Carcinoembryonic Antigen

Centralized Core Laboratory - Cleveland Clinic Laboratories : Send Out

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. Carcinoembryonic Antigen
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

CEA

Test Workstation :

CLEVE

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

2.5 mL

Minimum Volume:

1.5 mL

Storage:

Refrigerated

Availability:

Sent to reference lab. Days Performed: Mon-Fri

Methodology:

Immunoenzymatic Assay

Special Instructions:

This test is not recommended as a screening test.

Lab/Phone:

330-543-8418

TAT:

1-3 days

Additional Info:

Reference range: 0-2.9 ng/mL

CPT Code:

82378

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Carcinoembryonic Antigen

Centralized Core Laboratory - Cleveland Clinic Laboratories : Send Out

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