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Vaginal Culture
See Culture, Genital

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Vaginal Culture Neisseria Gonorrhoeae Only
See Culture, Neisseria Gonorrhoeae (GC Screen)

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Vaginal Trich Smear
See Trichomonas vaginalis Preparation

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Vaginitis DNA Probe		Test Code: VGDNA
Includes:	• Determine presence of: • Candida species • Gardnerella vaginalis (bacterial vaginosis) • Trichomonas vaginalis
CPT:	87800
Alternate Name:	AFFIRM VPIII®; Cervical DNA Probe; DNA Probe for Candida species; DNA Probe for Gardnerella vaginalis; DNA Probe for Trichomonas vaginalis
Methodology:	DNA Probe, Affirm VPIII
Testing Schedule:	Routine, Monday-Friday only
Report Available:	1-3 days
Specimen Requirements:
Container:	AFFIRM VPIII ambient temperature transport system
Collection:	Follow package instructions on collection kit: • Label the sample collection tube (SCT) with the patient identification information. • Remove Ambient temperature transport regent (ATTS) dropper from package in collection kit, break ampule in reagent dropper and dispense liquid into tube provided in collection kit. • Place patient in position for pelvic examination, insert an unlubricated speculum (without jelly or water) into the vagina to permit visualization of posterior vaginal fornix OR If using a lubricated speculum, partially insert into vagina and collect specimen from above speculum. • Remove swab from packaging in collection kit. • Using swab from collection kit, obtain a sample from the posterior vaginal fornix; twist or roll the swab against the vaginal wall 2-3 times, ensuring the entire circumference of the swab has touched the vaginal wall. Swab the lateral vaginal wall while removing the swab. • IMMEDIATELY place swab into tube (SCT) and break swab at score line. • Close cap firmly and transport to the laboratory within 72 hours.
Special Instructions and/or Comments:
DO NOT predispense ATTS reagent. The ATTS reagent is toxic and flammable, avoid inhalation and skin contact when dispensing reagent.
Reference Range:
Negative for Candida species, Gardnerella vaginalis and Trichomonas vaginalis
Clinical Utility:
Detection of causative agents of vaginitis and bacterial vaginosis: Trichomonas vaginalis, Candida species, and Gardenella vaginalis.

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Valproic Acid		Test Code: VALP
CPT:	80164
Alternate Name:	Depakene®; Sodium Valproate, Depakote
Methodology:	Immunoassay (IA)
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Red top tube, or serum separator
Reference Range:
Therapeutic: 50-100 .µg/mL
Critical Values:
>200 .µg/mL
Clinical Utility:
Useful for monitoring therapy and assessing toxicity.

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Valproic Acid, Free		Test Code: FRVA
Includes:	Valproic Acid, Free
CPT:	80164
Alternate Name:	Depakene®, Free; Depakote®, Free
Methodology:	Ultrafiltration, Immunoassay
Testing Schedule:	Routine, daily
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum or plasma
Container:	Red top tube, no serum separator or Green top, Lithium Heparin
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Free: • Therapeutic..................4-15 µg/mL • Toxic...........................>15 µg/mL
Clinical Utility:
The Valproic acid that circulates in blood is 85-90 % protein bound under normal circumstances. Since neurologic activity and toxicity of valproic acid are directly related to the unbound fraction of the drug, measurement of the free or unbound drug may be necessary where altered protein binding is possible, such as in hypoalbuminemia, pregnancy, renal or hepatic failure, the elderly or use of concomitant drug therapy.

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Vancomycin, Peak		Test Code: VANP
CPT:	80202
Alternate Name:	Vancocin®
Methodology:	Immunoassay
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Red top or SST tube
Collection:	• Peak: Collect 1 hour after completion of a 60-minute I.V. infusion. • Trough: Collect immediately prior to next dose.
Special Instructions and/or Comments:
• Transport to the laboratory immediately. • If delay in testing, centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice.
Reference Range:
Trough: Normal Therapeutic range is 10-20 µg/ml. For the management of central nervous system infections, endocarditis, or health care associated pneumonia, trough levels of 15-20 ug/ml are suggested. Peak: Therapeutic: 30-40 ug/ml
Critical Values:
>40µg/mL
Clinical Utility:
Useful for assessing adequate clearance, monitoring adequate blood concentrations during therapy and assessing toxicity.

