We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Vitamin B12

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. Vitamin B12
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

VIT12 E8011

Specimen Type:

Blood

Tube Type:

Green top (lithium heparin) tube

Collection Volume:

1.5 mL

Storage:

Shipping- Send Refrigerated; Storage-Room Temp: 2 hours; Refrigerated: 48 hours; Frozen: 56 days

Availability:

24 hours/day, 7 days/week

Methodology:

Roche-ECLIA Competition principle

Special Instructions:

If patient has received a vitamin B12 injection within the past two weeks, this test cannot be ordered. Send to lab ASAP.

Lab/Phone:

330-543-8418

TAT:

4 hours

Additional Info:

Reference range: 180-914 pg/mL

CPT Code:

82607

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