Centralized Core Laboratory - Cleveland Clinic Laboratories :
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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. LD, Isoenzymes
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
LDISO
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Gold top SST (serum separator tube, no anticoagulant)
Alternate Tube Type:
Red Top Serum
Collection Volume:
2.5 mL
Minimum Volume:
1.5 mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
LD: Enzymatic, Isoenzymes: Electrophoresis
Special Instructions:
Days Performed: SunSat
Remove serum from cells ASAP
Lab/Phone:
330-543-8418
TAT:
2-3 days
Additional Info:
Reference Range:
Lactate Dehydrogenase:
Age: 0-30 Days; Range: 200-465 U/L
Age: 1-17 Months; Range: 200-450 U/L
Age: 18-24 months; Range: 165-430 U/L
Age: 3-10 Years; Range: 165-430 U/L
Age: 11-16 Years; Range: 127-287 U/L
Age: 17-99 Years; Range: 105-230 U/L
LD1: Range: 14-27%
LD2: Range: 29-42%
LD3: range: 18-30%
LD4: Range:8-15%
LD5: Range: 6-23%
CPT Code:
83615, 83625
Panel Includes:
Lactate Dehydrogenase, LD1, LD2, LD3, LD4, LD5
LD, Isoenzymes
Test ID/Workstation :
LDISO
Specimen Type:
Blood
Tube Type:
Gold top SST (serum separator tube, no anticoagulant)
Collection Volume:
2.5 mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
LD: Enzymatic, Isoenzymes: Electrophoresis
Special Instructions:
Days Performed: SunSat
Remove serum from cells ASAP
Lab/Phone:
330-543-8418
TAT:
2-3 days
Additional Info:
Reference Range:
Lactate Dehydrogenase:
Age: 0-30 Days; Range: 200-465 U/L
Age: 1-17 Months; Range: 200-450 U/L
Age: 18-24 months; Range: 165-430 U/L
Age: 3-10 Years; Range: 165-430 U/L
Age: 11-16 Years; Range: 127-287 U/L
Age: 17-99 Years; Range: 105-230 U/L
LD1: Range: 14-27%
LD2: Range: 29-42%
LD3: range: 18-30%
LD4: Range:8-15%
LD5: Range: 6-23%
CPT Code:
83615, 83625
Panel Includes:
Lactate Dehydrogenase, LD1, LD2, LD3, LD4, LD5
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There are 10 nurses in the picture.
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The five differences are:
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The two matching doctors are 9 and 14.
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The correct path:
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