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 current Department of Transportation (DOT) and United States Postal Service (USPS) requirements for the shipment of Biological Substance, Category B. 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.
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. ^ Top 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 Biological Substance, Category B.
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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Submitting Specimens through the U.S. Postal System
The requirements for the submission of Biological Substance, Category B through the U.S. Postal Services system are:
Definition: “Biological Substance, Category B means any human or animal material, including excreta, secreta, blood and its components, tissue, and tissue fluids being transported for diagnostic or investigational purposes.”
Quantity: 50 ml or less per mail piece. Two or more primary receptacles may be included per mail piece.
Secondary container (liner): must contain sufficient absorbent materials to absorb the entire contents of primary containers in case of breakage or leakage.
Outer mailer: must be properly labeled.
Mailing unit must pass current shipping regulations for Biological Substance, Category B.
The Texas Department of State Health Services Laboratory,
effective immediately, will only supply mailing containers
for Biological Substance, Category B. Use of TDSHS containers
will insure compliance with U.S. Postal and DOT requirements.
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The definition of an acceptable triple container is:
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;
Secondary container: leak proof, securely sealed; placed within the strong outer mailer; Biohazard sticker affixed;
Outer mailer or container constructed of fiberboard or other equivalent material, clearly and durably marked “Biological Substance, Category B.”
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Packaging and Labeling Biological Substance, Category B
(Do not put any patient information on outer or secondary containers or lids.)
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Biohazard Label should be on Secondary Container.
DO NOT put Biohazard Label on Outer Container.
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Packaging and Shipping 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:
Label each tube of blood or serum with the name of the patient exactly the way it is written on the laboratory request form;
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;
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
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.
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1.) Assemble components.
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2.) Place absorbent into bottom of liner.
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3.) Wrap tubes in paper towels.
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4.) Place tubes in liner.
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5.) Place absorbent on top of tubes
and screw on plastic liner cap.
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6.) Place lab form around the outside of the liner. Place liner in cardboard mailer. (If applicable, insert DSHS Snap-apart Card for Hemoglobin Electrophoresis Testing between the cardboard mailer and liner.) Screw on appropriate, well-fitting metal cap.
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Note: Only use mailers approved for shipping Biological Substance, Category B.
Questions on proper packaging and shipment of blood tubes
should be directed to the Specimen Acquisition Branch at (512) 776-7598
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Cholesterol, Lipid Profile, Glucose, and Creatinine Packing Instructions and Diagram
Required Specimen Type for Cholesterol, Lipid Profile, and Creatinine:
- Collect blood in a red top tube and allow to clot completely.
- Centrifuge the specimen to separate the serum from the clot within 2 hours of collection.
- Transfer the serum from the red top tube into the transport tube.
- Label the transport tube with the patient’s first and last name, and a secondary identifier, such as Date of Birth, medical record number, or Medicaid number.
- Store the labeled transport tube in the freezer (-20 degrees Celsius or lower) until ready to ship.
- Specimens collected in a gold top or serum separator tube must have the serum removed and transferred to the transport tube. Tubes with gel separators are not intended to be frozen.
Required Specimen Type for Glucose:
- Collect blood in a red top tube and allow to clot completely.
- Centrifuge the specimen to separate the serum from the clot within 2 hours of collection.
- Transfer the serum from the red top tube into the transport tube.
- Label the transport tube with the patient’s first and last name, and a secondary identifier, such as Date of Birth, medical record number, or Medicaid number.
- Store the labeled transport tube in the freezer (-20 degrees Celsius or lower) until ready to ship.
- Specimens collected in a gold top or serum separator tube must have the serum removed and transferred to the transport tube. Tubes with gel separators are not intended to be frozen.
General Instructions:
- Clearly label each specimen with the patient’s first and last name as written on the submission form. Pre-printed patient labels used for specimen identification must match the patient’s name on the submission form.
- Submit a submission form for each patient with corresponding specimen tube.
- Retain a copy of the submission form for your records.
- Specimens must be triple-contained.
- Batching of specimens for shipment is recommended. Batch specimens for shipping once or twice per week.
- Specimens must be kept frozen until shipped. Ship specimens overnight on dry ice OR with adequate ice packs so that specimens arrive at the DSHS Laboratory cold. Specimens received at room temperature will be unsatisfactory for testing.
- Do not ship cholesterol, lipid profile, glucose, or creatinine specimens on Fridays or prior to a federally observed holiday.
For questions about shipment of cholesterol, lipid profile, glucose, or creatinine specimens, please call 512-776-6236 or toll free 1-888-963-7111, extension 6236.
For cholesterol, lipid profile or glucose specimens that are part of THSteps medical checkups, prepaid air bills are provided to enrolled THSteps providers. For non-THSteps cholesterol, lipid profile, glucose, and all creatinine specimens, the provider must pay the shipping costs, using a courier of their choice.
Flow Chart for Collection and Shipping of Cholesterol, Lipid Profile, Glucose and Creatinine
| Collect specimens for cholesterol, lipid profile, glucose, and creatinine testing in red top tubes. Allow to clot completely. |
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| Centrifuge specimen and separate serum from clot within 2 hours of collection. |
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Transfer serum into a transport container.
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Place specimen(s) in canisters. Multiple specimens may be contained inside the canisters. Freeze canister(s) containing specimens immediately.
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Place up to 4 canisters with frozen specimens in the bottom of the Styrofoam box.
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Place ice packs or dry ice on top of canisters. If using dry ice, ensure that the Styrofoam box is not airtight!
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Close the Styrofoam box.
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Place the Styrofoam box inside the fiberboard box.
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Before sealing the fiberboard box, record on each submission form for each specimen the date and time removed from the freezer. Circle "freezer" to indicate specimens were removed from the freezer.
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Place submission forms on top of the Styrofoam box, but inside fiberboard box. Seal fiberboard box.
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Place an air bill inside the shipping sleeve and attach to the top of the sealed fiberboard box. Ship specimens overnight.
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For cholesterol, lipid profile or glucose specimens that are part of THSteps medical checkups, prepaid air bills are provided to enrolled THSteps providers. For non-THSteps cholesterol, lipid profile, glucose and all creatinine specimens, the provider must pay the shipping costs, using a courier of their choice.
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