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

Gestational 3HR Challenge

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. Gestational 3HR Challenge  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
MG3HR
Test Workstation :
ACHM5
Specimen Type:
Blood
Tube Type:
Green top ( lithium heparin) tube
Minimum Volume:
500 uL
Preferred Volume:
1.5 mL
Storage:
Shipping- Send Refrigerated; Storage- Room Temp: 8 hours; Refrigerated: 72 hours; Frozen: 3 days
Availability:
Mon-Fri
Methodology:
Roche-UV Test
Special Instructions:
Separate plasma from cells ASAP. For outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
1 hour/draw
CPT Code:
82951, 82952

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