Pyruvate Kinase

Centralized Core Laboratory : Chemistry

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. Pyruvate Kinase
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PYKIN MAYO

Specimen Type:

Blood

Tube Type:

Yellow top (ACD-B) tube: Whole Blood

Collection Volume:

6.0 mL (minimum 1.0 mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Kinetic Spectrophotometry (KS)

Special Instructions:

Do not freeze. Do not transfer blood to other containers.

Lab/Phone:

330-543-8418

TAT:

1-4 days

Additional Info:

Reference range: 6.7-14.3 U/g Hgb

CPT Code:

84220

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