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Laboratory Services Section Home

Manual Of Reference Services

- Introduction | Contact Information | Local Health Department Labs | Specimen Collection and Submission -
- Specimen Shipping, Mailing | Specimen Receiving, Lab Hours | Lab Tests | Forms, Fee Schedule -

Guidelines for Specimen Shipping and Mailing

Submission of Specimens: 

 

Shipping Overview

Submitters are responsible for shipping specimens in conformity with all safety and labeling regulations. Be aware that many commercial carriers no longer accept specimens. When using any carrier, including the bus service or the U.S. Postal Service, package specimens to avoid leakage or breakage. All specimen mailing containers supplied by the Laboratory meet USPS and DOT requirements for the shipment of diagnostic specimens. Specimens must be packed in triple containment with sufficient absorbent material enclosed to absorb the entire volume of liquid. The container used must meet current DOT and USPS regulations.

  • Shipment of infectious agents requires specialized training and United Nations (UN)-approved packaging that the Lab does not provide.

ALWAYS EXERT THE MAXIMUM PROTECTION FOR THE SAKE OF THOSE WHO HANDLE THE PARCELS AND TO AVOID JEOPARDIZING THE SYSTEM FOR SHIPPING SPECIMENS.

The Laboratory policy is - ALL blood specimens in a container will be considered broken if one tube in that container is broken during shipment.

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Mailing Containers/Completion of Forms

The Laboratory provides specimen mailing containers and labels to physicians and public health laboratories and water sample containers to any citizen upon request. The containers are the property of the State of Texas and must not be used for any purpose other than the shipment of specimens to the TDSHS laboratory.  The mailing containers and labels meet current Department of Transportation (DOT) and United States Postal Service (USPS) regulations for shipping diagnostic specimens. 

  • Shipping infectious specimens requires special mailing containers that the Lab does not supply.

  • TDSHS request form must be included with every specimen in the same container.

Forms should be completed as follows:

  • Use BOLD CAPITAL BLOCK LETTERS to complete all information that is requested on the form.

  • If the patient is Medicaid eligible, you must provide the Medicaid number.

  • For THSteps (EPSDT) specimens, you must provide the Medicaid number.

  • Date of Birth, Date of Collection and test request are required.

  • Unidentified or improperly identified specimens are unsatisfactory and they will not be tested.

We will test specimens identified by number only; however, we will not report the results until a patient's name is provided. Good laboratory practice recommends, and our federal license requires, the patient's name on the specimen vial.

THE PATIENT'S NAME ON THE SPECIMEN REQUISITION FORM AND THE SPECIMEN MUST BE THE SAME. IF THEY ARE NOT THE SAME, THE SPECIMEN WILL NOT BE TESTED.

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Submission of Specimens through the U.S. Postal System

The requirements for the submission of diagnostic specimens through the U.S. Postal Services system are:

  1. Definition:  “Diagnostic specimen means any human or animal material, including excreta, secreta, blood and its components, tissue, and tissue fluids being transported for diagnostic or investigational purposes”;

  2. Quantity:   50 ml or less per mail piece.  Two or more primary receptacles may be included per mail piece;

  3. Secondary container (liner):  must contain sufficient absorbent materials to absorb the entire contents of primary containers in case of breakage or leakage; and

  4. Outer mailer: must be properly labeled.

  5. Mailing unit must pass current shipping regulations for diagnostic specimens.

THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES LABORATORY, 
EFFECTIVE IMMEDIATELY, WILL ONLY SUPPLY MAILING CONTAINERS 
FOR CLINICAL DIAGNOSTIC SPECIMENS. USE OF TDSHS CONTAINERS 
WILL INSURE COMPLIANCE WITH U.S. POSTAL AND DOT REQUIREMENTS.

 The definition of an acceptable triple container is:

  1. primary receptacle:  a bottle or tube in which the specimen is collected or held, such as a feces bottle, test tube, or tube (vacutainer) of blood or serum; leak proof and securely sealed; surrounded by absorbent material capable of taking up the entire contents of the primary receptacle(s); held within the secondary container;

  2. secondary container:  leak proof, securely sealed; placed within the strong outer mailer; Biohazard sticker affixed;

  3. outer mailer or container constructed of fiberboard or other equivalent material, clearly and durably marked “Diagnostic Specimen”. 

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Packaging and Labeling of 
Clinical Diagnostic Samples

(Do Not Put Any Patient Information on Outer or 
Secondary Containers or Lids)

Packaging and Labeling of Clinical Diagnostic Samples

Biohazard Label should be on Secondary Container.
DO NOT put Biohazard Label on Outer Container.

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Packaging and Shipment of Blood Tubes

Containers are available in three sizes for blood specimens. You may order for: 1 specimen, 4 specimens, and 7 specimens. 

In order to insure the satisfactory receipt and proper testing of your specimens in our Laboratory, it is necessary to:

  1. label each tube of blood or serum  with the name of the patient exactly the way it is written on the laboratory request form;

  2. put absorbent material, such as paper towels, around each tube, sufficient to absorb the entire contents of the tubes, prior to placing the tubes in the secondary plastic liner;

  3. wrap the properly completed laboratory request form(s) {must have the name of patient and a correct return address} around the secondary plastic liner.   Place the secondary container in the fiberboard cylinder; and

  4. attach the proper mailing label to the outside container before the specimens are mailed.

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Instructions for Packing Blood Tubes for Shipment 

The number of blood tubes broken in transit can be greatly reduced or eliminated 
by using appropriate packaging and following these simple instructions. 

Assemble components

Place absorbent into bottom of liner.

1) Assemble components.

2) Place absorbent into bottom of liner.

Wrap tubes in paper towels

Place tubes in liner

3) Wrap tubes in paper towels.

4) Place tubes in liner.

Place absorbent on top of tubes and screw on liner cap

Place lab form around the outside of the liner. Place liner in cardboard mailer. Screw on appropriate, well fitting cap

5) Place absorbent on top of tubes 
and screw on plastic liner cap.

6) Place lab form around the outside 
of the liner. Place liner in cardboard mailer. 
Screw on appropriate, well fitting metal cap.


Note: Only use mailers approved for diagnostic shipping.

Questions on proper packaging and shipment of blood tubes 
should be directed to the Specimen Acquisition Branch at (512) 458-7598

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Cholesterol, Lipid Profile, and Glucose Packing Instructions and Diagram

General Instructions:

  1. Submit a G-1B form for each patient with corresponding specimen tube.
  2. Retain a copy of the G-1B submission form for your records.
  3. Clearly label each specimen with the patient’s first and last name as written on the G-1B specimen submission form.  Pre-printed patient labels used for specimen identification MUST match the patient’s name on the submission form.
  4. Specimens must be triple-contained.

Special Requirements:

Required Specimen Type:  Collect specimens for cholesterol and lipid profiles in a red top tube. Remove serum from clot within 2 hours of collection.  Transfer at least 1 mL of serum to another plastic transport tube.  Plastic transport tube can be a plain blood collection tube.

Collect specimens for glucose testing in gray top tubes.  Plasma must be separated from red blood cells within 24 hours from time of collection.

Special Instructions:

  1. Allow samples to clot completely before centrifugation.  Immediately transfer serum/plasma to transport tube and freeze (-20 degrees C or lower). Batching of specimens for shipment is recommended.
  2. Specimens MUST be kept frozen until shipping is initiated.  Ship specimens overnight on dry ice OR with adequate ice packs so that specimens arrive at DSHS laboratory cold.  Specimens received at room temperature will be unsatisfactory for testing.            
  3. Do NOT ship ANY cholesterol, lipid profile or glucose specimens on Fridays or prior to a federally observed holiday.

Instructions for Shipping Diagnostic Specimens:

To ensure proper packaging, please follow these instructions:

  1. Obtain enough dry ice to keep the specimens frozen or enough ice packs to keep specimens cold for the duration of the shipment.
  2. Place the frozen specimen(s) in mailing canisterand seal.  Place up to 4 canisters in the bottom of the Styrofoam box. 
  3. Fill the Styrofoam box with dry ice or ice packs.  Ensure canisters are completely covered with dry ice or ice packs, and secured.  
  4. Place the lid on the Styrofoam box.  Make sure the date and time is documented on each G-1B form when specimens are removed from the freezer.  Please circle freezer to indicate specimens were removed from the freezer not the "fridge".
  5. Place the completed G-1B form(s) in a plastic “zip lock” bag.  Then place the plastic “zip lock” bag on top of the closed Styrofoam box and seal the fiberboard box.
  6. Secure the outer fiberboard box with packing tape.
  7. Ensure that a diamond-shaped UN 3373 label is on exterior of the fiberboard box, when shipping diagnostic specimens.
  8. Dry ice is considered a “dangerous good”.  If using dry ice:
    1. Use less than 5 lbs of dry ice. 
    2. Mark the blank box and write “dry ice” in the Special Instructions section of the air bill.
    3. Attach a diamond-shaped dry ice label on the package with the number “9” and “UN1845” on it.  This label must include the amount of dry ice used.  Ensure that this is legible and does not overlap any other label on the fiberboard box.
  9. Fill out the air bill and place it inside the sleeve and attach to the top of the sealed fiberboard box.

