Laboratorio Clínico Toledo

Transcription

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# 51 Calle Palma I Arecibo, PR 00612
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
www.laboratoriotoledo.com
Información General
Laboratorio Clínico Toledo, Inc.
Licencia Número: 774
Medicare: 3-8281
CLIA: 40-D0657994
Nombre Corporativo:
Laboratorio Clínico Toledo, Inc.
Dirección Postal y Física:
51 Calle Palma, Arecibo, PR 00612
Teléfonos:
(787) 880-0444
(787) 880-0460
(787) 816-1388
(787) 880-0477
(787) 817-0093
Número de Fax:
(787) 880-7281, 816-1309
Dirección de Correo Electrónico (E - Mail):
[email protected]
[email protected]
[email protected]
Acreditaciones:
- Departamento de Salud de Puerto Rico
- CLIA (Clinical Lab Improvement Act)
- Medicare
- AAB
- CAP
- Minority Business Enterprise
Horario Días Laborables
Lunes a Jueves
Viernes
Sábados
6:30 am - 8:00 pm
6:30 am - 7:00 pm
6:30 am - 3:00 pm
Servicio al Cliente
Lunes a Viernes
Sábados
7:00 am - 5:00 pm
7:00 am - 12:00 m
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- En el Laboratorio Clínico Toledo contamos con los mejores servicios de
salud, la mejor tecnología, un excelente grupo de profesionales con 25 años
de experiencia; comprometidos para garantizarle el mejor servicio. Para el
Laboratorio Clínico Toledo es un placer tenerlo como cliente y le
agradecemos su confianza en nuestros servicios.
- Actualmente procesamos una gama bien amplia de análisis. Adjunto, una
lista de áreas que Toledo ofrece servicios:
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Alergias
Química
Endocrinología
Genética
Hematología
HIV
Inmunología
Enfermedades Infecciosas
Microbiología
Oncología
Paternidad
Evaluación Reproductiva
Serología
Química Especial
Drogas de Abuso y Terapéuticas
Marcadores de Tumor
Paternidad
Molecular
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LIC # 774
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Recogido de Muestras y Entrega de Resultados
Contamos con un grupo de representantes de ruta que recogen muestras y entregan resultados
a diario. Su itinerario de rutas es de 7:00 am - 5:00 pm de lunes a viernes, los sábados y días
festivos de 7:00 am - 1:00 pm. La entrega de los resultados variará dependiendo del día de su
proceso, en los manuales se especifica los días del proceso de cada muestra y las
especificaciones de la toma de muestras.
Servicio al Cliente
Contamos con un Departamento de Servicio al Cliente para aclarar sus dudas y ayudarle
en el manejo de las muestras y de sus resultados. El mismo opera de lunes a viernes de 7:00am 5:00 pm. Sábado de 7:00 am a 12:00 m.
Tarifas y Facturación
En nuestro catálogo aparecen los precios de las pruebas, se aplicará un recargo de 30 %
a cada factura que pase de 60 días. Si necesita información adicional, favor comunicarse al
Departamento de Servicio al Cliente o con su representante de mercadeo.
Análisis Repetidos
Todo valor anormal será debidamente cotejado y evaluado antes de dar su resultado final.
Cualquier discrepancia con el criterio médico será repetida la muestra sin cargo adicional y debe
referirse a la Supervisora General del Laboratorio o a los Directores del mismo. Contamos con un
médico consultor para cualquier información que requiera algún médico. Los sueros recibidos
se guardan por 3 días en congelador por si hay que repetir o hacer alguna prueba adicional.
Materiales
Supliremos el material de rutina necesario para el recogido de muestras, tubos, bolsas plásticas,
etiquetas de identificación y hojas de requisición. Todo tubo o material de toma de muestra se
facturará a un precio mínimo.
Resultados de Emergencia
Cualquier resultado de emergencia puede enviarse vía fax, medio electrónico o notificarse vía
telefónica al Laboratorio o médico de preferencia si es necesario.
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Pruebas referidas
Las pruebas que no tienen mucha demanda son referidas a otro Laboratorio certificado y
el resultado tarda aproximadamente una semana. En este catálogo aparecen marcados con
asterisco las pruebas referidas.
Personal
Nuestro personal goza de la experiencia y capacidad en cada área de trabajo y están
certificados según la reglamentación y leyes de Puerto Rico. Contamos con más de 100
empleados regulares.
Todo personal adicional ha cumplido con los más estrictos requisitos del Laboratorio y han sido
debidamente entrenados. Un excelente equipo profesional nos hace sentir orgullosos de la
excelencia de nuestros servicios.
Garantía de Calidad
Realizamos un control de calidad confiable en cada área del Laboratorio donde se evalúa los
resultados, metodología y equipo. Se usan los diferentes controles y estándares ya establecidos
garantizando así la exactitud, precisión y confiabilidad del resultado. Contamos con un equipo
de alta tecnología en las diferentes áreas que nos facilita grandemente la labor y calidad del
análisis.
Es de suma importancia que se sigan las instrucciones recomendadas en la toma de muestras y
el manejo inicial adecuado de las mismas para garantizar la calidad en el resultado.
Recomendaciones a seguir:
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Referirse al catálogo para tomar la muestra adecuadamente; cualquier duda
Comuníquese con nuestro Departamento de Servicio al Cliente.
Separe adecuadamente, cuando así lo requiera la muestra y mantenerlas en
las temperaturas adecuadas hasta ser recogidas por nuestros mensajeros.
Rotule e identifique adecuadamente la muestra con:
Nombre del Laboratorio
Nombre, fecha de Nacimiento y sexo del paciente
Fecha y hora de la toma de muestras
Nombre de la muestra requisada
Debe escribir en letra de molde para que sea legible la información
suministrada.
Tanto el tubo como la requisición debe estar rotulada e identificada.
Escribir claramente las pruebas en nuestra requisición.
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Cuando un paciente tiene varias pruebas deben enviar un vial por cada
prueba, para asegurar el manejo correcto de la muestra.
Para evitar atrasos en la ruta les pedimos tener listas las muestras.
Cualquier requisición de material debe ser por escrito.
Si tiene algún paciente con una condición conocida, le agradeceremos nos lo
notifique.
Si la prueba a referirse es para Medicare u otro plan médico, debe enviar toda
la información de paciente, copia de la tarjeta, orden médica, nombre, fecha de
nacimiento, diagnóstico y número de pin de médico que refiere y factura debidamente
firmada.
Toda la información debe venir con la muestra el mismo día.
Agradecemos su patrocinio y la oportunidad que nos da de ofrecerles un excelente servicio a un
costo razonable sin que la calidad de los resultados se afecte.
Somos una empresa netamente Puertorriqueña con grandes expectativas en este nuevo siglo y
queremos compartir nuestras aspiraciones y nuestros logros para beneficio de nuestros
pacientes, nuestra gente y el pueblo de Puerto Rico.
Gracias
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Panel Description
Test
CPT
Electrolyte Panel
Panel Includes:
- Carbon dioxide
- Chloride
- Potassium
- Sodium
80051
Electrolyte Panel
Panel Includes:
- Carbon dioxide
- Chloride
- Potassium
- Sodium
Hepatitis Panel, Acute
Panel Includes:
- Hepatitis A Antibody, IgM
- Hepatitis B Core Antibody, IgM
- Hepatitis B Surface Antigen
- Hepatitis C Virus Antibody
Lipid Panel
Panel Includes:
- Cholesterol, Total
- High Density Lipoprotein (HDL) Cholesterol
- Triglicerides
- LDL, VLDL
Basic Metabolic Panel
Panel Includes:
- BUN
- BUN/Creatinine Ratio
- Calcium, Serum
- Carbon Dioxide, Total
- Chloride, Serum
- Creatinine, Serum
- Glucose, Serum
- Potassium, Serum
- Sodium, Serum
80076
80074
80061
80048
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Comprehensive Metabolic Panel
Panel Includes:
- Alanine Aminotransferase (ALT/SGPT)
- Albumin, Serum
- Albumin/Globulin (A/G) Ratio (calculation)
- Alkaline Phosphatase, Serum
- Aspartate Aminotransferase (AST/SGOT)
- Bilirubin, Total
- BUN
- BUN/Creatinine ratio (calculation)
- Calcium, Serum
- Chloride, Serum
- Creatinine, Serum
- Globulin, Total
- Glucose, Serum
- Potassium, Serum
- Protein, Total, Serum
- Sodium, Serum
80053
Ana Panel = Lupus Panel
- Ana Test
- Anti DNA
- Anti ENA
- Anti Sm/RNP
- Anti SSA SSB
- Anti Jo
- Anti RF (IgM)
- C3
- C4
-TPO
- Anti Scleroderma 70
- Anti Sm
86038
86225
86235 x 5
86160 x 2
86431
86376
Renal Function Panel
Panel Includes:
- Albumin, Serum
- BUN
- BUN/Creatinine Ratio
- Calcium, Serum
- Chloride, Serum
- Creatinine, Serum
- Glucose, Serum
- Phosphorus, Serum
- Potassium, Serum
- Sodium, Serum
80069
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Code
Test
4491
17 HYDROXYCORTICOSTERDS
24 HR URINE
83491
5143
17 HYDROXYPREGNENOLONE
84143
4498
17 HYDROXYPROGESTERONE 17
OH
83498
219
17 HYDROXYPROGESTERONE
NG/DL
83498
4586
17 KETOSTEROIDS 24 HRS URINE
83582
262
18 HYDROXYCORTISCOSTERONE
82542
290
2 C19 ALLELE P450
MULTI
5 HIAA 24 HR URINE
83497
4495
5 HYDROXINDOLACETIC ACID
URINE QL
83497
4915
5-NUCLEOTIDASE
83915
4497
CPT
Test Information
SPECIMEN: 30 ML URINE 24HR URINE COLLECTION
SHIP TEMPERATURE: REFRIGERATE
SCHEDULE:1WEEK, SEND OUT
NOTE: RECORD TOTAL URINE VOLUME ON THE REQUEST FORM
SPECIMEN: 2 ML SERUM OR EDTA PLASMA
SHIP TEMPERATURE: FROZEN
SCHEDULE: 7 - 10 DAYS, SEND OUT
SPECIMEN: 2 ML SERUM
SCHEDULE: WEDNESDAY & FRIDAY ( AM )
SCHEDULE: WEDNESDAY & FRIDAY ( AM )
SPECIMEN:30 ML URINE 24 HRS COLLECTION
NOTE: STATE TOTAL 24 HRS URINE VOLUME ON THE REQUEST
FORM.
SPECIMEN: 3 ML SERUM OR EDTA PLASMA OR GREEN TOP PLASMA
SPECIMEN: WHOLE BLOOD EDTA
SHIP TEMPERATURE: ROOM TEMPERATURE
CPT 83891 / 83892 / 83894 / 83896 / 83900 / 83903 / 83912
SPECIMEN: 30 ML URINE 24 HRS STERILE SCREW CAP CONTAINER NO
PRESERVATIVE
SHIP TEMPERATURE: REFRIGERATE SCHEDULE: 7 - 10 DAYS, SEND
OUT NOTE: MEASURE AND RECORD TOTAL 24 HRS URINE VOLUME
ON THE REQUEST FORM.AVOID BANANAS, AVOCADOS, PLUMS,
EGGPLANT, TOMATOES, PLANTAIN, PINEAPPLES, WALNUTS,
TOMATOES, PLUMS,PLANTAIN AND INTERFERING DRUGS FOR 72
HRS PRIOR TO AND DURING THE COLLECTION.
SCHEDULE: SEND OUT 7 - 10 DAYS
SPECIMEN: 10 ML RANDOM URINE
SCHEDULE: 7 -10 DAYS, SEND OUT
NOTE: AVOID BANANAS, AVOCADOS, PLUMS, EGGPLANT,
TOMATOES, PLANTAIN, PINEAPPLES, WALNUTS, AND INTERFERING
DRUGS FOR A 72 HRS PERIOD PRIOR TO COLLECTION.
CPT: 83497,82570
SCHEDULE: TUESDAY & THURSDAY ( AM )
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4542
7 DEHYDROXYCHOLESTEROL
82542
255
ABSOLUTE RETIC PANEL
85045
63
ACACIA T029
ALLERGEN
86003
ACETAMINOPHEN: SERUM
82003
7010
ACETOACETATE
82010
3009
ACETONE SERUM
82009
282
ACETONE URINE
81003
3010
ACETONE/OTH KETONE BODIES
SERUM QUAN
82010
101
ACETYLCHOLINE BLOCKING AB
84238
3004
5238
ACETYLCHOLINE MODULATING
AB
84238
7685
ACETYLCHOLINE RECEPTOR
BINDING AB
84238
3013
ACETYLCHOLINESTERASE
82013
213
ACID PHOSPHATASE FRACTION
(REF)
84066
6307
ACTIVATED PROTEIN C APC
RESISTANCE ASSAY
85307
3017
ACYLCARNITINES QUAN EA SPEC
82017
SPECIMEN: PLASMA EDTA FROZEN
SCHEDULE : SEND OUT 7 - 10 DAYS
SPECIMEN: WHOLE BLOOD EDTA TUBE
SCHEDULE: DAILY
SCHEDULE: 3 DAYS.
SCHEDULE: 7-10 DAYS, SEND OUT
SPECIMEN: 1 ML SERUM OR PLASMA GRAY TOP-TUBE
SCHEDULE: DAILY
SCHEDULE: DAILY.
SPECIMEN: 1ML SERUM OR PLASMA GRAY TOP TUBE
SCHEDULE: DAILY.
SCHEDULE: 7 - 10 DAYS, SEND OUT.
SCHEDULE: 7-10 DAYS SEND OUT.