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Vancomycin, Trough		Test Code: VANT
CPT:	80202
Alternate Name:	Vancocin®
Methodology:	Immunoassay
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Red top or SST tube
Collection:	• Peak: Collect 1 hour after completion of a 60-minute I.V. infusion. • Trough: Collect immediately prior to next dose.
Special Instructions and/or Comments:
• Transport to the laboratory immediately. • If delay in testing, centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice.
Reference Range:
Trough: • Normal Therapeutic range is 10-20 µg/ml. • For the management of central nervous system infections, endocarditis, or health care associated pneumonia, trough levels of 15-20 ug/ml are suggested. Peak: Therapeutic: 30-40 ug/ml
Critical Values:
>40µg/mL
Clinical Utility:
Useful for assessing adequate clearance, monitoring adequate blood concentrations during therapy and assessing toxicity.

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Vancomycin, Random		Test Code: VANC
CPT:	80202
Alternate Name:	Vancocin®
Methodology:	Immunoassay
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Container:	Red top or SST tube
Collection:	• Peak: Collect 1 hour after completion of a 60-minute I.V. infusion. • Trough: Collect immediately prior to next dose.
Special Instructions and/or Comments:
• Transport to the laboratory immediately. • If delay in testing, centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice.
Reference Range:
Trough: Normal Therapeutic range is 10-20 µg/ml. For the management of central nervous system infections, endocarditis, or health care associated pneumonia, trough levels of 15-20 ug/ml are suggested. Peak: Therapeutic: 30-40 ug/ml
Critical Values:
>40µg/mL
Clinical Utility:
Useful for assessing adequate clearance, monitoring adequate blood concentrations during therapy and assessing toxicity.

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Vanillylmandelic Acid, 24-Hour Urine		Test Code: VMAU
Includes:	• Volume Measurement • Collection Period • Vanillylmandelic Acid, Urine
CPT:	81050,84585
Alternate Name:	VMA, 24-Hour Urine
Methodology:	Liquid Chromatography / Tandem Mass Spectrometry (LC-MS/MS)
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	25 mL aliquot of a well mixed 24-hour urine collection.
Container:	• 24 hour plastic urine container • Add 15 mL of 50% acetic acid at beginning of collection
Collection:	• Instruct the patient to void at the beginning of collection period and discard the specimen • Collect all urine including the final specimen voided at the end of the collection period. • Refrigerate during collection • Container must be labeled with the patient’s name
Special Instructions and/or Comments:
• Instruct patient not to void directly into container. • Transport to the laboratory promptly
Reference Range:
Adults: <8.0 mg/24 hours
Clinical Utility:
Useful for screening for cathecholamine-secreting tumors in children when accompanied by homovanillic acid (HVA). Supporting a diagnosis of neuroblastoma. Monitoring neuroblastoma treatment. In the past, this test has been used to screen for pheochrome-cytoma. However, VMA is not the analyte of choice to rule out a diagnosis of pheochromocytoma . Recommended tests for this purpose are Metanephrines, Fractionated, Free, Plasma (PLMET), Metanephrines, Fractionated, 24-Hour, Urine (FMET), and/or Catecholemines, 24-Hour Urine (UCAT).

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Varicella-Zoster, Culture
See Culture, Viral, General

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Varicella-Zoster DFA		Test Code: VZDFA
CPT:	87290
Alternate Name:	Herpes Zoster
Methodology:	Direct Fluorescent Antibody Test
Testing Schedule:	7 days a week, 0700-1530
Report Available:	1 day
Special Instructions and/or Comments:
• Slides are prepared by physician and should be transported to the laboratory promptly.
Reference Range:
Direct FA negative for Varicella Zoster virus.
Clinical Utility:
Varicella –Zoster virus, a member if the Herpes group, causes chicken pox (Varicella) .After an attack of chickenpox, the virus lies dormant in the nerve tissue. It can reactivate and reappear later in life in the form of shingles (Herpes Zoster), a skin disease with painful rashes, blisters, and sores similar to chickenpox.

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Varicella-Zoster IgG Antibody, Immune Status		Test Code: HZVA
CPT:	86787
Alternate Name:	Chickenpox Immune Status; Herpes Zoster Antibody; Herpes Zoster Screen for Immune Status;Shingles Screen for Immune Status; Varicella-Zoster Screen; VZV Screen
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Reference Range:
See table Varicella-Zoster IgG Antibody Screen ELISA Antibody Index Interpretation Comment <=0.90 Negative Indicates no detectable IgG antibody to Varicella (herpes) Zoster virus. Patient is not immune and therefore susceptible to primary infection. If primary infection is suspected, specimens obtained within days after onset of symptoms may not contain detectable IgG antibodies, and second specimen should be obtained in 14-21 days. 0.91-1.09 Equivocal IgG antibody levels to Varicella (herpes) Zoster virus may not equate with immunity. Suggest a new specimen be submitted for testing >=1.10 Positive Indicates presence of detectable IgG antibody to Varicella (herpes) Zoster virus. Patient is immune. Results suggest past infection or vaccination. Immunity to exogenous reinfection is lifelong, so second attacks of disease are virtually unknown. However, recurrence of virus may occur in the form of zoster.
Clinical Utility:
Diagnose Varicella Zoster Virus (VZV) infection; determine adult susceptibility to infection.

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VAP Cholesterol		Test Code: VAPCH
Includes:	• Total LDL • Total HDL • Total VLDL • Total Cholesterol • Triglyceride • Total Non-HDL Cholesterol(LDL + VLDL) • Lp(a) Cholesterol • Remnant Lipoproteins, LDL subclasses • HDL subclasses, VLDL subclasses • LDL Pattern size
CPT:	83701,84478
Methodology:	Ultracentrifugation, Spectrophotometry
Report Available:	7-10 days
Specimen Requirements:
Minimum Volume:	2 mL Serum
Container:	2 Gold Top (Serum Separator) Tubes
Special Instructions and/or Comments:
• Refrigerate • Fasting Specimen Required
Reference Range:
Accompanies report
Clinical Utility:
Useful to identify cholesterol abnormalties.

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Varicella-Zoster Screen
See Varicella-Zoster IgG Antibody, Immune Status

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Varicella-Zoster Virus IgM Antibody		Test Code: HZVM
CPT:	86787
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
<0.91 titer
Critical Values:
Positive results are reported to the appropriate State Department of Health.
Clinical Utility:
To aid in the determination of current or recent Varicella-Zoster Virus (Chickenpox) infection.

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Varicella-Zoster Virus, PCR, Cerebrospinal Fluid		Test Code: VZVPR
CPT:	87799
Alternate Name:	VZV, PCR, CSF
Methodology:	Rapid Polymerase Chain Reaction (RT-PCR)
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL frozen cerebrospinal fluid
Container:	Sterile conical tube *Each test ordered must have a separate tube of frozen CSF*
Special Instructions and/or Comments:
• Aliquot specimen into 2 plastic vials and freeze. Once frozen, transport specimen submerged in dry ice. • Specimen must be frozen within 4 hours of collection
Reference Range:
<500 copies/mL
Clinical Utility:
Quantitates Varicella-zoster virus DNA down to 500 copies/mL to monitor viral load and therapeutic efficacy, primarily in immunocompromised patients.

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Vasoactive Intestinal Polypeptide		Test Code: VIP
CPT:	84586
Alternate Name:	VIP
Methodology:	Radioimmunoassay (RIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL plasma
Container:	Lavender top (EDTA) tube
Collection:	8 hour fasting required. NOTE: This test should not be done on a patient who recently received radioactive material.
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice.
Reference Range:
< 75.0 pg/mL
Clinical Utility:
Useful for, detection of VIPoma in patients with chronic diarrheal diseases.

