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Section-D

TEST NAME

DANTRIUM* (Dantrolene)

MERCY TEST NAME

MISC GENERAL LAB

MERCY LAB CODE

CMIS

Comment:  Indicate test name in comment.
Specimen:  1 ml serum from plain red top tube or EDTA plasma. Minimum 0.3 ml.
Cause for rejection: SST not acceptable. 
Processing:  Send wrapped in foil, refrigerated, to Mayo/NMS.  Mayo order code FDANT.
Performed:  5 days
Reference value: Included with test results
Method:  Spectrofluorometry
CPT Code: 80299

 

TEST NAME

DAT

See:   Coombs Direct

 

TEST NAME

DATE RAPE DRUGS

MERCY TEST NAME

MISC GENERAL LAB

MERCY LAB CODE

CMIS

Processing: Send to Medtox Scientific.  Order Medtox # 811 Sedative Hyphotic Panel.
Specimen: 10 ml urine
Includes: Ethyl Alcohol, Barbiturates, Benzodiazepines, Flunitrazepam, Ketamine, and GHB.

 

POWERCHART NAME

D-DIMER

MERCY TEST NAME

D-DIMER TEST

MERCY LAB CODE

DDIMER

Specimen:  Draw a blue top tube (3.2% citrate) filled appropriately with amount of blood listed on label.
Stability: 4 hours room temp, freeze if > 4 hours, good for 4 weeks frozen.
Cause for rejection: Improperly filled tubes will NOT be tested.  Avoid gross hemolysis.
Processing:
  • Centrifuge immediately.  Refrigerate. 
  • Test within 4 hours of collection. 
  • Double spin, aliquot and freeze plasma if testing delayed longer than 4 hours.  
  • Label frozen vial “CITRATED PLASMA”.         

Double spin coagulation specimens to ensure that all platelets are removed:     1.  Centrifuge specimen.  Aliquot plasma (leaving some above the cells) to a plastic centrifuge tube.   2.  Centrifuge the aliquot tube.  Pipette plasma (leaving some above the bottom of the tube) to another plastic aliquot tube.   3.  Store plasma as required for the test ordered.

Performed:  Within 8 hours of receipt.  Available stat. 
Reference value: 

0-500 ng/mL FEU

The cutoff for suspected DVT or PE is 500 ng/mL FEU.

A DDIMER result

Elevated levels of DDIMER are found in clinical conditions such as DVT, PE, and DIC.  DDIMER levels also rise during normal pregnancy but very high lefels are associated with complications.

Method: Turbidimetric method on IL ACL TOP500.
CPT Code:  85379

 

TEST NAME

DEGRADATION PRODUCTS

See:   D-Dimer Test
          FDP Serum
          FDP Urine

 

TEST NAME

DEPAKEN or DEPAKOTE

See:   Valproic Acid

 

POWERCHART NAME

DERMATOLOGY CHEMISTRY PANEL

MERCY TEST NAME

DERM PANEL

MERCY LAB CODE

ATPN

Includes:

Alk Phos                             ALT                              AST                             BUN
BUN/Creat Ratio                  Cholesterol                    Creatinine                      Glucose
Protein,Total                      Triglyceride

Specimen:
  • Preferred in house: 1 ml lithium heparin plasma from a PST tube. 
  • Preferred reference lab: 1 ml serum from a SST tube.
  • Also acceptable: Sodium heparin plasma, or serum from a plain red top tube. 
Stability: 8 hours room temp, 48 hours refrigerated, freeze if >48 hours.
Performed:  Within 8 hours or receipt.  Available stat.
Reference value: See individual test entry.
Method:  See individual test entry.
CPT Code:  

84075 Alk Phos+                      82565 Creat+
84460 ALT+                              82947 Glucose+
84450 AST+                              84155 Prot Ttl+
84520 BUN+                             84478 Trig+
82465 CHOL+                          NA   BUN/Creat Ratio

 

POWERCHART NAME

DERMATOPHYTE CULTURE

MERCY TEST NAME

DERMATOPHYTE CLT

MERCY LAB CODE

DERMCT

Specimen:

  • Skin scrapings, hair or nail clippings.
  • Culture media will be inoculated directly by the dermatology office.

Comment:

  1. Label DTM agar with the patient name, date, and time of collection, and source.
  2. Do not cover agar slant with label.

