Centralized Core Laboratory - Cleveland Clinic Laboratories :
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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. Cryofibrinogen
2.
3.
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6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CRYFI
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
5.4 mL
Minimum Volume:
2.7 mL
Cause for Rejection:
Frozen or heparinized specimen.
Storage:
Ambient
Availability:
Sent to reference lab
Methodology:
Cold Precipitation
Special Instructions:
Draw 2 to 3 2.7mL prewarmed (37C) light blue top tubes.
Keep at 37C during transport to lab.
Fasting for 12 hours is required.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)
Lab/Phone:
330-543-8418
TAT:
4-6 days
Additional Info:
Reference range: Negative at 72 hours
CPT Code:
82585
Cryofibrinogen
Test ID/Workstation :
CRYFI
Specimen Type:
Blood
Tube Type:
Blue top (sodium citrate) tube
Collection Volume:
5.4 mL
Cause for Rejection:
Frozen or heparinized specimen.
Storage:
Ambient
Availability:
Sent to reference lab
Methodology:
Cold Precipitation
Special Instructions:
Draw 2 to 3 2.7mL prewarmed (37C) light blue top tubes.
Keep at 37C during transport to lab.
Fasting for 12 hours is required.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)
Lab/Phone:
330-543-8418
TAT:
4-6 days
Additional Info:
Reference range: Negative at 72 hours
CPT Code:
82585
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