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VBG
See Blood Gas, Venous

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VDRL, Cerebrospinal Fluid		Test Code: VDRL
Includes:	• VDRL, Qualitative Screen • Reactive screens are titered and reported quantitatively
CPT:	86592, Reflexed when appropriate: 86593
Alternate Name:	Cerebrospinal Fluid VDRL; CSF VDRL; Serologic Test for Syphilis, CSF; Spinal Fluid VDRL
Methodology:	Flocculation
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	0.5 mL cerebrospinal fluid
Container:	Sterile conical tube
Special Instructions and/or Comments:
Serum is NOT acceptable for analysis, see RPR listing.
Reference Range:
Nonreactive (NR)
Clinical Utility:
Test for syphilis, neurosyphilis. Although false positives in the VDRL test are generally restricted to serum and are not usually found in VDRL CSF, the possibility of false positives must always be considered.

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Venom Allergen Profile
See Allergen Profile, Venom

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Venous Blood Gas
See Blood Gas, Venous

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Ventricular Fluid Culture
See Culture, Cerebrospinal Fluid

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Ventricular Tap Cytology
See Cytopathology, Cerebrospinal Fluid

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Verapamil		Test Code: VERP
Includes:	• Verapamil • Norverapamil Metabolite
CPT:	80299
Alternate Name:	Calan®; Isoptin®
Methodology:	High Performance Liquid Chromatography (HPLC)
Testing Schedule:	Routine, 2 times per week
Report Available:	5-days
Specimen Requirements:
Minimum Volume:	3 mL serum
Container:	Red top tube (large 10mL), no serum separator
Collection:	Collect 1-2 hours after last dose.
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Verapamil: • Therapeutic: 100-600 ng/mL Norverapamil: • Therapeutic: 100-400 ng/mL
Clinical Utility:
Useful for, assessing achievement of optimal therapeutic levels.

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Very Long Chain Fatty Acids
See Fatty Acid Profile, Peroxismal (C22-C26)

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VIII Antigen
See Factor VIII Antigen

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VIP
See Vasoactive Intestinal Polypeptide

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Viral Culture, Bronchial Wash
See Culture, Viral, Respiratory

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Viral Culture, Nasopharyngeal
See Culture, Viral, Respiratory

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Viral Culture, Pulmonary Biopsy
See Culture, Viral, Respiratory

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Viral Culture, Throat Swab
See Culture, Viral, Respiratory

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Virtual HIV-1 Genotype
See Virtual Phenotype Profile

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Virtual Phenotype Profile		Test Code: PTYPE
Includes:	• HIV-1 Viral Load, PCR, Ultrasenstitive • Reflexed when appropriate: • Additional HIV-1 Viral Load quantitation when ultrasensitive values are >100,000 copies/mL • HIV-1 Genotype when HIV-1 Viral Load is >1,000 copies/mL • Virtual Phenotype when HIV-1 Viral Load is >1,000 copies/mL
CPT:	87536 Reflexed when appropriate: 87536, 87901, 0023T
Alternate Name:	Virtual HIV-1 Genotype
Methodology:	• Reverse Transcription Polymerase Chain Reaction (RT-PCR) COBAS Amplicor Monitor Test, Version 1.5 • Rapid Polymerase Chain Reaction (RT-PCR) with DNA Sequencing
Testing Schedule:	Routine, Monday-Friday
Report Available:	10-14 days
Specimen Requirements:
Minimum Volume:	8 mL plasma
Container:	4 White top (EDTA) plastic tubes
Special Instructions and/or Comments:
• DO NOT submit heparinized specimen. • Transport whole blood at 2-25C • Must be processed within 6 hours of collection. • Centrifuge specimen. DO NOT aliquot. Freeze 2 original tubes and refrigerate the 2 remaining tubes. Once frozen, transport specimen submerged in dry ice. • A HIV-1 Viral Load of >1,000 copies/mL is required for the specimen to be valid for both HIV- 1 Genotype and Virtual Phenotype testing. NOTE: No HIV-1 Genotype or Virtual Phenotype results will be reported on specimens with <1,000 copies/mL.
Reference Range:
See report.
Clinical Utility:
• The use of resistance testing is recommended. • Whenever treatment is to be changed • In HIV positive pregnancies • When treatment is initiated Phenotyping can predict HIV-1 drug resistance, guide selection of effective antiretroviral drugs, and monitor transmission of drug- resistant HIV-1.

