Arsenic, Blood

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. Arsenic, Blood
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

ARSBL CLEVE

Specimen Type:

Blood

Tube Type:

Navy Blue top (EDTA) tube: Whole Blood

Collection Volume:

7.0 mL (minimum 1.0 mL)

Cause for Rejection:

Storage:

Ambient

Availability:

Sent to reference lab

Methodology:

Inductively Coupled Plasma/Mass Spectrometry

Special Instructions:

Lab/Phone:

330-543-8418

TAT:

2-5 days

Additional Info:

Reference range: 0.0-13.0 ug/L

CPT Code:

82175

Synonyms:

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Arsenic, Blood

Centralized Core Laboratory : Chemistry

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