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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:

Test ID/Workstation :

ESTRA MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

3.0 mL (minimum 2.0 mL)

Cause for Rejection:

Specimen collected in Serum gel tube (SST)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Special Instructions:

Separate cells from serum within 24 hours of draw.

Lab/Phone:

330-543-8418

TAT:

2-4 days

Additional Info:

Reference range available on patient report

CPT Code:

82670

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Estradiol

Centralized Core Laboratory : Chemistry

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