SPECIMEN: 2ML SERUM
SPECIMEN: 2ML SERUM REFRIGERATE
SCHEDULE: DAILY AM.
SPECIMEN:2ML PLASMA BLUE-TOP (SODIUM CITRATE) TUBE
SCHEDULE: SEND OUT, 1 WEEK
SPECIMEN: 4 ML PLASMA GREEN TOP TUBE
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3544
ACYLGLICINE URINE
82544
5311
ADENOSINE BLOOD
84311
3030
ADENOSINE DEAMINASE SERUM
82030
7603
ADENOVIRUS AB
86603
236
ADENOVIRUS AG DETECTION
STOOL
87301
280
ADENOVIRUS DETECTION PCR
SWAB
87798
286
ADENOVIRUS PCR BLOOD
5588
ADH ANTI DIURETIC HORMONE
84588
3000
ADRENAL AB
86255
7681
ADRENAL CORTEX AB
86255
3024
ADRENOCORTICOTROPIC HORM
7000
AGGLUTININS FEBRILE EA AG
86000
333
ALBUMIN BODY FLUID
82042
3040
ALBUMIN SERUM
82040
82024
SPECIMEN: RANDOM URINE
SCHEDULE: 7 - 10 DAYS , SEND OUT
SPECIMEN: WHOLE BLOOD YELLOW-TOP (ACD) TUBE.
SCHEDULE: 1 WEEK, SEND OUT
SPECIMEN: 1ML SERUM
SHIP TEMPERATURE:REFRIGERATE
SCHEDULE: SCHEDULE: 1 WEEK, SEND OUT
SPECIMEN: 2 g FRESH STOOL IN STERILE SCREW-CAP CONTAINER
SPECIMEN: THROAT OR NASOPHARYNGUEAL SWAB IN UNIVERSAL
TRANSFER MEDIUM (M2) OR CSF IN STERILE CONTAINER
SHIP TEMPERTURE: FROZEN OR REF STABLE FOR UP TO 7 DAYS
SPECIMEN: 7ML EDTA WHOLE BLOOD
SPECIMEN: 2 ml SERUM AND 2 ML EDTA PLASMA
SHIP TEMPERATURE: REFRIGERATE SERUM ,FROZEN PLASMA
CPT:83930 / 84588
SPECIMEN: 2ML SERUM
SCHEDULE: 7 - 10 DAYS SEND OUT.
SCHEDULE: 1 WEEK, SEND OUT.
SPECIMEN: 2 ML PLASMA LAVENDER-TOP TUBE ( EDTA ) PRE
CHILLED TUBE. DRAW FROM 6AM - 10AM
SCHEDULE: MONDAY, WEDNESDAY AND FRIDAY
SCHEDULE: DAILY.
CPT: 86000 X 8
SPECIMEN: BODY FLUID IN STERILE TUBE
SHIP TEMPERATURE : REFRIGERATE
SCHEDULE: DAILY
SPECIMEN: 1ML SERUM
SCHEDULE: DAILY
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3042
ALBUMIN URINE/OTH SRC QUAN
EA SPEC
82042
3055
ALCOHOL ETHANOL BLOOD
82055
334
ALCOHOL IN URINE
82055
3085
ALDOLASE
82085
3088
ALDOSTERONE
82088
3089
ALDOSTERONE: URINE
82088
102
ALKALINE PHOSPHATASE BONE
SPECIFIC
84080
5080
ALKALINE PHOSPHATASE
ISOENZYMES
84080
418
ALLERGEN ALTERNARIA
ALTERNATA
86003
417
ALLERGEN BLOOMIA
TROPICALIS
ALLERGEN
DERMATOPHAGOIDES
PTERONYSSINUS
86003
ALLERGEN IGG
86001
420
1290
86003
SPECIMEN: 1ML URINE
SCHEDULE: DAILY
SPECIMEN: 1 ML SERUM OR PLASMA GRAY TOP TUBE OR 5 ML
WHOLE BLOOD GRAY TOP TUBE.
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: MONDAY & THURSDAY (AM)
SCHEDULE: MONDAY & THURSDAY ( OVERNIGHT )
PATIENT PREPARATION: TAKE OFF MEDICATIONS 3 WEEKS PRIOR TO
SAMPLE COLLECTION. PATIENT SHOULD AMBULATE 30 MINUTE
BEFORE COLLECTION. PATIENT SHOULD BE IN A NORMAL SODIUM
DIET.
SPECIMEN: 5 ML URINE 24 HRS
COLLECTION: PLASTIC CONTAINER WITH 1 G BORIC ACID TO
MAINTAIN PH BELOW 7.5
SCHEDULE: 1 WEEK
NOTE: RECORD URINE VOLUME ON REQUEST FORM.
CPT: 84080 , 84075
SCHEDULE: 7 - 10 DAYS SEND OUT. CPT 84080,84075
SPECIMEN:1 ML SERUM
SCHEDULE: 5 - 7DAYS, SEND OUT
NOTE:INCLUDE ALTERNARIA TENIUS
SPECIMEN:1 ML SERUM
SPECIMEN:1 ML SERUM
SPECIMEN:1 ML SERUM
SCHEDULE: 5 - 7DAYS, SEND OUT.
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422
ALLERGEN WALNUT
86003
904
ALLERGENS IGE EACH
86003
4883
ALPHA 1 ACID GLYCOPROTEIN
83883
5488
ALPHA 1 ANTI-TRYPSIN FECES
QUAL
84488
3103
ALPHA 1 ANTITRYPSIN
QUANTITATION
82103
3104
ALPHA 1 ANTITRYSIN
PHENOTYPING
82104
269
ALPHA 2 MACROGLOBULIN
QUANTITATIVE
83883
3107
ALPHA FETO PROTEIN PLUS
OR TRIPLE
MULTI
3102
ALPHA FETO PROTEIN TETRA
MULTI
3106
ALPHA FETO PROTEIN TUMOR
MARKER
82105
3105
ALPHA-FETOPROTEIN
MATERNAL
82105
64
ALTERNARIA TENUIS M6
86003
3108
ALUMINUM
82108
SPECIMEN:1 ML SERUM
SCHEDULE: 3 - 5 DAYS.PLEASE SPECIFY THE ALLERGEN
SCHEDULE:5 -7 DAYS, SEND OUT
NOTE: FASTING IS PREFERRED.
CPT: 83883 ; 82985
SPECIMEN: 1GM STOOL IN CREW CAP
SHIP: FROZEN
SEND OUT 3 - 5 DAYS
SCHEDULE: DAILY
SCHEDULE:3 - 5DAYS, SEND OUT.
TIENE 2 CPT82104 ; 82103.INCLUYE TOTAL
SCHEDULE: 7- 10DAYS, SEND OUT
SCHEDULE: DAILY.
NOTE: SEND PATIENT INFORMATION FORM.
CPT: 82105 ; 82677 ;84702
SCHEDULE: DAILY
NOTE: PLEASE FILL PATIENT FORM.
CPT: 82105;83520;82677;84702
SCHEDULE: DAILY.
SCHEDULE: DAILY
NOTE: SEND PATIENT INFORMATION FORM
SCHEDULE: 3 - 5 DAYS
SPECIMEN: 7 ML WHOLE BLOOD ROYAL BLUE TOP TUBE
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3109
ALUMINUM URINE 24 HR
82108
1150
AMIKACIN
80150
3139
AMINO ACIDS 6/> AMINO
ACIDS QUAN EA PLAS
82139
3131
AMINO ACIDS QUANT 24 HR
URINE
82139
3127
AMINO ACIDS RANDOM
URINE
82139
3135
AMINOLEVULINIC ACID DELTA
24 HRS
82135
3117
AMIODARONE (CORDARONE)
82542
SPECIMEN: 24 HRS URINE, NO PRESERVATIVE
SCHEDULE: 7-10 DAYS, SEND OUT. CPT 82108 / 85570
TEST INCLUDE: ALUMINUM URINE, CREATININE URINE,
ALUMINUM:CREATININE RATIO, ALUMINUM 24HRS
NOTE: SEPARATED SERUM PEAK OR TROUGH
TROUGH= DRAWN IMMEDIATELY PRIOR TO THE NEXT DOSE
PEAK= 60 MINUTES AFTER DOSE
SPECIMEN : 4 ML PLASMA HEPARINIZED GREEN TOP TUBE
SPECIMEN: 20 ML OF 24HR URINE COLLECTION
CONTAINER: PLASTIC URINE CONTAINER, NO PRESERVATIVE.
NOTE: KEEP FROZEN DURING COLLECTION DOES NOT THAW.
PROVIDE PATIENTS AGE, SEX, A BRIEF CLINICAL HISTORY, TENTATIVE
DIAGNOSIS AND ANY THERAPY OVER THE LAST THREE DAYS (DRUGS,
X-RAY, INFANT FORMULA, AND DIET).
SPECIMEN: 20 ML URINE RANDOM , NO PRESERVATIVE
NOTE: KEEP FROZEN DURING COLLECTION, DO NOT THAW. PROVIDE
PATIENT , AGE, SEX, A BRIEF CLINICAL HISTORY TENTATIVE
DIAGNOSIS AND ANY THERAPY OVER THE LAST THREE DAYS ( DRUGS,
X RAY, INFANT FORMULA, DIET )
CPT 82108 / 85570
SPECIMEN: 20 ML 24 HRS URINE CONTAINER , PH < 6.0 WITH 30 ML
30% GLACIAL ACETIC ACID. USE AMBER PLASTIC CUP OR COVER
WITH ALUMINUM FOIL.
SHIP TEMPERATURE: FROZEN AND PROTECT FROM LIGHT.
NOTE: KEEP FROZEN DURING COLLECTION, DO NOT THAW. PROVIDE
PATIENT , AGE, SEX, A BRIEF CLINICAL HISTORY, TENTATIVE
DIAGNOSIS AND ANY THERAPY OVER THE LAST THREE DAYS ( DRUGS,
X RAY, INFANT FORMULA, DIET )
SPECIMEN: 2 ML SERUM OR PLASMA EDTA OR HEPARIN TUBE. DO
NOT USE GEL BARRIER TUBE.
NOTE: INCLUDES METABOLITE NORAMIODARONE
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1152
AMITRIPTYLINE (ELAVIL)
80152
3140
AMMONIA
82140
7753
AMOEBA AB
86753
3145
AMPHETAMINE URINE
80105
3150
AMYLASE
82150
344
AMYLASE 2HR
82150
265
AMYLASE BODY FLUID
82150
3156
AMYLASE URINE
82150
166
AMYLASE URINE 24HR
82150
3151
AMYLASE: ISOENZYMES
82664
7038
ANA TEST
86038
SPECIMEN: 2 ML SERUM, EDTA PLASMA OR HEPARINIZED PLASMA
DO NOT USE GEL BARRIER TUBE.
NOTE: INCLUDES METABOLIC NORTRIPTYLINE
SPECIMEN: 1 ML PLASMA SODIUM HEPARINIZED (GREEN TOP TUBE
PRECHILLED)
SHIP TEMPERATURE: SEND FROZEN IN A BAG WITH ICE OR COLD
PACK.
SCHEDULE: DAILY
NOTE: SEPARATE PLASMA WITHIN 15 MIN FROM THE COLLECTION
AND FREEZE IMMEDIATELY.PLEASE NOTIFY LAB
SPECIMEN: 10 ML URINE
SCHEDULE: DAILY. PLEASE INCLUDE CHAIN OF CUSTODY
SCHEDULE: DAILY
SPECIMEN: 2HR URINE RANDOM COLLECTION
SCHEDULE: DAILY
SPECIMEN: 1 ML BODY FLUID (PLEURAL, PERITONEAL, PERICARDIAL,
SYNOVIAL, CYST )
SCHEDULE: DAILY
SPECIMEN: 7ML RANDOM URINE
SCHEDULE: DAILY
SPECIMEN: 10 ML URINE 24 HRS URINE COLLECTION, NO
PRESERVATIVE
SCHEDULE: DAILY
NOTE: SPECIFY URINE VOLUME
CPT : 82150 ; 82664
SCHEDULE: DAILY (AM)
NOTE: IF ANA IS POSITIVE MONDAY(AM), WEDNESDAY(AM) AND
FRIDAY(AM) FOR PATTERN
14
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
233
ANABOLIC (STEROID)
RANDOM URINE QUE
80100
332
ANABOLIC STEROID URINE
PANEL
143
ANALYZER / LUPUS PANEL 9
MULTI
3157
ANDROSTENEDIONE
82157
3164
ANGIOTENSIN CONVERTING
ENZYME (ACE)
82164
90
ANIMAL ALLERGEN PANEL
86003
7590
ANTI PM1 POLYMIOSITIS
ASSOC AB
86235
7225
ANTI DNA DOUBLE
STRANDED AB
86225
7226
ANTI DNA SS AB IGG
86226
251
ANTI ENA ANTIBODY
86235
7210
ANTI HU
86235
288
ANTI ICA (ANTI IA2)
178
ANTI JO ANTIBODIES
86235
267
ANTI MULLERIAN HORMONE
83516
STORAGE: REFRIGERATE
SEND OUT: 7 - 10 DAYS
SEND OUT: 7 - 10 DAYS
SCHEDULE: 1 WEEK.
PANEL INCLUDE: ANA, DsDNA, ANTI SM/RNP, ANTI SL-70, ANTI
S-jo, RF IgM, ANTI SSA,SSB, C3,C4.
SCHEDULE: TUESDAY & THURSDAY (AM)
SCHEDULE:DAILY
SPECIMEN:3 ML SERUM
PANEL INCLUDE: CAT HAIR DANDER EPITELIUM, CHICKEN FEATHERS,
DOG EPITHELIA, HORSE DANDER, RAT EPITELIUM
SCHEDULE: TUESDAY & FRIDAY (AM)
SCHEDULE: 3-5DAYS
SCHEDULE: WEDNESDAY (AM)
SCHEDULE : 7 - 10 DAYS SEND OUT
SPECIMEN: 4ML SERUM WITHOUT SEPARATOR
SHIP TEMPERATURE: REFRIGERATE.