Processing:

  1. Specimen to be collected in dermatology office and inoculated directly to DTM agar.  
  2. The specimen should be sent at room temperature to Mercy lab.

Performed:

Preliminary Report: 1 week.
Final Report: 2 weeks.

Method:

Standard Culture Technique.

CPT Code:

87101

 

TEST NAME

DESIPRAMINE

See:   Imipramine & Desipramine* or can be ordered separately.

TEST NAME

DESIPRAMINE*

MERCY TEST NAME

MISC GENERAL LAB  

MERCY LAB CODE

CMIS

Specimen:     
  • 3 ml serum from plain, red-top tube(s).  Minimum 1.1 ml.
  • Collect immediately before next scheduled dose (minimum 12 hours after last dose.)
Cause for rejection:  Serum from a SST tube.
Comment:  Indicate test name and time of last dose in comment.
Processing:
  • Remove serum from cells within 2 hours of collection.
  • Send refrigerated to Mayo.  Ambient or frozen acceptable. Mayo order code DESIP.
Performed:   1 day.  Test set up Monday through Saturday.
Method:    High-Pressure Liquid Chromatography (HPLC)
CPT Code: 80160 Desipramine+*

 

TEST NAME

Detection of CSF in Other Body Fluids

See: 

BETA-2 TRANSFERRIN:  Detection of Spinal Fluid in Other Body Fluid

 

TEST NAME

DEXAMETHASONE

See: Cortisol Free 24-Hour Urine*
Cortisol Random

 

POWERCHART NAME

DHEA-S (DEHYDROEPIANDROSTERONE SULFATE)

MERCY TEST NAME

DHEAS BATTERY

MERCY LAB CODE

DHEASB

Specimen:  0.8 ml serum from a SST or plain red top tube.  Minimum 0.35 ml.
Comment: 

This test is used for the diagnosis of congenital adrenal hyperplasia and adrenal carcinoma and to determine the cause of hirsutism, virilization, and polycystic ovary disease.

Processing:

1 ml serum from SST or plain red top tube.  Stable refrigerated 48 hours.  Freeze for longer storage.

Performed: Within 8 hours of receipt.
Reference value: 

Age (Years)        Female (mcg/dL)        Male (mcg/dL)

18-21                   51-321                            24-537

21-30                   18-391                            85-690

31-40                    23-366                           106-464

41-50                    19-231                           70-495

51-60                    8-188                              38-313

61-70                    12-133                            24-244

>70                        7-177                              5-253

Reference ranges have not been established by Beckman Coulter for children under 18 years of age.     

Method: Chemiluminescent Assay
CPT Code: 82627

 

TEST NAME

Diagnostic H1N1

See: diagnostic H1N1

 

POWERCHART NAME

DIALYSIS CHEMISTRY PANEL

MERCY TEST NAME

DIALYSIS PANEL

MERCY LAB CODE

DPNL

Comment: For use by Dialysis Unit ONLY.
Includes:

A/G Ratio            Albumin                       Alkaline Phosphatase  
AST(SGOT)         BUN                            BUN/Creatinine Ratio
Calcium               CO2                            Creatinine
LDH                    Phosphorus                  Potassium
Sodium               Total Protein      

Specimen: 
  • Preferred in house: 1 ml lithium heparin plasma from a PST tube. 
  • Preferred reference lab: 1 ml serum from SST tube.  Refrigerate. 
  • Also acceptable: serum from a plain red top tube.
  • Specimens must be received in the Lab within 2 hours of collection for centrifugation.   
  • Keep tube closed.
Stability: 8 hours room temp, 48 hours refrigerated, freeze if >48 hours.  (Exception: LDH is stable 24 hours room temp only.)
Cause for rejection: Delay in centrifugation will result in falsely elevated Potassium and Phosphorus results.
Performed:  Within 8 hours of receipt.  Available stat.
Reference value: See individual test entry
Method: See individual test entry
CPT Code: 

82040  Albumin           84075  Alk Phos              84450  AST               84520  BUN
82310  Calcium            82374  CO2                   82565  Creat              83615  LD
84100  Phosphorus      84132  Potassium            84295  Sodium           84155 Prot TTL

 

TEST NAME

DIAPHRAGM WASHINGS

See: Cytology Section Peritoneal Fluid

 

