Centralized Core Laboratory - University of California San Diego :
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. Cystine, Pl Univ of California
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6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CYUCP
Test Workstation :
UCSD
Specimen Type:
Blood
Tube Type:
Yellow Top (ACD Solution A) tube: Whole Blood
Collection Volume:
5.0 mL (minimum 2.5 mL)
Cause for Rejection:
Yellow top with ACD, Solution B is NOT acceptable.
Storage:
Refrigerate within 1 hour of collection
Availability:
Sent to reference lab
Methodology:
Intracellular Cystine Assay
Special Instructions:
Special tube required. Do not Freeze. Collect and ship specimens Monday-Thursday by FedEx Priority Overnight on the same day the sample is collected.
Indicate Date and Time of last medication dose.
Lab/Phone:
330-543-8418
TAT:
10 days
Additional Info:
Reference range is available on patient report
CPT Code:
84999, 82131
Synonyms:
Granulocytes for Cystine Determination
Cystine, Pl Univ of California
Test ID/Workstation :
CYUCP
Specimen Type:
Blood
Tube Type:
Yellow Top (ACD Solution A) tube: Whole Blood
Collection Volume:
5.0 mL (minimum 2.5 mL)
Cause for Rejection:
Yellow top with ACD, Solution B is NOT acceptable.
Storage:
Refrigerate within 1 hour of collection
Availability:
Sent to reference lab
Methodology:
Intracellular Cystine Assay
Special Instructions:
Special tube required. Do not Freeze. Collect and ship specimens Monday-Thursday by FedEx Priority Overnight on the same day the sample is collected.
Indicate Date and Time of last medication dose.
Lab/Phone:
330-543-8418
TAT:
10 days
Additional Info:
Reference range is available on patient report
CPT Code:
84999, 82131
Synonyms:
Granulocytes for Cystine Determination
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