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Viscosity, Fluid		Test Code: FVIS
CPT:	85810
Alternate Name:	Fluid Viscosity; Synovial Fluid, Viscosity
Methodology:	Manual
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	5 mL synovial fluid
Container:	Sterile tube or red top tube, no serum separator
Special Instructions and/or Comments:
Refrigerate
Reference Range:
High
Clinical Utility:
Used in the evaluation of inflammatory and infectious disorders.

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Viscosity, Serum		Test Code: VISC
CPT:	85810
Alternate Name:	Serum Viscosity
Testing Schedule:	Routine, daily
Specimen Requirements:
Minimum Volume:	3 mL serum
Container:	2 Gold top (serum separator) tubes
Reference Range:
1.1 - 20 mPa.S
Clinical Utility:
Evaluate hyperviscosity syndrome associated withmonoclonal gammopathy states (myeloma, macroglobulinemia of Waldenstrom, and otherdysproteinemias), including occasional cases of rheumatoid arthritis, SLE, systemic lupus erythematosus, hyperfibrinogenemia.

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Vitamin A		Test Code: VITAB
CPT:	84590
Alternate Name:	Retinol, Serum
Methodology:	High Performance Liquid Chromatography (HPLC)
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Red top tube, no serum separator
Collection:	• Overnight 12-14 hour fast required. • Infants draw prior to next feeding
Special Instructions and/or Comments:
• Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice. • Protect from light by wrapping the entire aliquot tube with aluminum foil or use amber aliquot vial.
Reference Range:
Retinol: • 0-6 years old:....................113-647 ug/L • 7-12 years old...................128-812 ug/L • 13-17 years old:................144-977 ug/L • > 18 years old..................325-780 ug/L
Clinical Utility:
Useful for, diagnosing vitamin A deficiency and toxicity.

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Vitamin B1		Test Code: VTB1
CPT:	84425
Alternate Name:	Thiamine
Methodology:	Flourimetry
Testing Schedule:	Routine, 2 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	3 mL plasma
Container:	2 Lavender top (EDTA) tube
Collection:	Draw 2 tubes to prevent a quantity not sufficient result. 3 mLs of plasma is the minimum requirement.
Special Instructions and/or Comments:
• Must be processed and frozen immediately • Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice. • Protect from light by wrapping the entire aliquot tube with aluminum foil or use amber aliquot vial
Reference Range:
4.5 - 15.1 nmol/L
Clinical Utility:
Assessment of thiamin deficiency.

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Vitamin B6		Test Code: VTB6
CPT:	84207
Methodology:	High Performance Liquid Chromatography (HPLC)
Testing Schedule:	Routine, 2 times per week
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	1 mL plasma
Container:	Green top (sodium heparin) tube
Collection:	• No alcohol or vitamin consumption 24 hours prior to collection • Overnight 12-14 hour fast is required • Infants: Draw prior to next feeding.
Special Instructions and/or Comments:
• Must be processed and frozen immediately. • Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice. • Protect from light by wrapping the entire aliquot tube with aluminum foil.
Reference Range:
5-50 µg/mL
Clinical Utility:
Useful for, determining vitamin B(6) status, including in persons who present with progressive nerve compression disorders, such as carpal tunnel and tarsal tunnel syndromes. Determining the overall success of a vitamin B(6) supplementation program. Diagnosis and evaluation of hypophosphatasia

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Vitamin B12, Serum		Test Code: VB12
CPT:	82607
Alternate Name:	B12; Cobalamin, True; Cyanocobalamin
Methodology:	Direct Chemiluminescence
Testing Schedule:	Routine; STAT testing available 0600-2100
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
• Testing must be performed within 8 hours of collection. • If delay in transport, specimen, transfer to plastic aliquot tube and refrigerate tube in the upright position. Specimen should remain capped until time of testing.
Reference Range:
>211 pg/mL
Clinical Utility:
Assist in the diagnosis of hematologic and/or neurologic states.