POWERCHART NAME

DIAZEPAM AND NORDIAZEPAM LEVEL  

MERCY TEST NAME

DIAZEP NORDIAZ*   

MERCY LAB CODE

DIAN

Specimen:  3.0 ml serum from a plain red top tube. Minimum 1.1 ml.
Processing:    Separate from cells.  Send refrigerated to Mayo.  Ambient or frozen acceptable.   Mayo  order code - DIA.
Performed:  Mayo Medical Laboratories, Thursday 9 am
Reference values:

Included with test results

Method:   High-Pressure Liquid Chromatography (HPLC)
CPT Code: 80154

 

POWERCHART NAME

DIC PANEL

MERCY TEST NAME

DIC PANEL

MERCY LAB CODE

DICPNL

Includes: 

Fibrinogen                             D-Dimer
Protime/INR                          Thrombin Time
PTT

Specimen: 2 Blue top tubes (3.2% Citrate) filled appropriately with amount of blood listed on label.
Stability: 4 hours room temp, freeze if >4 hours, good for 4 weeks frozen.
Cause for rejection: Gross hemolysis.  Improperly filled tubes will not be tested.
Processing:
  • Centrifuge immediately. 
  • Seperate plasma within 2 hours of collection.
  • Double spin and freeze plasma if testing delayed longer than 4 hours. 
  • Label frozen vial “Citrated Plasma.”
Preformed: Within 8 hours of receipt.  Available stat.
Method: Photo-optical clot detection
CPT Code:

85380 D-Dimer 
85610 PT  
85384 Fibrinogen
85730 PTT
85610 PT

 

TEST NAME

DIFFERENTIAL

Included in a CBC
If physician specifically orders CBC with manual diff, see CBC with MANUAL DIFF
For technical staff review of smear:  See DIFFERENTIAL MANUAL
For pathologist review of smear:  See CELL MORPHOLOGY  

 

POWERCHART NAME

DIFFERENTIAL

MERCY TEST NAME

DIFFERENTIAL MANUAL

MERCY LAB CODE

DIFF

Specimen:  Purple top tube adequately filled and mixed immediately. 
Stability: 4 hours room temp, 36  hours refrigerated.
Comment:
  • Includes differential count of white cells and morphology of red cells.
  • May be performed on a CBC specimen which was ordered and reported within the previous 36 hours.
  • Indicate in comment if previous days specimen is to be used.
  • Please send a copy of the CBC results from your instrument.
Performed: Within 8 hours of receipt.  Available stat
Reference value: Included with test results.  See Special Helps section for complete listing.
Method: Microscopy, Wright stained smear.
CPT Code: 85007

 

POWERCHART NAME

DIGOXIN LEVEL

MERCY TEST NAME

DIGOXIN           

MERCY LAB CODE

DIG

Comment:
  • Indicate time last dose in comment. 
  • A nursing home patient's morning dose should be held if Lab is to collect a morning specimen.
Specimen:
  • Preferred in house: 0.5 ml lithium heparin plasma from a PST tube.
  • Preferred reference lab: 0.5 ml serum from a SST tube.
  • Also acceptable:  Sodium Heparin, EDTA plasma tubes, or serum from a plain red top tube. 
  • Collect 8-24 hours following last dose of digoxin (not digitalis or digitoxin), but before next dose.  
Stability: 8 hours room temp, 48 hours refrigerated, freeze if >48 hours.
Performed: Within 8 hours of receipt.  Available stat.
Reference value: Therapeutic range: 0.8-2.0 ng/ml
Method: Emit Enzyme Immunoassay
CPT Code: 80162

 

TEST NAME

DILANTIN

See:    Phenytoin Total & Free

 

TEST NAME

DILANTIN FREE

See:   Phenytoin Total & Free

 

TEST NAME

DIPHENYLHYDANTOIN

See:   Phenytoin Total & Free

 

TEST NAME

DIRECT ANTIGLOBULIN TEST

See:  Coombs Direct

 

POWERCHART NAME

LDL CHOLESTEROL DIRECT

MERCY TEST NAME

DIRECT LDL CHOL

MERCY LAB CODE

DLDL

Note: Measured not calculated.
Specimen: 
  • Preferred in house: 0.5 ml lithium heparin plasma from a PST tube.
  • Preferred reference lab: 0.5 ml serum from a SST tube.
  • Also acceptable: Sodium Heparin, or serum from a plain red top tube.  
  • Fasting not necessary.
Stability: 5 days refridgerated, freeze if > 5 days.
Reference Value:

