Vitamin K

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 K
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

VITMK

Test Workstation :

MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Alternate Tube Type:

SST

Collection Volume:

6.0 mL

Minimum Volume:

1.9 mL

Cause for Rejection:

Gross lipemia, specimen not protected from light

Storage:

Refrigerated

Availability:

Sent to Mayo Medical Laboratories

Methodology:

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Special Instructions:

Protect from light. Submit specimen in amber transport tube. Obtain specimen following an overnight (12 hour) fast. (Infants: draw prior to next feeding)

Lab/Phone:

330-543-8418

TAT:

2-5 days

Additional Info:

Reference range available on patient report

CPT Code:

84597

Synonyms:

Phylloquinone, Phytonadione, Mephyton, Phytomenadione, Synthex, Konakion

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Vitamin K

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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