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Vitamin C		Test Code: VITC
CPT:	82180
Alternate Name:	Ascorbic Acid
Methodology:	High Performance Liquid Chromatography (HPLC)
Testing Schedule:	Routine, Monday-Friday only
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	2 mL plasma
Container:	Green top (sodium heparin) tube
Collection:	• Overnight 12-14 hour fast required, water can be taken as needed. • Infants: Draw prior to next feeding
Special Instructions and/or Comments:
• Keep specimen cold and centrifuge within 4 hours of collection • Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice. • Protect from light by wrapping the entire aliquot tube with aluminum foil.
Reference Range:
0.6-2.0 mg/dL
Clinical Utility:
Useful for: • The diagnosis of vitamin C deficiency. • As an aid to deter of excessive intake.

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Vitamin D, 1,25-Dihydroxy		Test Code: VDDI
CPT:	82652
Methodology:	Extraction/Liquid Chromatography-Tandem Mass Spectrometry LC-MS/MS
Testing Schedule:	Routine, 3 times per week
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	2.0 mL serum
Container:	Gold top (serum separator) tube
Collection:	Fasting patient preferred. (4 hours preferred but not required)
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Males: 24-86 pg/mL (<16 y) 18-64 pg/mL (>=16 y) Females: 24-86 pg/mL (<16 y) 18-78 pg/mL (>=16 y)
Clinical Utility:
Useful for the differential diagnosis of hypercalcemia. 1,25 dihydroxy vitamin D levels may be needed along with Vitamin D, 25-Hydroxy (VD2D3) to adequately assess vitamin D status. May be useful in the investigation of some patients with clinical evidence of vitamin D deficiency (e.g., vitamin D-dependent rickets due to hereditary deficiency of renal 1-alphahydroxylase or end-organ resistance to 1,25-dihydroxy vitamin D).

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Vitamin D, 25-Hydroxy		Test Code: VD2D3
CPT:	82306
Alternate Name:	Calcifediol, Calcidiol
Methodology:	LC-MS/MS Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS
Testing Schedule:	Daily, M-F
Report Available:	2-3 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Collection:	Fasting patient preferred.
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and refrigerate.
Reference Range:
• <10 ng/mL (severe deficiency) • 10-24 ng/mL (mild to moderate deficiency) • 25-80 ng/mL (optimum levels) • >80 ng/mL (toxicity possible)
Clinical Utility:
Useful for, the diagnosis of vitamin D deficiency. Differential diagnosis of causes of rickets and Osteomalacia Monitoring vitamin D placement Therapy Diagnosis of hypervitaminosis D.

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Vitamin E		Test Code: VITAE
CPT:	84446
Alternate Name:	Alpha Tocopherol
Methodology:	High Performance Liquid Chromatography (HPLC), Specific quantitation of alpha tocopherol
Testing Schedule:	Routine, 3 times per week
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	2 mL
Container:	Red top tube, no serum separator
Collection:	• Overnight fast (12-14 hours) required. • Infants draw prior to next feeding
Special Instructions and/or Comments:
• Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice. • Protect from light by wrapping the entire aliquot tube with aluminum foil or use amber aliquot tube
Reference Range:
0-17 years:.......................3.8-18.4 mg/L > 18 years:........................5.5-17.0 mg/L Significant deficiency:......< 3.0 mg/L Significant excess:............ > 40 mg/L
Clinical Utility:
Useful for the diagnosis of (or evaluation of) individuals with motor and sensory neuropathies. Monitoring vitamin E status of premature infants requiring oxygenation. Evaluation of persons with intestinal malabsorption of lipids.

