Aldolase
| 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. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
ALDOL
Test Workstation :
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