SCHEDULE : 7 - 10 DAYS SEND OUT
CPT: NOT AVAILABLE
SCHEDULE: WEDNESDAY ( AM )
SPECIMEN: 2ML SERUM
SCHEDULE: 1WEEK, SEND OUT
15
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7148
ANTI PHOSPHATIDYLSERINE
AB IGG IGA IGM
86148
1307
ANTI RNA POLIMERASE III IGG
ANTIBODY
237
ANTI SM / RNP
86235
7256
ANTI SMOOTH AB (ASMA) ACTIN
86256
7255
ANTI STRIATED MUSCLE AB
86255
6300
ANTI THROMBIN III ACTVITY
FUNCTIONAL
85300
6301
ANTI THROMBIN III ANTIGEN
85301
7870
ANTIBODY ID PANEL
86870
7234
ANTI-ENA PANEL AB
86235
7261
ANTI-GLOMERULAR
ANTIBODY (ANTI-GBM)
83520
7233
ANTI-GM1
83520
7257
ANTI-MITOCHONDRIAL
ANTIBODY AMA
86256
7271
ANTI-NEUTROPHIL
CITOPLASMIC Abs (ANCA) P
86256
7258
ANTI-PARIETAL CELL
ANTIBODY
86256
83520
SCHEDULE: 1-2 WEEKS.CPT 86148 x 3
SCHEDULE: WEDNESDAY
SCHEDULE: WEDNESDAY
SPECIMEN: 2 ML PLASMA SODIUM CITRATE (LIGHT BLUE-TOP TUBE)
SCHEDULE: FRIDAY (AM)
SPECIMEN: 2 ML PLASMA LIGHT BLUE-TOP TUBE (SODIUM CITRATE)
SPECIMEN: 2 ML SERUM + WHOLE BLOOD EDTA
CPT: 86870 /86886
NOTE: INCLUDES SM & RNP
SCHEDULE: WEDNESDAY
SCHEDULE: WEDNESDAY
SCHEDULE: WEDNESDAY
16
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
6614
ANTIPHOSPHOLIPID PROFILE
MULTI
7230
ANTI-RNP
7238
ANTI-SJOGREN'S ANTIBODY
(ANTI-SS-A/SS-B)
7252
ANTI-SMITH ANTIBODY (ANTISM ANTIBODY)
86235
7060
ANTISTREPTOLYSIN 0 TITER
(ASO TITER)
86060
3172
APOLIPOPROTEIN A1 & B
82172
163
APOLIPOPROTEIN A1
164
APOLIPOPROTEIN B
3173
APOLIPOPROTEIN E4
367
AQUAPORIN 4 ANTIBODY
3175
ARSENIC BLOOD
82175
3176
ARSENIC RANDOM OR 24 HR
URINE
82175
86235
86235
82172
82172
MULTI
SPECIMEN: 3 ML SERUM + 3 ML PLASMA (LIGHT BLUE-TOP)
SCHEDULE: FRIDAY (AM).
CPT: 85613 ; 85732 ; 86147.
NOTE: INCLUDES CARDIOLIPIN ABS IGG & IGM / LUPUS
ANTICOAGULANT
SCHEDULE: DAILY
SCHEDULE: DAILY. CPT 82172 x 2
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 7 ML WHOLE BLOOD EDTA
SHIP TEMPERATURE: ROOM TEMPERATURE (SEND FROM MONDAY
TO WEDNESDAY)
SCHEDULE: 15 - 18 DAYS. SEND OUT.
NOTE: NO MEDICAL INSURANCE
CPT: 83912 ; 83891 ; 83892
SPECIMEN: 3ML SERUM
SHIPMENT: REFRIGERATE.
SPECIMEN: 5 ML WHOLE BLOOD ROYAL BLUE-TOP (EDTA) TUBE
SPECIMEN: 10 ML URINE 24 HR OR RANDOM NO PRESERVATIVE
NOTE: PATIENT SHOULD REFRAIN FROM EATING ALL SEAFOOD;
SHELLFISH, SHRIMP, CRAB, LOBSTER, AND BOTTOM FEEDERS AT
LEAST THREE DAYS PRIOR COLLECTION.CPT 82175, 82570
17
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
1072
ARTHRITIS PANEL (REF)
MULTI
211
ARTHRITIS PROFILE (REF)
MULTI
3657
ARYSULFATASE
82657
315
ASPERGILLUS AG
GALACTOMANAN
7606
ASPERGILLUS ANTIBODY
QUANTI
86606
7067
ASPERGILLUS FLAVUS
PRECIPATING AB IGG
86606
274
ASPERGILLUS FUMIGATUS
86606
66
ASPERGILLUS FUMIGATUS M3
86003
1002
ASPERGILLUS NIGER
PRECIPATING AB IGG
86606
1049
BABESIA IGG/IGM
86753
3205
BARBITURATES URINE
80101
347
BARTONELLA PROFILE (HENS
G M QUINT G&M)
86611
SPECIMEN: 7 ML WHOLE BLOOD EDTA (LAVENDER ) + 4 ML SERUM
SCHEDULE: DAILY (AM).
PANEL INCLUDE: ANA, RF IgG, SED RATE, URIC ACID
CPT: 86431 ; 85651 ; 86038 ; 84550
SPECIMEN: 7 ML WHOLE BLOOD EDTA ( LAVENDER ) + 4 ML SERUM
PANEL INCLUDE: ANA, RF IgG, SED RATE, URIC ACID, CRP, ASO
SCHEDULE: DAILY (AM).CPT : 86431 ; 85651 ; 86038 ; 84550
SPECIMEN: 10 ML WHOLE BLOOD YELLOW-TOP ( ACD ) TUBE
SCHEDULE: 1 - 2 WEEKS ;SEND OUT
SHIP TEMPERATURE: FEFRIGERATE
NOTE: EACH TEST IS SEND INDIVIDUAL- FUMIGATUS ANTIBODIES,
FLAVUS ANTIBODIES,NIGER ANTIBODIES
CPT: 86606 x 3
SCHEDULE: 1 WEEK, SEND OUT. CPT 86753 x 2
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY DOCUMENTATION IS REQUIRED
TEST INCLUDES: BARTONELLA HENSELAE IGG + IGM
BARTONELLA QUINTANA IGG + IGM.
CPT: 86611 x 4
18
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
1048
BASIC METABOLIC PANEL
80048
5185
BENCE JONES URINE
84160
1175
BENZENE BLOOD
84600
1155
BENZODIAZEPINES, QL.
80101
67
BERMUDA GRASS G2
86003
7146
BETA 2 GLYCOPROTEIN I AB
IGG, IGM,IGA
86146
3232
BETA 2 MICROGLOBULIN
82232
3231
BETA 2 MICROGLOBULIN ,
URINE
82232
8208
BETA HYDROXY BUTIRATE
84311
398
BETA THALASSEMIA
83891
3240
BILE ACIDS CHOLYLGLYCINE
82240
3239
BILE ACIDS TOTAL
82239
3248
BILIRUBIN DIRECT
82248
3252
BILIRUBIN FECES QUALITATIVE 82252
3247
BILIRUBIN TOTAL
82247
SHIP TEMPERATURE: REFRIGERATED
SCHEDULE: DAILY
SCHEDULE: DAILY.
SPECIMEN: WHOLE BLOOD 7ML EDTA, SUBMIT UNOPENED TUBE.
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY DOCUMENTATION IS REQUIRED.
SCHEDULE: DAILY
SCHEDULE: TUESDAY & THURSDAY
SHIP TEMPERATURE:FROZEN
SPECIMEN: 7ML WB EDTA
SCHEDULE: 1 WEEK SEND OUT
SCHEDULE: DAILY
NOTE: SYNONYMS CONJUGATED
SPECIMEN: 1 g FRESH STOOL
SCHEDULE: DAILY
SCHEDULE: DAILY
19
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
2005
BILIRUBIN URINE
81005
3250
BILIRUBIN:TOTAL DIRECT &
INDIRECT
82248
3261
BIOTINIDASE
82261
7903
BISMUTH BLOOD
83018
4018
BISMUTH URINE
83018
287
BK DNA PCR
87799
7612
BLASTOMYCES AB
86612
7900
BLOOD TYPING ABO
86900
6032
PLATELET MANUAL COUNT
85032
6031
BLOOD COUNT
85025
7901
BLOOD RH
86901
7906
BLOOD TYPE & BLOOD GROUP
REF
86906
148
BODY FLUID ELECTROLYTES
80051
908
BODY FLUID URIC ACID
84560
SCHEDULE: DAILY
NOTE: PROTECT FROM LIGHT
SCHEDULE: DAILY
NOTE: PROTECT FROM LIGHT
SCHEDULE: 1 WEEK. SEND OUT
SPECIMEN: 7 ML WHOLE BLOOD ROYAL BLUE TOP TUBE (EDTA)
SPECIMEN: 10 ML URINE RANDOM OR 24 HRS, NO PRESERVATIVE
SCHEDULE: 1 WEEK , SEND OUT
SPECIMEN: 1 LAVENDER TOP TUBE (EDTA) + 1 ML SERUM
SCHEDULE: DAILY.
CPT: 86900 ; 86901
SPECIMEN: 1 LAVENDER TOP TUBE (EDTA)
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 1 LAVENDER TOP TUBE ( EDTA ) + 1 ML SERUM
SCHEDULE: DAILY
SCHEDULE: DAILY.
SPECIMEN: 2ML BODY FLUID
SCHEDULE: DAILY.
CPT 84300 / 84133 / 82374 / 82438
SPECIMEN: 2ML BODY FLUID
SCHEDULE: DAILY
20
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7615
BORDETELLA PERTUSSIS IGG
86615
7614
BORDETELLA PERTUSSIS IGM
86615
317
BORDETELLA PERTUSSIS
NASOPHARYNGEAL CULT
87070
423
BRAC 1 BRAC 2 ANALYSIS
4880
BRAIN NATRIURETIC PEPTIDE
(B-TYPE)
83880
7622
BRUCELLA ANTIBODY IGG
86622
388
BULLOUS PEMPHIGIOD AG
83520
5545
BUN 24 HR URINE
84545
181
BUN CREATININE/RATIO
MULTI
5520
BUN SERUM
84520
5540
BUN SPOT URINE
84540
8265
BUTALBITAL
87265
240
C1Q BINDING IMMUNE
COMPLEX
86332
SCHEDULE: 1 WEEK,SEND OUT
SPECIMEN: ONE SWAB
SCHEDULE: 1 - 2 WEEK, SEND OUT
SCHEDULE: ALL DETAILS ARE IN THE SPECIAL KIT. SAMPLE MUST BE
ACCOMPANIED WITH THE FOLLOWING: CONSENT FORM
COMPLETED IN ITS ENTIRETY BY THE PHYSICIAN. PROVIDE THE
PATIENT TO LOOK FOR THE SIGNATURE OF THE DOCTOR BEFORE
TAKING THE ANALYSIS. SAMPLE IS SENT BY FEDERAL EXPRESS.
COST: $4500.00 - PAID IN THE MOMENT
SPECIMEN: 2 ML PLASMA PLASTIC LAVENDER-TOP TUBE (EDTA)
SCHEDULE: DAILY
SPECIMEN: 2ML SERUM
SPECIMEN: 10 ML 24 HRS URINE, NO PRESERVATIVE
SCHEDULE: DAILY
NOTE: STATE TOTAL 24 HRS URINE VOLUME ON THE REQUEST
FORM.
SCHEDULE: DAILY. CPT: MULTI
SCHEDULE: DAILY
SPECIMEN: 10 ML RANDOM URINE, NO PRESERVATIVE
SCHEDULE: DAILY
SCHEDULE: 1 - 2 WEEK
DEMOSTRATED IN RHEUMATIC ,INFECTIOUS AND NEOPLASTIC
DISEASES
21
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7304
CA 125
86304
7300
CA 15-3
86300
7301
CA 19-9
86301
7312
CA-27-29
86300
292
CADMIUM BLOOD
82300
3300
CADMIUM URINE
82300
372
CAFFEINE SERUM
82491
3308
CALCITONIN
82308
406
CALCIUM 12 HRS URINE
82340
3335
CALCIUM URINE SPOT
82340
3330
CALCIUM IONIZED
82330
3310
CALCIUM TOTAL
82310
3340
CALCIUM URINE 24 HR
82340
4993
CALPROTECTIN FECAL
83993
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 7 ML WHOLE BLOOD ROYA BLUE TOP TUBE (EDTA)
SPECIMEN: 5 ML RANDOM OR 24 HRS URINE NO PRESERVATIVE.
CPT: 82300,82570
SPECIMEN: SERUM WITHOUT SEPARATOR OR PLASMA EDTA TUBE
OR GREEN TOP TUBE. DO NOT USE GEL BARRIER TUBE
SCHEDULE: THURSDAY
SPECIMEN: URINE 12 HRS COLLECTION
VOLUMEN: 3 ML ALIQUOT
SCHEDULE: DAILY
SPECIMEN: 10 ML URINE 24 HRS OR RANDOM, NO PRESERVATIVE
SCHEDULE: DAILY
SPECIMEN: 2 ML SERUM, COLLECT IN A GEL BARRIER TUBE, LET CLOT
AND SPIN INMEDIATELY WITH THE CAP ON. SHIP THE
UNOPENED TUBE.
SCHEDULE: DAILY
SPECIMEN: 10 ML URINE 24 HRS COLLECTION OR RANDOM NO
PRESERVATIVE.