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Vitamin K		Test Code: VITK
CPT:	84597
Methodology:	HPLC
Testing Schedule:	Routine, 1 time per week
Specimen Requirements:
Minimum Volume:	4 mL (minimum 2 mL) heparinized plasma
Container:	Green top (sodium heparin) tube
Collection:	Overnight fast is preferred
Special Instructions and/or Comments:
• Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice • Protect from light by wrapping the entire aliquot tube with aluminum foil or using amber aliquot tubes.
Reference Range:
80-1160 pg/mL
Clinical Utility:
Useful for determining vitamin K status

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Vivactyl®
See Protriptyline

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VMA, 24-Hour Urine
See Vanillylmandelic Acid, 24-Hour Urine

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Volatile Screen		Test Code: VOSC
Includes:	• Identification and quantitation of: • Ethanol • Methanol • Isopropanol • Acetone
CPT:	84600
Methodology:	Gas Chromatography (GC)
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL whole blood OR serum
Container:	Gray top (sodium fluoride) tube OR red top tube, no serum separator
Collection:	• Prepare skin with Betadine® or Zephiran®. • DO NOT use an alcohol swab.
Special Instructions and/or Comments:
• DO NOT centrifuge, aliquot or freeze. • Must remain as whole blood in original tube. • Refrigerate only.
Reference Range:
Negative
Critical Values:
Toxic: • Acetone: >20 mg/dL or 0.02% • Ethanol: >200 mg/dL or 0.20% • Isopropanol: >20 mg/dL or 0.02% • Methanol: >10 mg/dL or 0.01%
Clinical Utility:
Useful for detecting and assessing possible toxicity from ingestion of ethanol, methanol, acetone, or isopropanol.

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von Willebrand Disease Profile
See von Willebrand Profile, Comprehensive

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von Willebrand Factor
See Ristocetin Cofactor

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von Willebrand Multimers		Test Code: VWMUL
CPT:	85247
Methodology:	Western Blot (WB)
Testing Schedule:	Routine, 2 times per week
Report Available:	7-10 days
Specimen Requirements:
Minimum Volume:	2 mL plasma, split equally into 2 plastic aliquot tubes and FROZEN immediately.
Container:	2 Blue top (sodium citrate) tubes
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
• Testing is contraindicated for patients on Heparin or Coumadin therapy. • Immediately centrifuge the specimens at 1500-1700 X G for 10 minutes. Avoiding the buffy coat, carefully remove the plasma from the cells using a plastic aliquot pipette. Aliquot the plasma into the required number of plastic aliquot tubes and label with “citrated plasma” labels. • Freeze the aliquoted specimens at –40 to –60°C. Once frozen, transport the specimens submerged in dry ice. Causes for rejection: • Extended transport time to laboratory • Clotted specimens • Hemolyzed specimens • Blue top sodium citrate tubes insufficiently filled • Aliquots not received frozen on dry ice • Frozen aliquots not clearly identified as “citrated plasma”
Reference Range:
See report.
Clinical Utility:
Useful when type 2 von Willebrand disease is suspected and to further categorize disease.

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von Willebrand Profile, Comprehensive		Test Code: VWD
Includes:	• Partial Thromboplastin Time, Activated (APTT) • Factor VIII Activity • Factor VIII Antigen • Ristocetin Cofactor • Ristocetin Aggregation • Interpretation
CPT:	85730, 85240, 85246, 85245, 85576
Alternate Name:	von Willebrand Disease Profile
Methodology:	See individual test listings.
Testing Schedule:	NOTE: Testing is performed by appointment only due to the handling of the ristocetin aggregation. This procedure must be scheduled in advance.
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	4 mL plasma AND 10 mL whole blood
Container:	6 Blue top (sodium citrate) tubes
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
• Transport all tubes at room temperature and deliver immediately to the testing department. • No more than 2 hours can elapse from the time of collect to time of receipt in the laboratory. • DO NOT chill; platelets are activated at low temperatures. • DO NOT centrifuge or aliquot; must remain as whole blood in original tubes. Causes for rejection: • Extended transport time to laboratory • Clotted specimens • Hemolyzed specimens • Blue top sodium citrate tubes insufficiently filled
Reference Range:
See individual test listings.
Clinical Utility:
See individual test listings.

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VRE Screening Culture
See Culture, Vancomycin-Resistant Enterococci Screen

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vW Factor Assay
See Ristocetin Cofactor

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vWF Antigen
See Factor VIII Antigen

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VZV Screen
See Varicella-Zoster IgG Antibody,Immune Status