von Willebrand Factor Multimer
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. von Willebrand Factor Multimer | |
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| 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
