Gastrin
| 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. Gastrin | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
GAST
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Gold top SST (serum separator tube, no anticoagulant)
Collection Volume:
2.5 mL
Minimum Volume:
1.5 mL
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Chemiluminescence Immunoassay (CLIA)
Special Instructions:
Patient preparation: Preferably fasting for 12 hours or more. Patients taking a Biotin dose of up to 5 mg/day should refrain from taking Biotin for 4 days prior to sample collection. Patients taking a Biotin dose > 5 mg/day to 10 mg/day should refrain from taking Biotin for 7 days prior to sample collection. Patients taking a Biotin dose > 10 mg/day should consult with their physician or the laboratory prior to having a sample taken. Clinicians should consider biotin interference as a source of error, when clinically suspicious of the laboratory result.
Lab/Phone:
330-543-8418
TAT:
1-4 days
Additional Info:
Reference range: Fasting: <115.0 pg/mL
CPT Code:
82941
