Centralized Core Laboratory - Mayo 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. Fatty Acid Profile Peroxismal
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
FAPRX
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
1.5 mL (minimum 0.5 mL)
Cause for Rejection:
Grossly lipemic
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Gas Chromatography-Mass Spectrometry (GC-MS) Stable Isotope Dilution Analysis
Special Instructions:
Fastingovernight (1214 hrs).
Spin down within 45 minutes of draw.
Patient must not consume any alcohol for 24 hours before the specimen is drawn.
Lab/Phone:
330-543-8418
TAT:
2-5 days
Additional Info:
Reference range is available on patient report
CPT Code:
82726
Panel Includes:
C22:0
C24:0
C26:0
C24:0/C22:0 ratio
C26:0/C22:0 ratio
Pristanic Acid
Phytanic Acid
Pristanic/Phytanic Acid
Synonyms:
LCFA
Long Chain Fatty Acids
Fatty Acid Profile Peroxismal
Test ID/Workstation :
FAPRX
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
1.5 mL (minimum 0.5 mL)
Cause for Rejection:
Grossly lipemic
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Gas Chromatography-Mass Spectrometry (GC-MS) Stable Isotope Dilution Analysis
Special Instructions:
Fastingovernight (1214 hrs).
Spin down within 45 minutes of draw.
Patient must not consume any alcohol for 24 hours before the specimen is drawn.
Lab/Phone:
330-543-8418
TAT:
2-5 days
Additional Info:
Reference range is available on patient report
CPT Code:
82726
Panel Includes:
C22:0
C24:0
C26:0
C24:0/C22:0 ratio
C26:0/C22:0 ratio
Pristanic Acid
Phytanic Acid
Pristanic/Phytanic Acid
Synonyms:
LCFA
Long Chain Fatty Acids
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There are 10 nurses in the picture.
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The five differences are:
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The two matching doctors are 9 and 14.
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