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Akron Children's > For Healthcare Professionals > Lab Tests : Akron | Mahoning Valley

Calculus Analysis

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. Calculus Analysis  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CALCU
Test Workstation :
MAYO
Specimen Type:
Entire Stone
Tube Type:
Clean container
Collection Volume:
Entire kidney stone
Cause for Rejection:
Embedded in tissue, sent with collection devices, sent in fluidfilled containers, or sent with significant nonstone debris. Source other than renal.
Storage:
Ambient
Availability:
Sent to reference lab
Methodology:
Infrared Spectrum Analysis
Special Instructions:
Specimen Source is required. Specimen must be sent clean and dry.
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference range is available on patient report
CPT Code:
82365

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