Protein S Activity

Centralized Core Laboratory : Hematology

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. Protein S Activity
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PRTS3 MAYO

Specimen Type:

Blood

Tube Type:

Blue top (sodium citrate) tube

Collection Volume:

2.7 mL

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Optical Clot-Based

Special Instructions:

Days Performed: Monday through Friday; 12 p.m.

Centrifuge, remove plasma, and centrifuge again. Please send 1 mL frozen citrated plasma. If collected at an offsite location, send by a STAT Courier to Hospital lab.

Lab/Phone:

330-543-8418

TAT:

1-4 days

Additional Info:

Males: 65-160%

Females

<50 years: 50-160%

or =50 years: 65-160% Newborn infants have normal or near-normal free protein S antigen (> or =50%), although total protein S antigen is usually below the adult reference range. There are insufficient data concerning protein S activity in normal neonates, infants, and children; but normal or near-normal activity (> or =50%) probably is present by age 3 to 6 months.

CPT Code:

85306

Synonyms: