We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Estradiol

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. Estradiol
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

ESTA E8011

Specimen Type:

Blood

Tube Type:

Green top (lithium heparin) tube

Collection Volume:

1.5 mL

Storage:

Shipping- Send Refrigerated; Storage-Room Temp: 24 hours; Refrigerated: 2 days; Frozen: 6 months

Availability:

Sent to reference lab

Methodology:

Roche-ECLIA Competition principle

Lab/Phone:

330-543-8418

TAT:

4 hours

Additional Info:

Reference range available on patient report

CPT Code:

82670

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