Salicylate
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Salicylate | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
SALIM
Test Workstation :
MACH3
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Collection Volume:
500 uL microtainer; 1.5 mL macrotainer
Minimum Volume:
500 uL microtainer; 1.5 mL macrotainer
Preferred Volume:
500 uL microtainer; 1.5 mL macrotainer
Storage:
Shipping: Send Refrigerated; Storage: Refrigerated: 2 weeks
Availability:
24 Hours/day, 7 days/week
Methodology:
Roche- Enzymatic-colorimetric
Special Instructions:
For therapeutic monitoring, draw peak levels 1 hour postoral ingestion and trough levels immediately prior to next dose. Please indicate whether the specimen is a peak, trough, or random level.
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference range:
Therapeutic 0-30 mg/dL
Toxic > 30 mg/dL
CPT Code:
80179
Synonyms:
Acetylsalicylic/Salicylic acid, Aspirin