The National Cholesterol Education Program of the National Heart, Lung, and Blood Institute has announced the following guidelines:
     Optimal:            <100mg/dl
     Near Optimal:    100-129mg/dl
     Borderline high:  130-159mg/dl
     High:                 160-189mg/dl
     Very High:          ≥190mg/dl

Performed:  Within 8 hours of receipt
Method:  Enzymatic         
CPT Code:  83721

 

TEST NAME

DIRECT GRAM STAIN

See:  Gram Stain Direct

 

POWERCHART NAME

DISOPYRAMIDE (NORPACE) LEVEL

MERCY TEST NAME

DISOPYRAMIDE*     

MERCY LAB CODE

DSPY

Specimen:   1.0 ml serum from a plain red top tube only.  Minimum 0.4 ml.
Processing: Send at refrigerated to Mayo. Ambient or frozen acceptable.   Mayo order code DSP.
Performed:  1 day.  Test set up Monday through Sunday.
Reference value:   Included with results.
Method: Immunoassay
CPT Code: 80299

 

POWERCHART NAME

DNA ANTIBODY DOUBLE STRANDED

MERCY TEST NAME

dsDNA

MERCY LAB CODE

DNADS

Specimen: 
  • Minimum 1.0 ml serum from a SST tube
  • Aliquot specimen immediately, store frozen before testing
Comment: 
  • Included in Autoimmune Profile, which is reflex ordered when ANA screen is reported as positive.
  • dsDNA can be ordered seperately on patients being followed for treatment of autoimmune disease.
  • Results will be reported as a Quantitative value, in IUs.
Performed: Tuesdays, 1200 cutoff
Reference value:

25-30 IU: Borderline postive

31-60 IU: Low positive

61-200 IU: Positive

>200 IU: Strong positive

 

Method:  EIA
CPT Code: 86225

 

POWERCHART NAME

DONOR COLLECTION

MERCY TEST NAME

COLLECT CHG DONOR

MERCY LAB CODE

MDONOR
Comment:
  • When a potential bone marrow, tissue, or organ donor comes to the lab to be drawn for compatibility, we will do the collection at no charge to the donor.
  • DO NOT add a collect charge or a processing charge. 
  • The test code "MDONOR" is ordered simply to track that the patient did hava a specimen drawn, but there is no charge associated with the test.
  • Patient may bring in their own kit, or kit may be located in processing department. 
  • Proccess and sendout kit as instructed.

 

POWERCHART NAME

DOXEPIN (SINEQUAN) LEVEL

MERCY TEST NAME

DOXEPIN NORDOXEPIN*

MERCY LAB CODE

DXPN

Specimen:
  • 3 ml serum from a plain  red-top tube. Minimum 1.1 ml. 
  •  Collect immediatly before next scheduled dose (minimum 12 hours after last dose.)  
  • Spin down within 2 hours of draw. If serum is not removed within this time, TCA levels may be falsely elevated due to drug release from red blood cells.
Cause for rejection: Hemolysis is NOT acceptable. Serum gel tube is NOT acceptable.
Processing:    
  • Centrifuge within 2 hours of collection. 
  • Send refrigerated to Mayo. Frozen or ambient acceptable.  Mayo order code  DOXP.
Performed:  2-4 days.  Test set up Monday through Saturday.
Reference value:  Included in report.
Method:  High-Pressure Liquid Chromatography (HPLC)
CPT Code:  

80166 - Doxepin
80299 - Quantitation of drug

 

POWERCHART NAME

COLLECTION DRUG SCREEN HEALTH WORKS

MERCY TEST NAME

DRUG ABUSE TESTING FOR EMPLOYMENT, PRE-EMPLOYMENT, POST-ACCIDENT, CDL (Commercial Driver's License), NON-CDL

 CCDAHW 

Comment:
  • Employers each have specific procedures.  Certain industries are mandated by DOT regulations.  Chain-of-custody available.
  • Refer Healthworks clients to Healthworks at Mercy, Cheslea Creek, 8:00 AM to 5:00 PM. 1-800-622-6352 or 421-5244.
  • After hours, Laboratory support services staff will collect the urine specimens.  Clients are to register in Patient registration or through ER.
  • An Employer representative must accompany the employee and the employee must have a photo ID.  (Exception: Post accident or out of area).
  • The Lab will refrigerate the sealed package in a locked box and secure paperwork. 

