Centralized Core Laboratory - Mayo Clinic Laboratories :
Send Out
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. Liver - Kidney Microsome (Mayo)
2.
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6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
LKIDM
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top tube
Collection Volume:
1.5 mL (minimum 1.0 mL)
Cause for Rejection:
Gross hemolysis, gross lipemia, Heat treated
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Enzyme-Linked Immunosorbent Assay (ELISA)
Special Instructions:
Draw blood in a plain red top tube or serum gel tube. Spin down and send 0.5mL serum refrigerated. Submitting the minimum specimen volume makes it impossible to repeat or to do confirmatory testing or perform reflux testing. In some situations a minimum specimen volume may result in QNS.
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference available on patient report
Days Performed: Mon, Wed, Fri
CPT Code:
86376
Synonyms:
LK Ab
Liver - Kidney Microsome (Mayo)
Test ID/Workstation :
LKIDM
Specimen Type:
Blood
Tube Type:
Red top tube
Collection Volume:
1.5 mL (minimum 1.0 mL)
Cause for Rejection:
Gross hemolysis, gross lipemia, Heat treated
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Enzyme-Linked Immunosorbent Assay (ELISA)
Special Instructions:
Draw blood in a plain red top tube or serum gel tube. Spin down and send 0.5mL serum refrigerated. Submitting the minimum specimen volume makes it impossible to repeat or to do confirmatory testing or perform reflux testing. In some situations a minimum specimen volume may result in QNS.
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference available on patient report
Days Performed: Mon, Wed, Fri
CPT Code:
86376
Synonyms:
LK Ab
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