SCHEDULE: DAILY
22
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7628
CANDIDA AB
86628
355
CANDIDA AB (IGA, IGG, IGM)
86628
244
CANNABINOID (MARIHUANA)
80101
1156
CARBAMAZEPINE (TEGRETOL)
80156
1157
CARBAMAZEPINE FR
80157
3375
CARBOXYHEMOGLOBIN
QUANTITATIVE
82375
3378
CARCINOEMBRYONIC AG
(CEA)
82378
1067
CARDIAC PROFILE
(SGOT,LDH,CPK)
84999
7149
CARDIOLIPIN ANTIBODY IGG
IGA IGM PANEL
86147
157
CARDIOLIPIN IGA
86147
156
CARDIOLIPIN IGG
86147
158
CARDIOLIPIN IGM
86147
3379
CARNITINE TOTAL & FREE
82379
3380
CAROTENE
82380
SCHEDULE: 1 - 2 WEEK, SEND OUT.
CPT: 86628 X 3
SPECIMEN: 10 ML URINE RANDOM
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: SEND OUT 7 - 10DAYS
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER-TOP TUBE (EDTA)
DO NOT OPEN
NOTE: CARBON MONOXIDE
SCHEDULE: DAILY
SCHEDULE: DAILY (AST / CPK / LDH)
SCHEDULE: FRIDAY (AM).
CPT: 86147 X 3
SCHEDULE: FRIDAY
SCHEDULE: FRIDAY
SCHEDULE: FRIDAY
SHIP TEMPERATURE: FROZEN AND PROTECT FROM LIGHT
23
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
68
CAT DANDER EPHITHELIUM E1
86003
7611
CAT SCRATCH BARTONELLA
HENSELAE IGG/IGM
86611
3383
CATECHOLAMINES
FRACCIONATED PLASMA
82383
3382
CATECHOLAMINES RANDOM
URINE FRACC & FREE
82384
CATHECHOLAMINE FRACC &
FREE 24 HRS
82384
6025
CBC
85025
254
CD 20
MULTI
7675
CD 55 / CD 59
MULTI
7361
CD3 / CD4 / CD8
HELPER/SUPPRESSOR
MULTI
7360
CD4 HELPER
86361
7359
CD4 HELPER / CD8
SUPPRESOR
86360
3384
CPT MULTIPLE : 86611 x 4
SPECIMEN: 4 ML PLASMA GREEN-TOP (HEPARIN) TUBE OR EDTA
CHILLED PRIOR TO VENIPUNCTURE.
NOTE: PATIENT SHOULD AVOID ALCOHOL, COFFEE, TEA, TOBACCO &
EXTREMOUS EXERCISE.
SPECIMEN: 30 ML URINE 24 HRS
CONTAINER: PLASTIC URINE CONTAINER WITH 25 ML 6N HCL
PRESERVATIVE.
NOTE: RECORD VOLUME ON REQUEST FORM AND VIAL. PATIENT
SHOULD AVOID ALCOHOL, COFFEE, TEA, TOBACCO, AND
EXTREMOUS EXERCISE OR STRESS
SPECIMEN: 1 LAVENDER-TOP (EDTA) TUBE
SCHEDULE: DAILY
SPECIMEN: WHOLE BLOOD GREEN TUBE AND EDTA
SHIPMENT: ROOM TEMPERATURE OR REFRIGERATE MONDAY
THROUGHT WEDNESDAY
SCHEDULE: 1 WEEK; SEND OUT
CPT: 86359, 86355, 86357, 86356 X3. CALL ONE DAY PRIOR
SPECIMEN: WHOLE BLOOD GREEN TUBE AND EDTA
SHIPMENT: ROOM TEMPERATURE OR REFRIGERATE MONDAY
THROUGHT WEDNESDAY
CPT: 86359, 86355, 86357, 86356 X3. CALL ONE DAY PRIOR
SPECIMEN: 1 WHOLE BLOOD LAVENDER-TOP ( EDTA ) TUBE
SCHEDULE: DAILY.
CPT: 86357,86359,86360
SCHEDULE: DAILY
SCHEDULE: DAILY
24
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
404
CELIAC DISEASE
COMPREHENSIVE AB PROFILE
MULTI
403
CELIAC DISEASE PEDRIATIC
PROFILE
MULTI
4515
CELIAC PROFILE IGA
MULTI
365
CELIAC PROFILE IGA / IGG
MULTI
7237
CENTROMERE ANTIBODY
86235
402
CEROQUEL LEVELS
80299
3390
CERULOPLASMIN
82390
97
CHICKEN FEATHERS
ALLERGEN
86003
3792
CHLAMYDIA & GC URINE
MULTI
7631
CHLAMYDIA AB IGG
86631
8491
CHLAMYDIA ANTIGEN
DETECTION URINE
87491
NOTE: PANEL INCLUDES TOTAL IGA / GLIADIN IGA & IGG / tTRANSGLUTAMINSE IGA & IGG /ENDOMYSIAL IGA.
SCHEDULE: 1 WEEK
CPT: 82784,83516X4, 86255
NOTE: TEST INCLUDES TOTAL IGA /GLIADIN IGG / TISSUE
TRANSGLUTAMINSE IGG.
SCHEDULE: 1 WEEK
CPT: 82784,83516X4, 86255
NOTE: PROFILE INCLUDES GLIADIN IGA / ENDOMYSIAL IGA /
IMMUNOGLOBULIN IGA.
SCHEDULE: 1 WEEK
CPT: 82784,83516X2
SPECIMEN:3 ML SERUM
SCHEDULE: 1 WEEK
PANEL INCLUDES: IGA/GLIADIN IGA &IGG / TISSUE
TRANSGLUTAMINSE IGA AND IGG
CPT: 82784,83516X4
SCHEDULE: WEDNESDAY
SCHEDULE: 8-10 DAYS. SEND OUT
SCHEDULE:DAILY
SCHEDULE: 3 DAYS.
SCHEDULE: DAILY AM.
CPT: 87591/87491
SCHEDULE:FRIDAY (AM)
SCHEDULE: DAILY
25
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7633
CHLAMYDIA PNEUMONIAE
IGG
86631
8485
IGG/IGM/IGA
MULTI
8490
IGM
86632
8110
CHLAMYDIA TRACHOMATIS
CULTURE
87110
8320
CHLAMYDIA TRACHOMATIS
IGM QUANTIATIVE
86632
277
CHLORIDE CSF
82435
3435
CHLORIDE SERUM
82435
3438
CHLORIDE SPOT URINE
82436
425
CHLORIDE STOOL
82438
3436
CHLORIDE URINE 24 HR
82436
119
CHOLESTEROL
ELECTROPHORESIS
83701
3465
CHOLESTEROL SERUM
82465
3482
CHOLINESTERASE RBC
82482
3480
CHOLINESTERASE SERUM
82480
CPT 86631X 2 CPT 86632
SPECIMEN: SWAB
NOTE: SWAB FLUIDS; MULTI USE MEDIA (M4 MYCOPLASMA, VIRAL,
CHLAMYDIA ) CPT 87110 ; 87140
SPECIMEN: 1 ML CSF (PLASTIC TUBE)
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: STERILE SPECIMEN CONTAINER (STOOL)
SPECIMEN: 20 ML 24 HRS URINE, NO PRESERVATIVE
SCHEDULE: DAILY
NOTE: STATE 24 HRS VOLUME ON THE TEST REQUEST FORM
CPT: 83701 / 84478 / 82465
SCHEDULE: DAILY
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER-TOP (EDTA)
26
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
410
CHROMATIN AB
3495
CHROMIUM PLASMA
82495
120
CHROMIUM URINE
82495
7316
CHROMOGRANIN A
86316
9237
CHROMOSOME
HEMATOLOGIC DISORDER
88230
9263
CHROMOSOME HIGH
RESOLUTION
MULTI
9262
CHROMOSOME KARIOTYPE
CONSTITUTIONAL
88262
9267
CHROMOSOME LEUKEMIA /
LYMPHOMA
MULTI
9230
CHROMOSOME
PHILADELPHIA
MULTI
7343
CHRONIC URTICARIA
86343
7682
CIRCUM OVAL TEST
86682
SPECIMEN: 2ML SERUM
SCHEDULE: 7 - 10 DAYS.
CPT: NOT AVAILABLE
SPECIMEN: 3 ML PLASMA (EDTA ROYAL BLUE)
SPECIMEN: 5 ML RANDOM URINE, NO PRESERVATIVE
SCHEDULE: 1 WEEK, SEND OUT CPT 82495 + 82570
NOTE: NO RADIOISOTOPES SHOULD BE ADMINISTERED TO THE
PATIENT WITHIN 48 HRS PRIOR TO VENIPUNCTURE.
SPECIMEN:7 ML WHOLE BLOOD SODIM HEPARIN (GREEN TOP TUBE)
TOMAR DE LUNES A JUEVES (OPD)
TOMAR DE LUNES A MIERCOLES (REF ) CPT 88237 / 88262 / 88291
SPECIMEN: 10 ML WHOLE BLOOD SODIUM HEPARIN (GREEN TOP
TUBE)
CPT 88230 / 88289 / 88262 / 88291
SPECIMEN: 5 ML WHOLE BLOOD SODIUM HEPARIN ( GREEN-TOP
TUBE)
SCHEDULE: 4 WEEKS SEND OUT.
CPT: 88230 / 88262 / 88291
SYNONYMS: PHILADELPHIA CHROMOSOME
SPECIMEN: 2 ML BONE MARROW OR 3 ML WHOLE BLOOD GREENTOP TUBE ( HEPARIN )
SHIP TEMPERATURE: ROOM TEMPERATURE.
SCHEDULE: 4 WEEKS; SEND OUT.
CPT 8823788264,88280X2,88291
SPECIMEN: 3 ML BONE MARROW OR 7 ML WHOLE BLOOD GREENTOP TUBE ( HEPARIN )
CPT: 88230,88262,88291,88289
SPECIMEN:5ML SERUM
SCHEDULE:1 WEEK, SEND OUT
SCHEDULE: 1 MONTH, SEND OUT
27
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
3507
CITRATE SERUM
82507
3508
CITRATES URINE 24 HRS.
82507
69
CLADOSPORIUM HERBARUM
M2
86003
3512
CLONAZEPAM (KLONOPIN)
80154
8324
CLOSTRIDIUM DIFFICILE
TOXIN A & B
87324
411
CLOZARIL
80154
7644
CMV (CYTOMEGALOVIRUS)
IGG
86644
7645
CMV (CYTOMEGALOVIRUS)
IGM
86645
284
CMV QUALI PCR
87496
285
CMV QUANTITATIVE PCR
87497
3374
CO2 SERUM
82374
82374
168
CO2 URINE 24 HRS
169
CO2 URINE SPOT
82374
SPECIMEN: 10 ML 24 HRS URINE
CONTAINER: PLASTIC URINE CONTAINER WITH 30 ML 6N HCL
PRESERVATIVE.
NOTE: RECORD TOTAL VOLUME ON THE REQUEST FORM.
SPECIMEN: 2 gm. STOOL FRESH
SCHEDULE: TUESDAY & THURSDAY AM).
SCHEDULE: MONDAY
SCHEDULE: THURSDAY
SPECIMEN: WHOLE BLOOD, CSF OR URINE (LAVENDER-TOP OR
YELLOW-TOP)
SPECIMEN: 2 ML PLASMA LAVENDER-TOP (EDTA)
SHIP TEMPERATURE: REFRIGERATE OR FROZEN
SCHEDULE: DAILY.
SCHEDULE: DAILY
NOTE: INCLUDE 24 HRS TOTAL URINE VOLUME ON THE REQUEST
FORM.
SCHEDULE: DAILY
28
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
121
COBALT PLASMA
83018
122
COBALT URINE
83018
3520
COCAINE/METABOLITE
80101
907
COCCIDIODES AB ID
86635
70
COCKROACH I6
86003
314
COENZYME Q10 TOTAL
82491
7157
COLD AGGLUTININ TITER
86157
7037
COLLAGEN VASCULAR
DISEASE PROFILE
125
COMPARATIVE GENOMIC
HYBRIDIZATION
83891
273
COMPLEMENT C1 ESTERASE
INH FUNCTIONAL
86161
7143
COMPLEMENT C1 ESTERASE
INHIBITOR
86160
7167
COMPLEMENT C1Q QUANTI
86160
409
COMPLEMENT C1R
408
COMPLEMENT C1S
SPECIMEN: 2 ML PLASMA ROYAL BLUE-TOP (EDTA)
SPECIMEN: 5 ML RANDOM OR 24 HRS URINE
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY IS REQUIRED FOR SAMPLES.
SPECIMEN: 2ml SERUM
SPECIMEN: 1 ML PLASMA GREEN-TOP (HEPARIN ) TUBE
SHIP TEMPERATURE: FROZEN & PROTECT FROM LIGHT
SPECIMEN: 2 ML SERUM + CELL'S OR CLOT
SCHEDULE: OVERNIGHT (24 HRS)
PANEL INCLUDE: ANA / ANTI DNA DS / RF / SED RATE / C3 / C4 /
URIC
SPECIMEN: WB GREEN TOP TUBE
SPECIAL DELIVERY: MONDAYS AND TUESDAY.
SCHEDULE: 1 MONTH
SCHEDULE: 1 - 2 WEEK SEND OUT
NOTE: STATE PATIENT'S SEX ON THE REQUEST FORM.