 

POWERCHART NAME

DRUG  OF ABUSE SCREEN URINE

MERCY TEST NAME

DRUG AB R UR      

MERCY LAB CODE

DRUG

Comment:

Performed at Mercy in Mason City.  No chain of custody is kept. 
Regional Lab Clients: Refer to Drug Abuse With Chain of Custody for legal actions.

Screens for:

Screens for these types of drugs:

  1. Amphetamines which includes amphetamine and methamphetamine.  Cutoff:  1000 ng/ml.
  2. Barbiturates which includes various barbiturate drugs.  Cutoff:  200 ng/ml.
  3. Benzodiazepines which includes a variety of compounds.  Cutoff:  200 ng/ml.
  4. Cocaine.  Cutoff:  300 ng/ml.
  5. Opiates which includes heroin, codeine, and morphine.  Cutoff:  300 ng/ml.
  6. Cannabinoids which includes marijuana and THC compounds.  Cutoff:  50 ng/ml.

Screening test for medical decisions, not for legal chain of custody.    

Comment:  If urine alcohol is needed, refer to Alcohol Ethyl Urine.
Specimen:  30 ml urine.  No preservative. 
Stability: 7 days refrigerated, freeze if > 7 days.
Processing:

Aliquot and refrigerate. 

Performed: Screening test done within 8 hours of receipt.  Available stat.  Done at Mercy Laboratory.
Reference value:

None detected
Interference has been demonstrated from mefenamic acid, a nonopoid analgesic.

Method:   Homogenous Enzyme Immunoassay
CPT Code: G0434 Drug Scr Mod Cmplx /ENCT 6-9

 

TEST NAME

DRUG ABUSE WITH CHAIN OF CUSTODY (Regional Lab Clients)

Comment: 

Regional Lab clients need to order the collection kit directly from MEDTOX. Regional Lab clients are responsible for the collection process, chain of custody, mailing kit, billing, and reporting.

MEDTOX Laboratories
402 West County Road D
St. Paul, MN   55112
Phone number:  800-832-3244.
CLIA ID# 24D0665278

 

TEST NAME

DRUG SCREEN AUTOPSY*

Specimen: Urine, Blood, Vitreous fluid, Gastric fluid, or Tissue.
Comment:  Ordered by Lab personnel on autopsy specimens as directed by pathologist or pathology assistant.
Processing:

Performed at Mercy Medical Center – North Iowa, send to Mayo, send to Medtox, send to Aegis Analytical Lab, or as indicated on the Mercy Drug Screen Autopsy form.

Refer To:

Drug Abuse Random Urine performed at Mercy North Iowa
DGS - Drug Screen Blood, Mayo order code DSS 
OTCU - OTC/Rx Drug Screen Urine Mayo order code PDSU.

 

POWERCHART NAME

DRUG SCREEN BODY FLUID- test obsolete 9/24/10

MERCY TEST NAME

DRUG SCN BF*

MERCY LAB CODE

DRGB

 

POWERCHART NAME

MECONIUM DRUG SCREEN

MERCY TEST NAME

DRUG SCN MECONIUM*

MERCY LAB CODE

CMIS

Includes: 

Amphetamines     Methamphetamines   Opiates
Cocaine                  Tetrahydrocannabinol

Comment: 

Request kits from Mercy Laboratory-Mason City.
Complete Mayo’s Chain of Custody form. 

Regional Lab Clients: Request kits from Mercy Laboratory – Mason City.  Complete Mayo’s Chain of Custody Form (included in the kit) and Mercy lab reference form. Do not seal chain of custody bag.

