Pipecolic Acid

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. Pipecolic Acid
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

PIPA

Test Workstation :

MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

4.0 mL (minimum 2.5 mL)

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Gas Chromatography-Mass Spectrometry (GC-MS)

Special Instructions:

Fasting 12 hours or more, infants and children just before next feeding.

Lab/Phone:

330-543-8418

TAT:

2-9 days

Additional Info:

Ref. range is age dependent; avail on patient report

CPT Code:

82542

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Pipecolic Acid

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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