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.

Phosphorous, Ur Random

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. Phosphorous, Ur Random
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PHOUR CLEVE

Specimen Type:

Urine

Tube Type:

Urine container

Collection Volume:

5.0 mL (minimum 3.0 mL) random urine

Storage:

Refrigerated

Availability:

Sent to Reference Laboratory

Methodology:

Ammonium Molybdate

Lab/Phone:

330-543-8418

TAT:

8 hours

Additional Info:

Reference range: 7-140 mg/dL

CPT Code:

84105

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