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Creatinine Urine 24 hr

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 24 hr
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

UC24M MACH3

Specimen Type:

Urine

Tube Type:

Urine Container

Collection Volume:

Entire 24 hour collection. See Special Instructions.

Storage:

Shipping- Send Refrigerated; Storage-Room Temp: 2 days; Refrigerated: 6 days; Frozen: 6 months

Availability:

24 hours/day, 7 days/week

Methodology:

Roche-Enzymatic Colorimetric

Special Instructions:

Instruct patient on 24 hour urine collection. Refrigerate 24 hour urines during collection. Do not use urine preservatives. Mark each collection container with the following information required for resulting: patient demographic information and date and time collection was started and finished. Deliver specimens promptly to the lab.

Lab/Phone:

330-746-9623

TAT:

1 hour

CPT Code:

82340

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The five differences are:
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The two matching doctors are 9 and 14.

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The correct path:

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