Complement AH50
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Complement AH50 | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
AH50
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red Top (no anticoagulant) tube
Collection Volume:
2.5 mL
Minimum Volume:
0.5 mL
Cause for Rejection:
Collected in SST
Storage:
Strict Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Enzyme-Linked Immunosorbent Assay (ELISA).
Special Instructions:
Immediately after drawing the specimen, place the tube on wet ice.
Spin down and separate serum from clot
Immediately freeze specimen.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
2-7 days
Additional Info:
Reference Values:
> or = 46% normal
CPT Code:
86161
Synonyms:
Complement, Alternate Pathway (AH50), Functional
