Creatinine, 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. Creatinine, Urine
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

CREUR ACHM1

Specimen Type:

Urine

Tube Type:

Urine container

Collection Volume:

5 mL (minimum 1.0mL)

Cause for Rejection:

Storage:

Refrigerated

Availability:

Daily, 24 hours; STAT

Methodology:

Enzymatic

Special Instructions:

Please collect without preservatives and deliver promptly to the lab. Patient's weight is required for resulting; please supply information with the specimen.

Lab/Phone:

330-543-8417

TAT:

1 hour

Additional Info:

Reference range: 15.0-25.0 mg/kg/24 hrs

First Morning Specimen: 28-217mg/dL (female); 39-259mg/dL (male)

24 hr Specimen: 740-1570mg/24hr (female); 1040-2350mg/24hr (male)

CPT Code:

82570

Synonyms:

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Creatinine, Urine

Centralized Core Laboratory : Chemistry

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