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LDL Cholesterol (Beta-Quant), S

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. LDL Cholesterol (Beta-Quant), S
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

LDLD MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant )tube

Collection Volume:

7.5 mL minimum 2.5 mL < 2 years minimum 5.0 mL > or = 2 years

Cause for Rejection:

Grossly hemolyzed and grossly icteric

Storage:

Refrigerated

Availability:

Mon- Thur, Saturday; 3p.m.

Methodology:

Ultracentrifugation/Selective Precipitation/Enzymatic Colorimetry (Beta-Quantification)

Special Instructions:

Patient must not consume any alcohol for 24-hours before the specimen is drawn.

Lab/Phone:

330-543-8418

TAT:

2-4 days

Additional Info:

Reference range available on patient report

CPT Code:

83701

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