Sickle Solubility
| 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. Sickle Solubility | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
SICK
Test Workstation :
SPHEM
Specimen Type:
Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Collection Volume:
2.0 mL (minimum 0.3 mL in BD Microtainer)
Cause for Rejection:
Specimen clotted, hemolyzed, or diluted with IV fluid; specimen from a patient younger than 6 months old.
Storage:
Refrigerated
Availability:
Daily, 24 hours; STAT
Methodology:
Sickle-Sol (hemoglobin solubility)
Lab/Phone:
330-543-8416
TAT:
8 hours
Additional Info:
Reference range: Negative
CPT Code:
85660
Synonyms:
Sickle Cell; Sickledex
