Aldolase

Centralized Core Laboratory : Special Chemistry

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. Aldolase
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

ALDOL SCMAN

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

1.75 mL (minimum 1.0 mL)

Cause for Rejection:

Hemolysis

Storage:

Refrigerated

Availability:

Mon-Fri (0800-1600); batched testing

Methodology:

Enzymatic Beckman

Special Instructions:

Specimen must be in lab by 0900 for same day results. Do not tube specimens - hand deliver only.

Lab/Phone:

330-543-8484

TAT:

72 hours

Additional Info:

Ref. range is age dependent; avail on patient report

CPT Code:

82085

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