Total Protein Urine 24 hr

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. Total Protein Urine 24 hr
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

UTP24

Test Workstation :

ACHM5

Specimen Type:

Urine

Tube Type:

Urine container

Minimum Volume:

Entire 24 hour Collection. See Special Instructions.

Preferred Volume:

Entire 24 hour Collection. See Special Instructions.

Storage:

Shipping- Send Refrigerated; Storage- Room Temp: 1 day; Refrigerated: 7 days; Frozen: 1 month

Availability:

24 hours/day, 7 days/week

Methodology:

Roche-Turbidimetric

Special Instructions:

Instruct patient on 24 hour urine collection. Refrigerate 24 hour urines during collection. Do not use urine preservatives. Mark each collection container with the following information required for resulting: patient demographic information and date and time collection was started and finished. Deliver specimens promptly to the lab.

Lab/Phone:

330-543-8418

TAT:

1 hour

Additional Info:

Reference interval:

24 hour = <149 mg/dL

CPT Code:

84156