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. von Willebrand Factor Multimer
2.
3.
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5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
VWFM
Test Workstation :
MAYO
Specimen Type:
Blood - Plasma
Tube Type:
Blue top (Sodium citrate) tube
Collection Volume:
Collect blood in two 2.7 mL blue top (Sodium citrate) tubes (Total Volume 5.5mL)
Minimum Volume:
Minimum 1.8 mL in 1.8 mL Blue top (Sodium citrate) tube.
Cause for Rejection:
Gross hemolysis, lipemia & icterus
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Agarose Gel Electrophoresis/Infrared Dye-Labeled Antibody Detection
Special Instructions:
Send to laboratory ASAP. Specimen must be spun down and plasma removed within 4 hours of collection. If collected at an offsite location, send by a STAT Courier to Hospital lab.
Lab/Phone:
330-543-8418
TAT:
7-14 days
CPT Code:
85247
Synonyms:
VWF Mult Anal, VW Factor Polymers
von Willebrand Factor Multimer
Test ID/Workstation :
VWFM
Specimen Type:
Blood - Plasma
Tube Type:
Blue top (Sodium citrate) tube
Collection Volume:
Collect blood in two 2.7 mL blue top (Sodium citrate) tubes (Total Volume 5.5mL)
Cause for Rejection:
Gross hemolysis, lipemia & icterus
Storage:
Frozen
Availability:
Sent to Reference Laboratory
Methodology:
Agarose Gel Electrophoresis/Infrared Dye-Labeled Antibody Detection
Special Instructions:
Send to laboratory ASAP. Specimen must be spun down and plasma removed within 4 hours of collection. If collected at an offsite location, send by a STAT Courier to Hospital lab.
Lab/Phone:
330-543-8418
TAT:
7-14 days
CPT Code:
85247
Synonyms:
VWF Mult Anal, VW Factor Polymers
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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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