SPECIMEN: PLASMA EDTA
29
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7159
COMPLEMENT C2
86160
7160
COMPLEMENT C3
86160
177
COMPLEMENT C3 & C4
MULTI
7161
COMPLEMENT C4
86161
7166
COMPLEMENT C5
86160
7174
COMPLEMENT C6
86160
7171
COMPLEMENT C7
86160
7169
COMPLEMENT C9
86160
7162
COMPLEMENT CH 50
86162
1053
COMPRENSIVE METABOLIC
PANEL(CMP)
80053
327
CONEXIN 26 HEARING LOSS
MULTI
7886
COOMB INDIRECT
86886
3525
COPPER SERUM
82525
127
COPPER URINE 24 HRS OR
RANDOM
82525
71
CORN F8
86003
SCHEDULE:DAILY
SCHEDULE: DAILY.
CPT: 86160 x 2
SCHEDULE: DAILY.
SCHEDULE: DAILY
CPT:83891,83892,83898X7,83909X6,83912
SPECIMEN: 1 ML SERUM + CELL'S OR CLOT
SCHEDULE: DAILY
SPECIMEN: 2 ML PLASMA (ROYAL BLUE TOP)
SCHEDULE:1 WEEK, SEND OUT
CPT: 82525,82570
SCHEDULE: 3-5 DAYS
30
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
3528
CORTICOSTERONE
82528
346
CORTICOTROPIC RELEASING
FACTOR HORMONE
83519
3535
CORTISOL AM
82533
3530
CORTISOL FREE 24 HR
82530
7200
CORTISOL FREE SERUM
82530
3533
CORTISOL LEVEL
82533
3532
CORTISOL PM
82533
369
CORTISOL SALVIARY
82533
3491
COUMADIN (WARFARIN)
82491
7657
COXSACKIE B VIRUS AB
86658
7758
COXSACKIE A ANTIBODY
86658
5681
C-PEPTIDE (SERUM)
84681
3553
CPK MB
82553
7140
C-REACTIVE PROTEIN
86140
SPECIMEN: 3 ML PLASMA HEPARIN
SCHEDULE: DAILY
NOTE: STATE COLLECTION TIME AND DATE.
SPECIMEN: 20 ML URINE 24 HRS NO PRESERVATIVE
NOTE: RECORD VOLUME ON REQUEST FORM AND VIAL.
SCHEDULE: DAILY
SCHEDULE: DAILY
NOTE: STATE COLLECTION TIME AND DATE
SPECIMEN : SALIVA IN AN SPECIAL KIT
TEMPERATURE: REFRIGERATE
TAT: 1WEEK SEND OUT
SCHEDULE: MONDAY, WEDNESDAY & FRIDAY (AM)
SCHEDULE: DAILY
CPT 82550 / 82553
SCHEDULE: DAILY
31
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7141
C-REACTIVE PROTEIN HIGH
SENSITIVITY
86141
3538
CREATINE 24hrs URINE - LAB
CORP
82540
3552
CREATINE KINASE
ISOENZYMES
82552
3550
CREATINE KINASE/ CPK
82550
3540
CREATINE SERUM
(REFERENCE)
82540
3570
CREATININE 24 HR
82570
405
CREATININE CLEARANCE 12
HRS
82575
3575
CREATININE CLEARANCE 24
HRS
82575
3565
CREATININE SERUM
82565
345
CREATININE URINE 2HR
82570
194
CREATININE URINE SPOT
82570
3585
CRYOFIBRINOGEN
82585
3595
CRYOGLOBULIN QUALI
82595
7641
CRYPTOCOCCUS ANTIBODY
86641
SCHEDULE: DAILY
SPECIMEN:10 ML OF 24 HRS URINE COLLECTION; NO PRESERVATIVE
SCHEDULE: FRIDAY (AM) CPT 82550 / 82552
SCHEDULE: DAILY
SCHEDULE : 1 WEEK; SEND OUT
SPECIMEN: 10 ML URINE;24 HRS COLLECTION
NOTE: RECORD VOLUME
SCHEDULE: DAILY
SPECIMEN: 1 ML SERUM & 3 ML ALIQUOT URINE (12 HRS)
SCHEDULE: DAILY
SPECIMEN: 10 ML URINE 24 HRS COLLECTION + 2 ML SERUM
SCHEDULE: DAILY
NOTE: RECORD VOLUME, HEIGHT AND WEIGHT
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 3 ML PLASMA BLUE-TOP (SODIUM CITRATE) OR
LAVENDER- TOP (EDTA)
SCHEDULE: 4 DAYS
32
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
8327
CRYPTOCOCCUS ANTIGEN
87327
8328
CRYPTOSPORIDIUM AG STO0L
87328
326
CRYTOCOCCUS AG (CSF)
87327
3523
C-TELOPEPTIDE SERUM
82523
103
CULTURE ABSCESS
87070
363
CULTURE AEROBIC
87070
104
CULTURE AEROBIC ID
87070
105
CULTURE AFB SPUTUM
87116
8116
CULTURE AFB URINE
87116
8075
CULTURE ANAEROBIC
87075
8027
CULTURE BACTERIAL: EAR
87070
8061
CULTURE BACTERIAL:
EXUDATE
87070
SPECIMEN: 2 GM FRESH STOOL
SPECIMEN: CSF IN STERILE PLASTIC TUBE.
TEST INCLUDES: IF POSITIVE, A TITER IS AUTOMATICALLY OBTAINED
AT AN ADDITIONAL CHARGE
SPECIMEN: SWAB CULTURETTE
SCHEDULE: 3 DAYS
SCHEDULE: 3 DAYS
SPECIMEN: SWAB OR STERILE CONTAINER SAMPLE
SHIP TEMPERATURE:ROOM TEMPERATURE
SCHEDULE: 3 DAYS
SPECIMEN: 50 ML THICK MOCUS FROM FIRST MORNING SPUTUM IN
STERILE CONTAINER.
SCHEDULE: 10 WEEKS, SEND OUT
CPT 87115 / 87116. FACTURAR SLOTS 8116/ 8206 /8015
INCLUDES: SMEAR
SPECIMEN: 50 ML CLEAN CATCH MIDSTREAM RANDON URINE
CATHETERIZED, SUPRA PUBIC IN STERILE CONTAINER.
SCHEDULE: 8 –10 WEEKS, SEND OUT.
PLEASE SEND SAMPLE SEPARATELY FROM OTHER SPECIMENS.
CPT: 8116, 8206 ,8015
NOTE: INCUDES TEST SMEAR
SPECIMEN: SPECIMEN IN ANAEROBIC CONTAINER
SPECIMEN: CULTURETTE SWAB
SCHEDULE: 3 DAYS
SCHEDULE: 3 DAYS
33
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
8029
CULTURE BACTERIAL: EYE
87070
8026
CULTURE BACTERIAL:
NASOPHARINGEAL
87070
8059
CULTURE BACTERIAL: NOSE
87070
8032
CULTURE BACTERIAL: SEMEN
87070
8031
CULTURE BACTERIAL: SKIN
LESIONS
87070
8063
CULTURE BACTERIAL:
SPUTUM
87070
8034
CULTURE BACTERIAL:
SYNOVIAL FLUID
87070
8033
CULTURE BACTERIAL:
VAGINAL
87070
8030
CULTURE BACTERIAL: WOUND
87070
8040
CULTURE BLOOD
87040
8070
CULTURE CAMPYLOBACTER
87046
106
CULTURE CERVIX
87070
7632
CULTURE CHLAMYDIA GENE
PROBE
87491
8230
CULTURE CLOSTRIDIUM
DIFFICILE
87075
SCHEDULE: 3 DAYS
SCHEDULE: 3 DAYS
SPECIMEN: SWAB CULTURRETE
SCHEDULE: 3 DAYS
SPECIMEN: EJACULATE SEMEN IN AN STERILE SPECIMEN
CONTAINER
SCHEDULE: 3 DAYS
SCHEDULE: 3 DAYS
SPECIMEN: SEND SPUTUM IN STERILE VIAL.
SCHEDULE: 3 DAYS
SPECIMEN: SYNOVIAL FLUID IN AN STERILE CONTAINER
SCHEDULE: 3-4 DAYS
SCHEDULE: 3 DAYS
PLEASE SPECIFY SOURCE
SCHEDULE: 3 DAYS
SPECIMEN:BLOOD CULTURE BOTTLE
SCHEDULE : 7 DAYS
SPECIMEN: FRESH STOOL IN CULTURETTE SWAB
SCHEDULE: 3-4 DAYS
SCHEDULE: 3 DAYS
NOTE: PLEASE SPECIFY SOURCE.
SPECIMEN: ENDOCERVICAL, URETHRAL, CONJUNCTIVAL SWAB,
GENPROBE COLLECTION KIT, ALSO URINE RANDOM NO
PRESERVATIVE
SHIP TEMPERATURE: ROOM TEMPERATURE OR REFRIGERATE
SCHEDULE : 48HRS
SPECIMEN: ONE SWAB OF STOOL IN AEROBIC TRANSPORT
SCHEDULE : 1 WEEK ; SEND OUT
34
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
107
CULTURE FOOT
87070
8121
CULTURE FOR TB:BODY FLUID
87116
8101
CULTURE FUNGUS
87101
8102
CULTURE FUNGUS EYE
(SABOURAUD)
87102
247
CULTURE GC
87070
8035
CULTURE GC CHLAMYDIA
GENE PROBE REF
MULTI
8590
CULTURE GC GENE PROBE
87591
1232
CULTURE HSV WITHOUT
TYPING
87255
395
CULTURE LEGIONELLA SPECIES
93027 CULTURE MYCOBACTERIA
87116
108
87070
CULTURE NAIL
SCHEDULE: 3 DAYS
SCHEDULE: 3 DAYS
NOTE: INCLUDE SMEAR.
SPECIMEN: SWAB CULTURETTE,URINE, STOOL,CSF FLUID, SKIN, NAIL,
AND BLOOD (SPECIFY TYPE SOURCE)
BLOOD SAMPLE:HEPARIN GREEN TUBE
SCHEDULE: 4-6 WEEKS
SPECIMEN: SABOURAUD PLATES
SCHEDULE: 4-6 WEEKS
NOTE: INCLUDE SMEAR.
SPECIMEN: SWAB TRANSPORT CULTURETTE
SCHEDULE: 3 DAYS
SPECIMEN: URINE
SCHEDULE: MONDAY / WEDNESDAY / FRIDAY.
CPT: 87591,87491
SPECIMEN: SPECIAL COBAS CONTAINER
SCHEDULE: MONDAY / WEDNESDAY / FRIDAY.
CPT: 87591,87491
NOTE: SWAB, COBAS SPECIMEN COLLECTION KIT FOR URETHRAL OR
CONJUNTIVAL SPECIMENS
SPECIMEN: SWAB, MULTI USE MEDIA (CHLAMYDIA, MYCOPLASMA
VIRAL). SUBMIT URETHRAL, VAGINAL, AND CERVICAL OR SKIN IN
MULTI USE MEDIA FROM LAB TOLEDO.
SCHEDULE: 8-10 DAYS
SPECIMEN: LUNG TISSUE, OTHER BODY FLUIDS TISSUE, PLEURAL
FLUID TRANSTRACHEAL ASPIRATION, LUNG EXUDATE, LUNG BIOPSY,
BRONCHIAL WASHING OR WATER FROM AIR
CONDITIONING/COOLING TOWERS.
SPECIMEN: STERILE SPECIMEN CONTAINER
SCHEDULE: 4-6 WEEKS
SPECIMEN: STERILE SPECIMEN CONTAINER (NAIL & PIECE OF NAIL)
SCHEDULE: 3 DAYS
35
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
110
CULTURE PERIANAL
87070
340
CULTURE RECTAL
87070
8045
CULTURE STOOL
87045
390
CULTURE STOOL VIBRIO ONLY
87046
8060
CULTURE THROAT
87070
112
CULTURE ULCER
87070
341
CULTURE URETRAL
87070
8088
CULTURE URINE
87088
113
CULTURE VAGINAL GBS
87070
8252
CULTURE VIRAL
87252
4514
CYCLIC CITRULINATE PEPTIDE
(CCP)
86200
1158
CYCLOSPORINE
80158
3610
CYSTATIN C
82610
SCHEDULE: 3 DAYS
SCHEDULE: 3 DAYS
SPECIMEN: FRESH STOOL IN CULTURETTE SWAB
SCHEDULE: 3-4 DAYS.
SPECIMEN: PARAPACK ORANGE (STOOL)
SCHEDULE: 8-10 DAYS.
SCHEDULE: 3 DAYS
SPECIMEN: SWAB
SCHEDULE: 3 DAYS
SPECIMEN: SWAB
SCHEDULE: 3 DAYS
SPECIMEN: STERILE CONTAINER
SCHEDULE: 3 DAYS
SPECIMEN: CULTURE SWAB
SCHEDULE: 3 DAYS CULTURE
SPECIMEN: VIRAL, CHLAMYDIA OR MYCOPLASMA CULTURE
TRANSPORT.
SAMPLE:BLOOD, CEREBROSPINAL (CSF), DERMAL, OCULAR, GENITAL,
MUCOSAL, ORAL, RECTAL, RESPIRATORY, STOOL, TISSUE, URINE OR
BIOPSY
SHIP TEMPERATURE: SPECIMEN MUST BE KEPT COLD AND
REFRIGERATED; EXCEPT BLOOD CULTURE (ROOM TEMPERATURE)
SCHEDULE: DAILY
SPECIMEN: SERUM 2 ML
SCHEDULE: DAILY
SCHEDULE: 3 DAYS
SCHEDULE: DAILY.
