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.

Leukemia Surface Markers

Centralized Core Laboratory : Hematology

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. Leukemia Surface Markers
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

LKMKR SUMMA

Specimen Type:

Blood, bone marrow, or cellular body fluid

Tube Type:

Purple top (EDTA) tube: Whole Blood

Collection Volume:

4.0 mL (minimum 1.0 mL)

Storage:

Ambient

Availability:

Sent to reference lab

Methodology:

Flow Cytometry

Special Instructions:

For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly)

Lab/Phone:

330-543-8418

TAT:

24 hours

Additional Info:

Reference ranges are available on patient report

CPT Code:

88180

Synonyms:

Leukemia Flow Cytometry Profile

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