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Get CA CHLA Consultation Request Form 2016

Children s Hospital Los Angeles Department of Pathology & Laboratory Medicine Ship To: Department of Pathology and Laboratory Medicine Children s Hospital Los Angeles 4650 Sunset Blvd. MS #43 Los Angeles, CA 90027 4650 Sunset Blvd. MS #43 Los Angeles, CA 90027 Phone: 323-361-2469 Fax: 323-361-8004 CONSULTATION REQUEST FORM Please use one form per case to include: 1) Cover letter containing a summary of the clinical history 2) A copy of the surgical pathology report, even if incomplete Ref.

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