Alkaline Phosphatase Isoenzymes
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Alkaline Phosphatase Isoenzymes | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
APISO
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Gold top SST (serum separator tube, no anticoagulant)
Alternate Tube Type:
Red Top
Collection Volume:
2.5 mL
Minimum Volume:
1.5 mL
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Colorimetric; Electrophoresis
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
CPT Code:
84075, 84080
Panel Includes:
Alkaline Phosphatase; Bone%; Bone U/L; Liver%; Liver U/L; Intestinal%; Intestinal U/L, Placental Isoenzymes