NOTE:  If overnight carrier does not make regular pick-ups at your facility, call the carrier and let them know you need a pick-up.

DHL:  (800) 225-5345
UPS:  (800) 742-5877

CAUTION:   MAKE SURE THAT YOUR STYROFOAM BOX IS NOT AIRTIGHT, IF USING DRY ICE!

By following these instructions when shipping diagnostic specimens, your responsibility should be fulfilled.

Shipping Instructions:

Check elsewhere in this section for specific test instructions and information about tube types. 

For questions about shipment of cholesterol, lipid and glucose specimens, call (512) 458-7111 ext. 2414. 

For shipping containers, call (512) 458-7661.

Cold Boxes are a new item. If you have not received your cold boxes by July 13, please call 512-458-7661 or 888-963-7111 ext. 7661 to request them.

For cholesterol, lipid profile or glucose specimens, prepaid airbills are provided for THSteps specimens only.  For all other cholesterol, lipid profile and glucose specimens the provider must pay the shipping costs, using a carrier of their choice.

Flow Chart for Collection and Shipping of Cholesterol, Lipid Profile and Glucose

1.   Collect specimens for cholesterol and lipid profile testing in red top tubes.
2.   Collect specimens for glucose testing in gray top tube containing sodium fluoride/potassium oxalate.

1.   Cholesterol and Lipid Profile specimens – centrifuge and separate serum within in 2 hours.
2.   Glucose specimens – centrifuge and separate plasma within 24 hours from time of collection.

Transfer serum/plasma into plastic transport container.

Place specimen(s) in canisters.
Multiple specimens may be contained inside the canisters.
FREEZE canister(s) containing specimens IMMEDIATELY

After specimens are frozen:

Batch specimens and ship once or twice a week. 
Do not ship on Fridays or the day before federal holidays.

Place up to 4 canisters with frozen specimens in the bottom of the Styrofoam box.

Place and secure ice packs or place dry ice on top of canisters

Close the Styrofoam box

Place the Styrofoam box inside the fiberboard box.

Before sealing the fiberboard box, record Time and Date on each G1-B form for each specimen removed from the freezer. Circle "freezer" to indicate specimens were removed from the freezer.

Place requisition forms on top of the Styrofoam box, but inside fiberboard box.
Seal fiberboard box.

Place an air bill inside the shipping sleeve and attach to top of the sealed fiberboard box and ship specimens overnight.

 

Cholesterol, Lipid, and Glucose Packing Diagram

 

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RHOGAM (HDN) Packing and Shipping Instructions

General Instructions:

  1. Submit a G-1B form for each patient with corresponding specimen tube.

  2. Retain a copy of the G-1B submission form for your records.

  3. Clearly label each specimen with the patient’s first and last name as written on the G-1B specimen submission form.   Pre-printed patient labels used for specimen identification MUST match the patient’s name on the submission form.

  4. Specimens must be triple-contained.

Special Requirements:

Required Specimen Type: Collect specimens for RhoGAM (HDN Screening) in a red top tube. DSHS Laboratory must receive specimens within 24 hours from time of collection. Specimens not received at DSHS Laboratory within 24 hours should be stored at 1° - 10°C and shipped cold. 

Special Instructions:

  1. Ship specimens overnight at ambient temperature.

  2. Specimens not received within 24 hours from time of collection must be shipped overnight with enough cold packs to maintain refrigerated temperature until arrival at DSHS Laboratory.

  3. Do not freeze.

  4. Do NOT ship ANY RhoGAM specimens on Fridays or prior to a federally observed holiday.

Instructions for Shipping Diagnostic Specimens:

To ensure proper packaging, please follow these instructions:

  1. Package and ship specimens overnight at ambient temperature.

  2. For specimens requiring overnight cold shipment, package with enough ice packs to maintain refrigerated temperature for the duration of the shipment. 

  3. Record the date and time each specimen was removed from the refrigerator on the G-1B form. 

  4. Please circle “FRIDGE” on the G-1B form to indicate specimens were removed from the refrigerator.

Shipping Instructions:

For specific test instructions, see the Manual of Reference Services section on Lab Tests for Diseases/Agents.
See sections above for information about tube types.

For questions about shipment of Rhogam (HDN screening) specimens, call (512) 458-7111 ext. 2414. 

Shipping containers for cold shipment are available upon request, call (512) 458-7661.

Last Updated March 31, 2006

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