T3 Total

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. T3 Total
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

T3TOT

Test Workstation :

e8011

Specimen Type:

Blood

Tube Type:

Green top (lithium heparin)

Alternate Tube Type:

Red top (serum), Purple top (EDTA)

Minimum Volume:

0.5 mL

Preferred Volume:

1.5 mL

Storage:

Refrigerated

Availability:

24 hours a day, 7 days a week

Methodology:

Electrochemiluminescence Immunassay

Lab/Phone:

330-543-8418

TAT:

Routine 4 hours and Stat 1 hour

Additional Info:

Reference range available on patient report

CPT Code:

84480

Synonyms:

T3 Suppression,T3 Total, Serum,Total T3, Serum, Triiodothyronine (T3),Triiodothyronine, Total T3,T3 (Triiodothyronine), Total Only, Serum,Thyroid Function Cascade, Triiodothyronine

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T3 Total

Centralized Core Laboratory - : Chemistry

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