36
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
42
CYSTIC FIBROSIS SCREENING
81220
3615
CYSTINE URINE 24 HR QUANT
82131
270
CYTOLOGY BODY FLUID
329
DAPTOMYCIN
6379
D-DIMER
85379
4799
DEMEROL (MEPERIDINE)
83925
115
DENGUE AB IGG
86790
117
DENGUE AB IGG/IGM
86790
116
DENGUE AB IGM
86790
3634
DEOXYCORTISOL 11
82634
1160
DESIPRAMINE (NORPRAMINE)
80160
320
DESMOGLEIN
83516
419
DESMOGLEINE 1-3
SPECIMEN: 7 ML WHOLE BLOOD EDTA (LAVENDER) OR YELLOW -TOP
(ACD)
SPECIMEN: RANDOM URINE OR 24 HRS URINE COLLECTION
CONTAINERS: PLASTIC WITH 30 ML 6N HCL PRESERVATIVE.
SCHEDULE: 1-2 WEEKS, SEND OUT
NOTE: MEASURE AND RECORD ON THE REQUEST FORM 24 HRS
TOTAL URINE VOLUME.
SPECIMEN: 50 ML SPECIMEN WITH AN EQUAL VOLUME OF FIXATIVE
SCHEDULE: 2 WEEKS
NOTE: ADD SAME AMOUNT OF ALCOHOL TO 50% TO THE SAME
AMOUNT OF SAMPLE. REQUEST KIT.
SCHEDULE: DAILY
SPECIMEN: 2 ML PLASMA (SODIUM CITRATE) LIGHT BLUE TOP.
SCHEDULE: DAILY
SCHEDULE: 1WEEK, SEND OUT
SPECIMEN: RED TEST TUBE WITHOUT SEPARATOR
37
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
3639
3626
3627
DEXAMETHASONE
80420
SUPPRESION TEST (DST)
DHEA DEHYDROEPIANDROSTERONE 82626
(DHEA)
DHEA -S
DEHYDROEPIANDROSTERONE- 82627
SULFATE
1154
DIAZEPAM (VALIUM)
80154
1298
DIGITALIS DIGITOXIN
80299
1162
DIGOXIN / LANOXIN
80162
3651
DIHYDROTESTOSTERONE
82651
1185
DILANTIN / PHENYTOIN
80185
7648
DIPHTHERIA ANTIBODY
86317
7880
DIRECT COOMBS
86880
73
DOG EPIPHELIA E2
86003
1166
DOXEPIN (ADAPIN /
SINEQUAN
80166
1103
DRUG III CONFIRMATION LAB
CORP
80102
150
DRUG PANEL III
80100
SCHEDULE: 1 WEEK
SCHEDULE: MONDAY / WEDNESDAY / FRIDAY
TEST INCLUDES METABOLIC NORDIAZENAN
NOTE: NO GEL-BARRIER TUBE.
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 3 ML WHOLE BLOOD (EDTA)
SCHEDULE: DAILY
SPECIMEN: 12ML URINE
NOTE:CHAIN OF CUSTODY NEEDED
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY IS REQUIRED FOR SAMPLES.
38
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
234
DRUG SCREENING
COMA/OVERDOSE SERUM
MULTI
235
DRUG SCREENING PANEL II
80100
354
DRUG SCREENING PANEL IV
80100
1100
DRUG V
80100
1102
DRUG V CONFIRMATION LAB
CORP
80102
1101
DRUG VII
80100
1106
DRUGS X
80100
245
DU
86901
382
EBV DNA QT, PCR
87799
216
EBV VIRUS PANEL
MULTI
7656
ECHOVIRUS PANEL SEROTYPE
(CSF)
86658
416
ECSTASY
80100
74
EGG, WHOLE F245
86003
SPECIMEN: 4 ML SERUM AND 7 ML WHOLE BLOOD GRAY TOP
TUBE
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY IS REQUIRED. COCAINE & MARIIHUANA
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY IS REQUIRED.
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY IS REQUIRED
SCHEDULE: DAILY.
SCHEDULE: DAILY
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER (EDTA)
SCHEDULE: DAILY
SPECIMEN:2MLPLASMA EDTA
TEMPERATURE:FROZEN
SCHEDULE: MONDAY & THURSDAY
PANEL INCLUDE: EBV VCA IGG, EBV VCA IGM, EBNA IGG, EARLY IGG
SPECIMEN: 4 ML CSF (STERILE CONTAINER)
SCHEDULE: 1 - 2 WEEK, SEND OUT. CPT86658 X 5
SPECIMEN: URINE
SCHEDULE: DAILY
39
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7666
EHRLICHIA IGG / IGM
86666
3656
ELASTASE FECAL
82656
1051
ELECTROLYTE PANEL SERUM
80051
7334
ELECTROPHORESIS
/IMMUNOFIXATION SERUM
86334
377
ELM (SEDAN)
86653
7653
ENCEPHALITIS ST. LOUIS AB
4516
ENDOMYSIAL AB IGA
83520
149
ENDOMYSIAL IGG
83520
8498
ENTEROVIRUS AB
(POLIO VIRUS)
7658
ENTEROVIRUS AB PCR
6998
EOSINOPHIL COUNT URINE
81015
6012
EOSINOPHIL COUNT, BLOOD
85048
142
EPSTEIN BARR NUCLEAR AG
EBNA IGM
86664
7662
EPSTEIN BARR VIRUS, IgM
86665
7664
EPSTEIN-BARR NUCLEAR AG
IGG
86664
SPECIMEN: 1 g STOOL
SPECIMEN: 2 ML SERUM AVOID HEMOLISIS
SCHEDULE: DAILY.
SHIP REFRIGERATE: REFRIGERATE
SHIP REFRIGERATE: ROOM TEMPERATURE
SCHEDULE: 1- 2 WEEK, SEND OUT
SCHEDULE: WENDSDAY (AM)
SCHEDULE: WENDSDAY (AM)
SCHEDULE: 1 - 2 WEEKS
SCHEDULE: 1-2 WEEK
SCHEDULE: DAILY.
SCHEDULE: DAILY
40
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7663
EPSTEIN-BARR VIRUS EARLY
AG IGG
86663
7665
EPSTEIN-BARR VIRUS VIRAL
CAPSID IGG
86665
3668
ERYTHROPOIETIN
82668
8335
ESCHERICHIA COLI 0157
87335
3670
ESTRADIOL
82670
385
ESTRADIOL FREE & TOTAL
82670
3677
ESTRIOL
82677
3672
ESTROGEN
82672
3679
ESTRONE
82679
6360
EUGLOBULIN LYSIS TIME
85360
17
FACTOR II DNA GENE
MUTATION
81240
6210
FACTOR II INTERNO
HEMATOLOGY
85210
6250
FACTOR IX
85250
6220
FACTOR V ACTIVITY
85220
6221
FACTOR V LEIDEN MUTATION
81241
SCHEDULE: MONDAY / WEDNESDAY / FRIDAY (AM)
SPECIMEN: SWAB OR 1 g STOOL
SCHEDULE: 3 DAYS
SCHEDULE: DAILY
SPECIMEN: RED TEST TUBE SERUM
SCHEDULE: DAILY
SCHEDULE: TUESDAY & THURSDAY (OVERNIGHT ) (AM)
SCHEDULE: TUESDAY & THURSDAY ( OVERNIGHT ) (AM)
SPECIMEN: BLUE TOP (SODIUM CITRATE) TUBE (4ML)
SPECIMEN: 2 ML PLASMA LIGHT BLUE-TOP TUBE
SCHEDULE: DAILY
41
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
6230
FACTOR VII ACTIVITY
85230
154
FACTOR VII ANTIGEN
85230
6335
FACTOR VIII INHIBITOR
85335
6240
FACTOR VIII ACTIVITY
85240
6244
FACTOR VIII AG
85244
6260
FACTOR X
85260
6270
FACTOR XI
85270
6280
FACTOR XII
85280
6290
FACTOR XIII
85290
93025 FANA BY IFA WITH TITER
86256
7254
FANA: FLUORESCENT ANTINUCLEAR ANTIBODY
86255
72
FARINAE MITE D2
86003
3705
FAT/LIPIDS FECES QUAL
82705
3710
FAT/LIPIDS FECES QUAN 72
HRS
82710
3725
FATTY ACIDS FREE
82725
SCHEDULE: TUESDAY & THURSDAY (AM )
SPECIMEN: 2 g STOOL
SCHEDULE: DAILY
SPECIMEN: 2 g STOOL
SCHEDULE: DAILY
42
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
3947
FBS GLUCOSE FASTING
82947
1301
FELBAMATE SERUM
82491
3728
FERRITIN
82728
6362
FIBRIN DEGRADATION
85362
6384
FIBRINOGEN
85384
1302
FLECAINIDE
82491
10050 FLUID CELL COUNT
89050
3735
FLUORIDE
82735
3740
FLUORIDE: URINE
82735
1303
FLUOXETINE (PROZAC)
82491
3747
FOLATE ACID RBC
82747
3746
FOLIC ACID SERUM
82746
89
FOOD ALLERGEN MENU
86003
X5
9248
FRAGILE X DNA ANALYSIS
MULTI
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 2 ML SYNOVIAL FLUID LAVENDER-TOP (EDTA) TUBE.
SCHEDULE: DAILY
SPECIMEN: 2 WHOLE BLOOD LAVENDER-TOP ( EDTA )
SHIP TEMPERATURE: TRANSFER 1 TUBE INTO PLASTIC TRANSPORT
TUBE AND FREEZE .REFRIGERATE SECOND WHOLE BLOOD TUBE.
SCHEDULE: 1 WEEK, SEND OUT. CPT 82747 / 85014
SCHEDULE: DAILY
SCHEDULE: 3-5 DAYS
PANEL INCLUDES:CORN, EGG, MILK, MANGO, WHEAT
CPT 83912 / 83891 / 83894 / 83898
43
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
3756
FREE THYROXINE INDEX (T-7)
3985
FRUCTOSAMINE
82985
3757
FRUCTOSE SEMEN
82757
4001
FSH
83001
323
FTA (CSF)
86780
7780
FTA TREPONEMA PALLIDUM
ABS
86780
8104
FUNGUS STAIN
87206
75
FUSARIUM MONILIFORME M9
86003
3955
G6PD
82955
3760
GALACTOSE
84378
3784
GAMMAGLOBULIN IGA IGG
IGM EACH
82784
3785
GAMMAGLOBULIN IGE
82785
3781
GAMMAGLOBULIN: A (IgA)
82784
3782
GAMMAGLOBULIN: D (IgD)
82784
3783
GAMMAGLOBULIN: G (IgG)
82784
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 2 ML SEMEN
SCHEDULE: DAILY
SPECIMEN: 1 ML CSF
SPECIMEN: BIOPSY, BODY FLUID, ASPIRATES, SKIN, NAILS, HAIR,
SINUS, SPUTUM, BRONCHOALVEOLAR LAVAGE, SPUTUM, STOOL,
SWAB OF CONJUNCTIVA, THROAT, TISSUE, URINE OR VAGINAL.
SPECIMEN: 3 ML PLASMA HEPARIN TUBE.
SCHEDULE: DAILY.
CPT 82784X3
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: 3 DAYS
SCHEDULE: DAILY
44
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
3786
GAMMAGLOBULIN: M (IgM)
82784
258
GANGLIOSIDE AB GM1 (IGG &
IGM)
83516
3802
GANGLIOSIDE ANTIBOY GM1
(IGG & IGM)
83520
3941
GASTRIN
82941
8591
GC URINE
87591
8907
GENOSURE PLUS VIRTUAL
PHENOTYPE
MULTI
8911
GENOSURE TM MG
MULTI
1170
GENTAMICIN
80170
159
(GFR )
GLOMERURAL FILTRATION
RATE
82565
3977
GGT (GAMMA
GLUTAMYLTRANSFERASE)
82977
7674
GIARDIA AB PANEL
86674
8329
GIARDIA LAMBLIA AG STOOL
87329
4517
GLIADIN AB IGA
83518
161
GLIADIN AB IGG
83516
SCHEDULE: DAILY
SCHEDULE: 12 - 15 DAYS, SEND OUT. CPT 83520 X 2
SCHEDULE: MONDAY / WEDNESDAY / FRIDAY (AM)
SPECIMEN: 5 ML PLASMA EDTA
SCHEDULE: 3 - 4 WEEKS.
CPT 87903, CPT87904 X 11
SPECIMEN: 5 ML PLASMA EDTA
SCHEDULE: 3 - 4 WEEKS. CPT 87903 / 87904 X 11
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 2ML SERUM
SCHEDULE: 1WEEK, SEND OUT.
PANEL INCLUDE: IGG/IGM / IGA
CPT 86674 X 3
45
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
357
GLOBULIN
3945
GLUCUSE BODY FLUID
OTHER/THAN BLD
82945
3950
GLUCUSE POST GLUC DOSE
82950
3951
GLUCUSE TOLERANCE TEST
GTT 3
82951
3943
GLUCAGON PLASMA
82943
306
GLUCOSE 2HR
82950
350
GLUCOSE 1 1/2
82950
5905
GLUCOSE 1 HRPPBS
82950
31
GLUCOSE 1/2 HOUR
82950
305
GLUCOSE 1HR
82950
5906
GLUCOSE 2 HRPPBS
82950
307
GLUCOSE 3HR
82950
304
GLUCOSE 4 HR
82950
SCHEDULE: DAILY
SPECIMEN: PERICARDIAL, PERITONEAL, PLEURAL OR SYNOVIAL.
2 ML FRESH BODY FLUID
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 2 ML FASTING SERUM + THREE ADDITIONAL SAMPLES 12-3 HOUR INTERVALS AFTER GLUCOLA. URINE SAMPLES
REQUEST WITH EACH BLOOD COLLECTION.
