Alpha-Fetoprotein, Serum (Tumor Marker)

Centralized Core Laboratory : Chemistry

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Alpha-Fetoprotein, Serum (Tumor Marker)
2.
3.
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6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

AFPT MAYO

Specimen Type:

Blood

Tube Type:

GOLD TOP (SST) TUBE

Collection Volume:

1.5 mL

Cause for Rejection:

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Immunoenzymatic Assay

Special Instructions:

This test is not to be used for maternal screening. Days Performed: Mon-Fri 5 a.m. - 12 a.m. Saturday 6 a.m. - 6 p.m.

Lab/Phone:

330-543-8418

TAT:

1-3 days

Additional Info:

Reference range: < 6 ng/mL

CPT Code:

82105

Synonyms:

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