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. Homocysteine, Total Plasma
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
HOM
Test Workstation :
MAYO
Specimen Type:
Blood - Plasma
Tube Type:
Purple top (EDTA) tube - Plasma
Collection Volume:
2.5 mL
Minimum Volume:
0.8mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Stable Isotope Dilution Analysis
Special Instructions:
Fasting (12 hours preferred but not required). Immediately place specimen on wet ice.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)
Lab/Phone:
330-543-8418
TAT:
3-5 days
Additional Info:
Reference range is available on patient report
CPT Code:
83090
Homocysteine, Total Plasma
Test ID/Workstation :
HOM
Specimen Type:
Blood - Plasma
Tube Type:
Purple top (EDTA) tube - Plasma
Collection Volume:
2.5 mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Stable Isotope Dilution Analysis
Special Instructions:
Fasting (12 hours preferred but not required). Immediately place specimen on wet ice.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)
Lab/Phone:
330-543-8418
TAT:
3-5 days
Additional Info:
Reference range is available on patient report
CPT Code:
83090
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