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 1 ML SERUM OR PLASMA GRAY TOP TUBE
SCHEDULE: DAILY
NOTE: DRAW SAMPLE AFTER 1HR of 50gm GLUCOLA
ADMINISTRATION
ADMINISTER GLUCOLA DRAWN SAMPLE AFTER 1/2 HRS
SCHEDULE: DAILY
ADMINISTER 50 gm GLUCOLA DRAWN SAMPLE AFTER 1 HR
SCHEDULE: DAILY
SPECIMEN: 1ML SERUM OR PLASMA GREY TOP TUBE
SCHEDULE: DAILY
SCHEDULE: DAILY
NOTE: DRAWN SANPLE AFTER 3 HRS BREAKFAST.
SPECIMEN: 1ML SERUM
SCHEDULE: DAILY
46
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
338
GLUCOSE TOLERANCE 3 HRS
(CON 2HR 1/2)
82951
5900
GLUCOSE TOLERANCE
TEST/GTT: 2 HOURS
82951
5901
GLUCOSE TOLERANCE
TEST/GTT: 3 HOURS
82951
5902
GLUCOSE TOLERANCE
TEST/GTT: 4 HOURS
82951
5903
GLUCOSE TOLERANCE
TEST/GTT: 5 HOURS
82951
5904
GLUCOSE TOLERANCE
TEST/GTT: 6 HOURS
82951
3970
GLUCOSE URINE
82945
170
GLUTAMIC ACID
83519
3978
GLUTATHIONE
82978
13
GLYCOSAMINOGLICANS
83866
SPECIMEN: 1ML SERUM
SCHEDULE: DAILY
SPECIMEN: 2 ML FASTING SERUM AND TWO ADDITIONAL SAMPLES
A 1-2 HOUR INTERVALS AFTER GLUCOLA. URINE SAMPLE
REQUEST WITH EACH BLOOD COLLECTION.
SCHEDULE: DAILY
AT 1-2-3 HOUR INTERVALS AFTER GLUCOLA. URINE
SAMPLE REQUEST WITH EACH BLOOD COLLECTION.
SCHEDULE: DAILY
CPT: 82951 / 82952
AT 1-2-3-4 HOUR INTERVALS AFTER GLUCOLA. URINE
SAMPLE REQUESTES WITH EACH BLOOD COLLECTION.
SCHEDULE: DAILY
CPT 82951 / 82952 X 2
AT 1-2-3-4-5 HOUR INTERVALS AFTER GLUCOLA. URINE
SCHEDULE: DAILY
CPT 82951 / 82952 X 3
AT 1-2-3-4-5-6 HOUR INTERVALS AFTER GLUCOLA.
URINE SAMPLE REQUESTES WITH EACH BLOOD
COLLECTION.
SCHEDULE: DAILY
CPT 82951 / 82952 X4
SCHEDULE: DAILY
SPECIMEN: YELLOW TUBW WHOLW BLOOD
SPECIMEN: URINE CONTAINER NON STERIL
47
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
91
GRASSES ALLERGEN MENU
86003
336
GTT 1 HR (1/2 HR INTERVALS)
308
GTT 2 HRS 1/2 HR INTERVALS
82951
123
GTT 3HRS CON 1/2 HR
82951
312
GTT 4HR 1/2 HR INTERVALS
82951
124
GTT 5HRS CON 1/2 HR
82951
7684
HAEMOPHILUS INFLUENZA B
ANTIGEN
86684
1173
HALOPERIDOL (HALDOL)
80173
1304
HALOPERIDOL,QUANTITATIVE
80173
4010
HAPTOGLOBIN QUANTITATIVE 83010
PANEL INCLUDES: ACACIA, CORN
AT ½, 1, HOUR INTERVALS AFTER GLUCOLA. URINE
SCHEDULE: DAILY
CPT 82951 / 82952 X 2
AT ½ ,1 ,1 ½ ,2 HOUR INTERVALS AFTER GLUCOLA. URINE
SCHEDULE: DAILY
CPT 82951 / 82952 X 2
AT ½, 1 ,1 ½ ,2 ,2 ½, 3 HOUR INTERVALS AFTER GLUCOLA.
URINE SAMPLE REQUESTES WITH EACH BLOOD COLLECTION.
SCHEDULE: DAILY
CPT 82951 / 82952 X 2
AT ½, 1 ,1 ½ ,2 ,2 ½, 3 , 3 ½, 4 HOUR INTERVALS AFTER
GLUCOLA. URINE SAMPLE REQUESTES WITH EACH BLOOD
COLLECTION.
SCHEDULE: DAILY
CPT 82951 / 82952 X 2
AT 1-2-3-4-5 HOUR INTERVALS AFTER GLUCOLA. URINE
SCHEDULE: DAILY
CPT 82951 / 82952 X 3
SPECIMEN: 4 ML SERUM DO NOT USE A GEL-BARRIER TUBE
SCHEDULE: MONDAY/ WEDNESDAY / FRIDAY (AM)
48
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5703
HCG QUALI / GONAD CHORNC
QUAL
84703
5702
HCG QUANT / GONAD
CHORNC QUAN
84702
162
HCG TUMOR MARKER
84702
4718
HDL ULTRA
83718
3269
HEAVY METAL BLOOD
PROFILE I
MULTI
2018
HEAVY METALPROFILE II
BLOOD
MULTI
2015
HEAVY METALS PROFILE I UR
24 HR/RANDOM
MULTI
4015
HEAVY METALS PROFILE II UR
24/RANDOM
MULTI
7678
HELICOBACTER PILORI PANEL
IGG IGA IGM
86777
7679
HELICOBACTER PYLORI - IgA
86677
7680
HELICOBACTER PYLORI - IgM
86677
86677
7677
HELICOBACTER PYLORI AB IGG
8338
HELICOBACTER PYLORI STOOL
AG
87338
6014
HEMATOCRIT
85014
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 7 ML WHOLE BLOOD ROYAL BLUE-TOP (EDTA)
CPT 82175,83655,83825
SPECIMEN: 7 ML WHOLE BLOOD ROYAL BLUE-TOP(EDTA) TUBE
CPT 82175 / 83655 / 83825/ 82300, Arsenic / Cadmium / Lead /
Mercury
SPECIMEN: 30 ML 24 HOUR URINE COLLECTION NO PRESERVATIVES.
CPT 82175 / 82570 / 83655 / 83825 LEAD URINE / ARSENIC URINE /
MERCURY URINE
SCHEDULE: 1 WEEK.
SCHEDULE: TUESDAY AM
SCHEDULE: TUESDAY AM
SCHEDULE: DAILY
SCHEDULE: MONDAY / WEDNESDAY / FRIDAY
SPECIMEN: WHOLE BLOOD LAVENDER-TOP (EDTA)
SCHEDULE: DAILY
49
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
6018
HEMOGLOBIN
85018
4021
HEMOGLOBIN A2
83021
4020
HEMOGLOBIN
ELECTROPHORESIS
83020
114
HEMOGLOBLINA/HEMACRITO
MULTI
4070
HEMOSIDERIN RANDOM
83070
7705
HEP B CORE IGM
86705
318
HEPARIN INDUCED PLATELET
AB
1076
HEPATIC FUNCTION PROFILE
(LIVER PROFILE)
80076
8350
HEPATITIS BE AG
87350
7709
HEPATITIS A IGM
86709
1063
HEPATITIS A PROFILE
86708
7708
HEPATITIS A TOTAL IGG AB
86708
1074
HEPATITIS ACUTE PANEL ABC
7704
HEPATITIS B CORE TOTAL AB
80074
86704
SPECIMEN: WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE
SCHEDULE: DAILY
SPECIMEN: 1 WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE.
SCHEDULE: TUESDAY & THURSDAY. CPT 83020 / 85029
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: 4 DAYS, SEND OUT
SCHEDULE: DAILY
SCHEDULE: DAILY
NOTE: HEPATITIS A Ab TOTAL, HEPATITIS A Ab IgM
SCHEDULE: DAILY
SCHEDULE: DAILY
PANEL INCLUDE: HEPATITIS A IgM, HEPATITIS B Ag, HBCORE IgM,
HEPATITIS C Ab
SCHEDULE: DAILY
50
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
8516
HEPATITIS B PCR QUANTI
87517
1064
HEPATITIS B PROFILE
84999
348
HEPATITIS B VIRUS (HBV)
GENOTYPE
7707
HEPATITIS BE ANTIBODY
86707
250
HEPATITIS BE PANEL
MULTI
7706
HEPATITIS BS ANTIBODY
86706
8340
HEPATITIS BS ANTIGEN
87340
8518
HEPATITIS BS
QUANTIFICATION
86317
7803
HEPATITIS C AB
86803
8902
HEPATITIS C GENOTYPE
87902
8521
HEPATITIS C PCR QUALI
87521
8520
HEPATITIS C PCR QUANTI
87522
7692
HEPATITIS DELTA ANTIBODY
86692
SCHEDULE: DAILY
PANEL INCLUDE: : HEPATITIS Bs Ag, HEPATITIS Bs Ab, HEPATITIS B
CORE Ab
SCHEDULE: 3-4 WEEKS
PANEL INCLUDE: HEPATITIS Be Abs, HEPATITIS Be Ag.
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY.
SCHEDULE: DAILY
SPECIMEN: 3 ML SERUM OR PLASMA (EDTA)
SPECIMEN: 4 ML SERUM COLLECTED IN SST TUBES OR PLASMA
(EDTA)
SHIP TEMPERATURE: FROZEN OR REFRIGERATE
SCHEDULE: 1 WEEK ,TRANSPORT AT 2 - 8C OR FROZEN
SPECIMEN: 4 ML SERUM COLLECTED IN SST TUBES OR PLASMA
(EDTA)
SHIP TEMPERATURE: FROZEN OR REFRIGERATE
SCHEDULE: 1 WEEK
51
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
261
HEPATITIS BE IGM
86790
109
HEPATITIS PANEL A, B, C
MULTI
134
HEPATITIS PROFILE 7
135
HEPATITIS PROFILE 8
132
HEPATITIS PROFILE 4
133
HEPATITIS PROFILE 5
356
HEPATITIS PROFILE 9
4912
HEREDITARY
HEMOCHROMATOSIS
83912
7791
HERPES I & II IGG
86695
7695
HERPES SIMPLEX I IGG
86695
8529
HERPES SIMPLEX I & II PCR
87529
SPECIMEN: RED TUBE SERUM
SCHEDULE: DAILY
PANEL INCLUDE: HBsAb, HBsAg, HBcore Ab, HEPATITIS C, HEPATITIS
A Ab TOTAL
SCHEDULE: DAILY
PANEL INCLUDE: HEP A TOTAL Ab,HEP A IgM ,,HEP Bs Ab, HEP Bs Ag
HEP B CORE Ab IgG,HEP B CORE IgM ,HEP C
SCHEDULE: DAILY
PANEL INCLUDE: HEP A TOTAL Ab, HEP A IgM ,HEP Bs Ab, HEP Bs Ag,
HEP B CORE Ab IgG, HEP Be Ag, HEP Be Ab, HEP C
SCHEDULE: DAILY
PANEL INCLUDE: HBs Ag, HBs Ab, HEP A TOTAL Ab, HEP A IgM
SCHEDULE: DAILY
PANEL INCLUDE: HBs Ag, HBs Ab, HEP B CORE Ab,HEP A TOTAL Ab,
HEP A IgM
SCHEDULE: DAILY
PANEL INCLUDE: HEP A TOTAL Ab, HEP A IgM ,HEP Bs Ab, HEP Bs Ag,
HEP B CORE Ab IgG, HEP B CORE IgM, HEP C
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE
52
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7696
HERPES SIMPLEX II IGG
86696
7694
HERPES I & II IGM
86694
7309
HETEROPHILE ANTIBODIES
86309
4036
HGB GLYCOSYLATED - HB A1 C
83036
222
HISTAMINE 24 HR URINE
83088
4088
HISTAMINE PLASMA
83088
7251
HISTONE ANTIBODY (AHA)
ELISA
86235
7698
HISTOPLASMA AB
86698
415
HISTOPLASMA CAPSULATUM
AB TITER A/G/M
86698
8385
HISTOPLASMA URINE
ANTIGEN
87385
8390
HIV 1 P24 ANTIGEN
87390
8901
HIV GENOTYPE
87901
8536
HIV PCR QUANTITATIVE
87536
8904
HIV PHENOSENSE GT WITH
REPLICATION
87904
SCHEDULE: DAILY
SPECIMEN: 5 ML WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE.
SCHEDULE: DAILY
SPECIMEN: 15 ML 24 HRS URINE NO PRESERVATIVE.
NOTE: STATE TOTAL VOLUME OF URINE COLLECTION.
SPECIMEN: 2 ML PLASMA LAVENDER-TOP (EDTA) TUBE.
SCHEDULE: 3-5 DAYS
CPT: 86698 x 3
SPECIMEN: URINE STERIL CONTAINER
SPECIMEN: 2 ML SERUM OR PLASMA ( EDTA)
SPECIMEN: 3ML PLASMA (EDTA)
SHIP TEMPERATURE: REFRIGERATE AT 2 - 8C OR FROZEN .STABILITY
1DAY AT ROOM TEMP, 2-8C FOR UP TO 6 DAYS OR FROZEN UP TO 6
WEEKS
SCHEDULE: 3 DAYS
SCHEDULE: 3-4 WEEKS
CPT:87903,87904X11
53
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
8903
HIV PHENOTYPE
COMPREHENSIVE
87903
7700
HIV RNA BY PCR QUALI
87535
7689
HIV WESTERN BLOT
CONFIRMATORY TEST
86689
7703
HIV-1/2 AB
86701
421
HLA A29
2382
HLA AB + DR
81382
4890
HLA ABC TRANSPLANT
MULTI
7812
HLA B-27 ANTIGEN
86812
800
HLA B5701
MULTI
93026 HLA DRB DQB TRANSPLANT
83898
4090
HOMOCYSTEINE
83090
3133
HOMOCYSTEINE URINE
82615
4150
HOMOVANILLIC ACID 24 HR
83150
SPECIMEN: TWO TUBE WITH 3 ML PLASMA (EDTA)
SCHEDULE: 1 - 2 WEEKS, SEND OUT
CPT 87903 X 1, CPT 87904 X 10
SPECIMEN: EDTA PLASMA
SHIP TEMPERATURE: REFRIGERATE AT 2 - 8C OR FROZEN.
