Chloride, CSF
| 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. Chloride, CSF | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
ZMSO,
Test Workstation :
MAYO
Specimen Type:
CSF
Tube Type:
CSF sterile container
Collection Volume:
1.0 mL (minimum 0.25 mL)
Cause for Rejection:
Gross hemolysis
Storage:
Refrigerated
Availability:
Sent to reference lab, MAYO
Methodology:
Indirect Ion-Selective Electrode (ISE)
Special Instructions:
Please order ZMSO send to Mayo
Lab/Phone:
330-543-8417
TAT:
1-2 days
Additional Info:
Mayo Reference Range: 120-130 mmol/L
CPT Code:
82438
