We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Amino Acids QN Random Urine

Centralized Core Laboratory : 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. Amino Acids QN Random Urine
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

AAQU MAYO

Specimen Type:

Urine

Tube Type:

Urine Container

Collection Volume:

2.0 mL (minimum 1.0 mL) random urine collection

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Liquid Chromatography-Tandem Mass Spectrophotometry

Special Instructions:

Include family history, clinical condition (asymptomatic or acute episode), diet, and drug therapy information. Patient's age is required.

Lab/Phone:

330-543-8418

TAT:

3-5 days

Additional Info:

Reference range is age dependent; available on the report

CPT Code:

82139

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