us to translate research assays into CAP/CLIA-validated diagnostic tests.

Contact lab client services

For questions regarding our testing, pricing or billing, call 720-777-6711 or email us at LabClientServices@childrenscolorado.org.