Specimen: 5 grams meconium (approximately 1 tablespoon).  Minimum 1 gram (approximately 0.5 tsp).
Processing:  Send frozen to Mayo.  Refrigerated acceptable. Order CMIS for  Mayo order code DASM4.
Performed:          3 days
Reference value:  Included with report.
CPT Code:

G0431 Drug Scr QL H Cmplx/ENCT<=5
99001
80299-Tetrahydrocannabinol carboxylic acid (if appropriate)
82145 x 2-Amphetamines (if appropriate)
82520-Cocaine (if appropriate)
83925-Opiates (if appropriate) 

 

POWERCHART NAME

DRUG SCREEN  COMPREHENSIVE PLASMA

MERCY TEST NAME

DRUG SCN BLOOD*

MERCY LAB CODE

DGS

Includes:

Analgesics           Hypoglycemics       Lidocaine           Sedatives
Stimulants           Anticonvulsants       Barbiturates  
Other miscellaneous drugs                 Psychotropics  Disopyrimide

Refer to Mayo catalog for complete listing of drugs tested.
Specimen:  5.25 ml serum from plain red top tube.  Minimum 2.1 ml.
Comment: Not to be used for drugs of abuse screening.
Processing: Send refrigerated to Mayo. Ambient or frozen acceptable.  Mayo order code  DSS.
Performed:  Test set up Monday through Sunday.
Reference value:  Included in report
Method:  Gas-Liquid Chromatography (GLC).  Confirmation by Gas Chromatography/Mass Spectrometry.
CPT Code:

80100
G0431 (if appropriate)
80299 (applies to confirmation ONLY)

 

TEST NAME

DRUG SCREEN URINE

See: Drug Abuse Random Urine

TEST NAME

DRUG SCREEN URINE-Buprenorphine

See:  BUPRENORPHINE SCREEN URINE 

  

TEST NAME

DRUG SCREEN URINE-Methadone

See:  METHADONE  (Dolophine) SCREEN URINE 

 

TEST NAME

DRUG SCREEN URINE-Oxycodone

See:  OXYCODONE SCREEN URINE 

 

POWERCHART NAME

DRUG SCREEN URINE PRESCRIPTON - OTC

MERCY TEST NAME

OTC/Rx Drug Screen Urine

MERCY LAB CODE

OTCU

Comment This test is limited to prescripton and OTC drugs. Drugs of abuse testing will need to be ordered separately if desired. 

This test looks for a broad spectum of prescription and over-the-couter drugs. It is designed to detect drugs that have toxic effects, as well as other antidotes or active therapies that clinician can initiate to treat toxic effects. It is intended to help physicians manage an apparent overdose of an intoxicated patient, to determine if a specific set of symptoms might be due to the presence of drugs, or to evaluate a patient who might be abusing these drugs intermittently.  This test does not test for all possible drugs.

Drugs of toxic significance that or NOT detected by this test include digoxin, lithium, and many other drugs of abuse/illicit drugs, some denzodiazepines, and some opiates.  Testing for durgs of abuse can be accomplished by ordering one of the available confirmed drugs of abuse urine panels, drugs of abuse screening urine panels, or by ordering individual tests for specific calsses of drugs or individiual drugs.
Specimen:  30 mL from a random urine collection. No preservative.
Processing: Send specimen refrigerated in a plasitc 60-mL urine bottle. Frozen is acceptable.  Mayo order code PDSU
Performed:  Monday thru Sunday
Method:  Gas-Liquid Chromatography - Mass Spectroscopy
CPT Code:

80100

 

POWERCHART NAME

QUICK DRUG SCREEN CHAIN OF CUSTODAY - ORDERABLE ONLY BY LAB

MERCY TEST NAME

DRUG SCRN COC QUICK

MERCY LAB CODE

QDRUG

Comment Refer clients to Healthworks at Mercy, Cheslea Creek, 8:00 AM to 5:00 PM. 1-800-622-6352 or 428-5244.
After hours, Laboratory support services staff will collect the urine specimens using the chain of custody and perform the Quick Drug screen testing. Employers each have specific procedures.  When Larson Manufacturing employees present to the lab the Quick Drug kit 11+4 is to be used. When Curries/Graham Manufacturing employees present to the lab the CRLSTAT kit is used.  An Employer representative must accompany the employee. The forms and kits for this testing are kept on site in the draw station room off of the lab waiting room. Order the test CCDAHW and QDRUG and result as “TCOM” test completed. See specific procedure for the handling of the paperwork.
CPT Code: 80100
G0431 (if appropriate)
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 Mercy Medical Center-North Iowa | 1000 4th Street SW Mason City, IA 50401 | 641-428-7000

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