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.

Folate

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. Folate
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

FOLAT E8011

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

1.5 mL

Cause for Rejection:

Hemolysis

Storage:

Shipping- Send Refrigerated; Storage-Room Temp: 2 hours; Refrigerated: 48 hours; Frozen: 1 month

Availability:

24 hours/day, 7 days/week

Methodology:

Roche-ECLIA Competition principle

Lab/Phone:

330-543-8418

TAT:

4 hours

Additional Info:

Reference Interval:

> or = 4.8 ng/mL

CPT Code:

82746

Synonyms:

Folic Acid

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