When an infant screens positive for one of the seven conditions, the Newborn Screening Laboratory notifies the follow-up office in the Bureau of Community Living, Children and Families. Lab Scientists also phone/fax one of the state-contracted medical management centers. For a metabolic condition, such as Phenylketonuria or Galactosemia, the Pediatric Neurology Medical Center is notified. If the test is positive for Congenital Adrenal Hyperplasia or Hypothyroidism, staff members contact the Pediatric Endocrine Center. A positive hemoglobinopathy is referred to the Sickle Cell Disease Association of America, Michigan Chapter, Inc. The physician responsible for care of the newborn is also informed. Depending on the test result, rescreening may be required, a serum test may be ordered, or, rarely, immediate referral to a specialist or hospital emergency room is ordered.