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Cryoglobulin

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. Cryoglobulin
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

CRYQN MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

12.5 mL (minimum 8.0mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Quantitation and Qualitative Typing Precipitation at 1 Degree C.

Special Instructions:

1. Tube must remain at 37 degrees C. 2. Allow blood to clot at 37 degrees C. 3. Centrifuge at 37 degrees C. (Do not use a refrigerated centrifuge. If absolutely necessary ambient temperature is acceptable). It is very important that the specimen remain at 37 degrees C until after separation of serum from red cells. Analysis can't be performed with < 3 mL of serum For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).

Lab/Phone:

330-543-8418

TAT:

2 days

Additional Info:

Reference range: Negative

CPT Code:

82595

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