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

Sequential Screen, First Trimester

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. Sequential Screen, First Trimester  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
SEQ1
Test Workstation :
GENZY
Specimen Type:
Blood
Tube Type:
Gold top SST (Serum Separator tube, no anticoagulant)
Collection Volume:
2.0 mL
Minimum Volume:
1.0 mL
Storage:
Refrigerated
Availability:
Sent to Reference lab
Methodology:
Enzyme Linked Immunoassay (ELISA)
Special Instructions:
Patient's gestation age required
Lab/Phone:
330-543-8418
TAT:
2-3 days after specimen received in reference lab
Additional Info:
Reference range is available on patient report
CPT Code:
84163, 84702
Panel Includes:
PAPP-A HCG, Qnt

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