Uric Acid, Random Urine

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. Uric Acid, Random Urine
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

UACUR CLEVE

Specimen Type:

Urine

Tube Type:

Urine container

Collection Volume:

5.0 mL (minimum 1.0 mL) random urine

Cause for Rejection:

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Uricase

Special Instructions:

5.0 mL (minimum 1.0 mL) from a well-mixed random urine specimen

Lab/Phone:

330-543-8418

TAT:

8 hours

Additional Info:

Reference range: 10-90 mg/dL

CPT Code:

84560

Synonyms:

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Uric Acid, Random Urine

Centralized Core Laboratory : Chemistry

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