Sodium Urine 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. Sodium Urine Random
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

UNA1

Test Workstation :

ACHM5

Specimen Type:

Urine

Tube Type:

Urine container

Minimum Volume:

1 mL

Preferred Volume:

3 mL

Storage:

Shipping- Send Refrigerated; Storage- Room Temp: 14 days; Refrigerated: 14 days; Frozen: stable

Availability:

24 hours/day, 7 days/week

Methodology:

Roche-Ion selective electrode (ISE) Indirect

Special Instructions:

Deliver promptly to the lab

Lab/Phone:

330-543-8418

TAT:

1 hour

Additional Info:

No reference interval established for random urine collections.

CPT Code:

84300

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