Vitamin B1 (Thiamin)
| PATIENT INFO |
| Patient Name: |
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| 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 (12-14 hrs). (Infants: draw 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
