Unfractionated Heparin

Centralized Core Laboratory - : Hematology

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. Unfractionated Heparin
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

UFHEP

Test Workstation :

ACOAG

Specimen Type:

Blood

Tube Type:

Blue top ( sodium citrate) tube

Collection Volume:

2.7 mL (minimum 1.8 mL) must use appropriate sodium citrate tube based on volume of blood drawn (1.8 or 2.7 mL tube)

Storage:

Ambient

Availability:

Daily, 24 hours

Methodology:

Chromogenic Assay

Special Instructions:

Send Whole Blood by courier STAT to Akron Childrens Laboratory. Specimen must be received within 1 hour of collection.

Lab/Phone:

330-543-8418

TAT:

24 hours

Additional Info:

Reference Range: Therapeutic: 0.3 - 0.7 IU/mL

CPT Code:

85520

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Unfractionated Heparin

Centralized Core Laboratory - : Hematology

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