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. Vitamin B1 (Thiamin)
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SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
VITB1
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Purple Top (EDTA)
Collection Volume:
4.0 mL
Minimum Volume:
0.5mL
Cause for Rejection:
Gross lipemia, specimen clotted, specimen received in glass vial, specimen not protected from light
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Extraction/Liquid Chromatography - Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Fasting overnight (1214 hrs). (Infantsdraw prior to next feeding).
Invert 8 to 10 times to mix blood.
Lab/Phone:
330-543-8418
TAT:
2-5 days
Additional Info:
Reference range available on patient report
CPT Code:
84425
Synonyms:
Thiamin
Vitamin B1 (Thiamin)
Test ID/Workstation :
VITB1
Specimen Type:
Whole Blood
Tube Type:
Purple Top (EDTA)
Collection Volume:
4.0 mL
Cause for Rejection:
Gross lipemia, specimen clotted, specimen received in glass vial, specimen not protected from light
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Extraction/Liquid Chromatography - Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Fasting overnight (1214 hrs). (Infantsdraw prior to next feeding).
Invert 8 to 10 times to mix blood.
Lab/Phone:
330-543-8418
TAT:
2-5 days
Additional Info:
Reference range available on patient report
CPT Code:
84425
Synonyms:
Thiamin
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There are 10 nurses in the picture.
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The five differences are:
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The two matching doctors are 9 and 14.
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The correct path:
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