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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:

Hospital:

Test ID/Workstation :

ARSBL CLEVE

Specimen Type:

Blood-Whole Blood

Tube Type:

NAVY BLUE (TRACE ELEMENT-K2EDTA)

Collection Volume:

7.0 mL (minimum 0.5 mL)

Storage:

Ambient

Availability:

Sent to reference lab

Methodology:

Inductively Coupled Plasma/Mass Spectrometry

Special Instructions:

Patient Prep: Diet, medication, and nutritional supplements may introduce interfering substances; Patient should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over -the-counter medications (upon advise of physician) and avoid shellfish and seafood for 48 to 72 hours; Send in original tube, Ambient

Lab/Phone:

330-543-8418

TAT:

2-4 days

Additional Info:

Reference range: 0.0-12.0 ug/L

CPT Code:

82175

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The five differences are:
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The correct path:

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