STABILITY 1DAY AT ROOM TEMP, 2-8C FOR
UP TO 6 DAYS OR FROZEN UP TO 6 WEEKS
SCHEDULE: 3DAYS
SCHEDULE: DAILY
SPECIMEN: EDTA WHOLE BLOOD
SCHEDULE: 1 -2 WEEK SEND OUT
SCHEDULE: 1 -2 WEEK SEND OUT
SPECIMEN: 5 ML WHOLE BLOOD LAVENDER-TOP (EDTA ) TUBE
CPT: 83890,83893X48,83896X158,83898,83912X3
CPT 83890,83893X3,83896X3,83898,83912
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE
SCHEDULE: DAILY
SPECIMEN: 10 ML 24HRS URINE WITH 25 ML 6N HCL.
NOTE: RECORD TOTAL 24 HRS URINE VOLUME ON THE REQUEST
FORM.
54
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
223
HOMOVANILLIC ACID
RANDOM URINE
83150
HORSE DANDER
82784
HTLV I/ HTLV II DIFF. HUMAN
T CELL
86688
HTLV-I & II AB
MULTI
7305
HUMAN EPIDIDYMIS PROTEIN
4 (HE4)
86305
7277
HUMAN GROWTH HORMONE
(HGH)
86277
389
HUMAN HERPES VIRUS 6 IGG
AB
8621
HUMAN PAPILLOMA VIRUS
HPV
87621
4500
HYDROXYPROLINE FREE AND
TOTAL 24 HRS
83500
4505
HYDROXYPROLINE PLASMA
83505
414
IA2 ANTIBODY
8337
IAAD EIA ENTAMOEBA
HISTOLYTICA GRP
87337
299
IGF BINDING PROTEIN 1
84305
4519
IGF BINDING PROTEIN IGFB3
83519
95
7688
SPECIMEN: SERUM
SCHEDULE: 3-5 DAYS
SCHEDULE: 1-2 TUESDAY & THURSDAY
CPT :86687 Y 86688
CPT 86687 & cpt86688
SCHEDULE: DAILY
SPECIMEN PREPARATION:CERVICAL SPECIMEN COLLECTED IN
PRESERVED CYT SOLUTION TRANSPORT AT
2- 30 C STABLE UP TO 6 MONTHS.
BY COBAS REALTIME PCR TECHNOLOGY
SPECIMEN: 30 ML URINE 24 HRS WITH 30 ML 6N HCL PRESERVATIVE.
SCHEDULE: 8-10 DAYS
SPECIMEN: GREEN TOP (HEPARIN) TUBE
SHIP TEMPERATURE: PLASMA FROZEN
SPECIMEN: SERUM
SCHEDULE: 8-10 DAYS
SCHEDULE: 8-10 DAYS
SCHEDULE:THUESDAY & THURSDAY
SCHEDULE: THUESDAY & THURSDAY
55
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
220
IGF BP II
83520
8906
IL28B POLYMORPHISM
GENOTYPE HIV
MULTI
1174
IMIPRAMINE
80174
225
IMMUNE COMPLEX
PROF./C1Q BINDING & RAJI
IMMUNE CPLX ASSAY C1Q
BINDING
86332
7320
IMMUNOELECTROPHORESIS
QUANT SERUM
86320
7325
IMMUNOELECTROPHORESIS
URINE
86325
7335
IMMUNOFIX/
ELECTROPHORESIS URINE
86335
394
IMMUNOGLOBULIN G
SYNTHESIS RATE
221
IMMUNOGLOBULIN
SUBCLASSES IGA
82787
3787
IMMUNOGLOBULIN
SUBCLASSES IGG
82787
263
INDIA INK
87210
153
INFLAMATORY BOWEL
DISEASE
MULTI
8276
INFLUENZA A
87276
7332
86332
82042
CPT:83891,83900,83896X4,83912
SCHEDULE: 1 WEEK, SEND OUT. CPT 86632X2
SPECIMEN: 10 ML URINE (RANDOM OR 24HR) NO PRESERVATIVE
SPECIMEN: 2 ML SERUM AND CEREBROSPINAL FLUID
CPT ;82784 X 2
CPT 82787,82784
CPT 82787 x 4,82784
SPECIMEN: 3 ML CEREBROSPINAL FLUID (CSF)
CPT: 86256 / 86671 x 2
SPECIMEN: NASOPHARYNGEAL SWAB, WASH OR ASPIRATE.
SCHEDULE: DAILY
56
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
10000 INFLUENZA A&B ANTIGEN
MULTI
7710
INFLUENZA ABS
86710
8275
INFLUENZA B
87275
7336
INHIBIN A
86336
268
INHIBIN B
83520
94
INSECTS ALLERGEN PANEL
86003
4525
INSULIN
83525
1437
INSULIN F, 1/2, , 1, 2,3
83525
INSULIN 1 1/2 HR
83525
309
INSULIN 1 /2 HOUR
83525
179
INSULIN 1 HR
83525
180
INSULIN 2 HRS
83525
4537
INSULIN 3HR
83525
4538
INSULIN 4HR
83525
4539
INSULIN 5HR
83525
4526
SCHEDULE: DAILY. CPT 86275,86276
SPECIMEN: 2 ML SERUN
SCHEDULE: DAILY
SCHEDULE: DAILY
PANEL INCLUDE: COCKROACH, AMERICAN COCKROACH
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY. CPT 83525
SCHEDULE: DAILY
SPECIMEN: SERUM
SCHEDULE: DAILY
57
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7337
INSULIN ANTIBODIES
86337
1432
INSULIN F, 1/2
80432
1439
INSULIN F, 1/2, 1, 2, 3,4 ,5
80439
1438
INSULIN F, 1/2, 1,2,3,4
80438
4527
INSULIN FREE
MULTI
1436
INSULIN TOLERANCE
F, 1/2, 1, 1 1/2, 2
80436
1435
INSULIN TOLERANCE F,1/2,1, 2 80435
1434
INSULIN TOLERANCE PANEL
FBS ,1/2,1
MULTI
337
INSULINE 2 1/2 HR
83525
7340
INTRINSIC FACTOR
ANTIBODIES
86340
4540
IRON
83540
4004
IRON & TOTAL IRON BINDING
MULTI
4550
IRON BINDING CAPACITY
83550
7341
ISLET CELL ANTIBODY ANTI
PANCREATIC
86341
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: 1 WEEK, SEND OUT. CPT 83527,83525
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY CPT 83525X6
SCHEDULE: DAILY
SCHEDULE: 1 WEEK
SCHEDULE: DAILY
SCHEDULE: DAILY
INCLUDES: IRON & TIBC. CPT 83550 / 83540
SCHEDULE: DAILY
SCHEDULE: WEDNESDAY (OVER NIGHT)
58
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
173
JAK 2 MUTATION
81270
351
JAPANESE ENCEPHALITIS
297
JC VIRUS RNA PCR BLOOD
87798
296
JC VIRUS RNA PCR URINE
87798
215
KAPPA & LAMBDA LIGHT
CHAIN SERUM
83883
313
KAPPA & LAMDA LIGHT
CHAIN URINE
83883
175
KAPPA LIGHT CHAIN
83883
188
KEPPRA (LEVETIRACETAM)
82542
8210
KOH PREP
87210
4605
LACTATE
83605
LACTATE DEHYD
83615
4630
LACTOFERRIN FECAL QUAL
83630
4234
LACTOSE TOLERANCE TEST
82951
86790
4615
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE OR
BONE MARROW.
SCHEDULE: 1-2 WEEK, SEND OUT
SAMPLE COLLECTION: MONDAY AND Y TUESDAY ONLY.
CPT:83891,83900,83914,83894,83912
SCHEDULE: 1 WEEK
SPECIMEN: 2 TUBE WHOLE BLOOD LAVENDER-TOP (EDTA) OR
CEREBROSPINAL FLUID (CSF)
SCHEDULE: 2 – 3 WEEK, SEND OUT
CPT 83883X2
SPECIMEN: 3 ML URINE 24 HRS OR RANDOM
SCHEDULE: TUESDAY & THURSDAY ( AM ) CPT 83883X2
SCHEDULE: TUESDAY & THURSDAY (AM). CPT 83883
SPECIMEN: SKIN, HAIR, NAILS AND SPUTUM.
SCHEDULE: DAILY
SPECIMEN: 1 ML PLASMA GRAY-TOP TUBE
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: PLASMA GRAY-TOP TUBE
NOTE: DRAW FASTING SAMPLE PRIOR TO 100 g LACTOSE
ADMINISTRATION THEN COLLECT BLOOD 15, 30, 60, 90, 120
MINUTES FOLLOWING ADMINISTRATION.
SCHEDULE: DAILY.
CPT 82951, 82952X3
59
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5911
LACTOSE TOLERANCE TEST:
3 HOURS
82951
5912
4 HOURS
82951
5913
5 HOURS
82951
176
LAMBDA LIGHT CHAIN
83883
LAMB'S QUARTER W10
86003
226
LAMICTAL (LAMOTRIGINE)
82491
325
LDH (CSF)
83615
266
LDH BODY FLUID
83615
4625
LDH ISOENZYMES
83625
4721
LDL
83721
275
LDL CHOLESTEROL DIRECT
83721
6544
LE (LUPUS ERYTHEMATOSUS)
CELL PREP
85540
4655
LEAD BLOOD (ADULT)
83655
76
SCHEDULE: DAILY
NOTE: LACTOSE LOAD ADULTS: 100 g in 300 ml WATER.
CPT 82951,82952X3
SCHEDULE: DAILY
NOTE: LACTOSE LOAD ADULTS 100 g in 300 ml WATER.
CPT: 82951,82952 X 4
SCHEDULE: DAILY
NOTE: LACTOSE LOAD ADULTS: 100g in 300 ml WATER.
CPT: 82951,82952 X 4
SPECIMEN: 2 ML CEREBROSPINAL FLUID (CSF)
SPECIMEN: 1 ML BODY FLUID
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 1 TUBE WHOLE BLOOD SODIUM HEPARIN GREEN TOP
SCHEDULE: DAILY
CPT 85009
SPECIMEN: 7 WHOLE BLOOD LAVENDER-TOP (EDTA)
SCHEDULE: DAILY
60
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
4654
LEAD BLOOD (PEDIATRIC)
83655
4660
LEAD: 24 HR / RANDOM
URINE
MULTI
7713
LEGIONELLA AB
86713
8278
LEGIONELLA URINE AG
8351
LEPTIN SERUM
83520
7720
LEPTOSPIRA AB IGG ELISA
86720
392
LEUKEMIA / LMYPHOMA
SPINAL FLUID
6541
LEUKOCYTES (WBC): SEMEN
6540
LEUKOCYTES ALK PHOS
(LAP SCORE)
85540
4002
LH
83002
87278
87205
1176
80176
LIDOCAINE
83690
4690
LIPASE
368
LIPASE BODY FLUID
83690
412
LIPASE 24 HRS URINE
330
LIPASE URINE
83690
SPECIMEN: 1 WHOLE BLOOD LAVENDER-TOP (EDTA)
SCHEDULE: DAILY
SPECIMEN: 10 ML RANDOM OR 24 HRS URINE, NO PRESERVATIVE.
SCHEDULE: 1 WEEK, SEND OUT. CPT 83655/82570
SPECIMEN: 30 ML URINE RANDOM
RESULT: 12-15 DAYS
SCHEDULE: 1 WEEK IN HOUSE
SPECIMEN: CEROSPINAL FLUID
SCHEDULE: 1 -2 WEEKS SEND OUT
SPECIMEN: EJACULATE SAMPLE
SCHEDULE: DAILY
SPECIMEN: 5 ML WHOLE BLOOD SODIUM HEPARIN GREEN TOP
TUBE.
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: BODY FLUID
SCHEDULE: DAILY
SPECIMEN: 30 ML 24 HRS URINE COLLECTION , NO PRESERVATIVE
TAT: DAILY
SCHEDULE: DAILY
61
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
1061
LIPID PANEL
80061
4695
LIPOPROTEIN A
83695
1178
LITHIUM
80178
7375
LIVER KIDNEY MICROSOMAL
ANTIBODY
86376
192
LORAZEPAM (ATIVAN)
80124
6613
LUPUS ANTICOAGULANT
85613
1071
LUPUS ANTICOAGULANT
COMPREHENSIVE
85613
360
LUPUS PANEL 14
7618
LYME DISEASE IGG IGM
BORRELIA ABS
86618
252
LYMPHOCYTE SUBSET PANEL I
MULTI
MULTI
253
LYMPHOCYTE SUBSET PANEL
II
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: SODIUM CITRATE TUBE
SPECIMEN: SERUM
SCHEDULE: 1 WEEK
PANEL INCLUDE: ANA, DsDNA, ANTI SM/RNP, ANTI SL-70, ANTI
S-jo, RF IgM, ANTI SSA,SSB, C3,C4, MICROSOMAL AB, SMOOTH
MUSCLE AB, MITOCHONDRIAL AB, PARIETAL CELL AB,
TYROGLOBULIN AB.
SCHEDULE: MONDAY (AM)
SPECIMEN: 5 ML LAVENDER TOP EDTA TUBE.
SHIP TEMPERATURE:
NOTE: DUE TO SHORT STABILITY SPECIMEN CALL LAB 24 HR PRIOR
FOR PICKUP SERVICE. SPECIMEN SHOULD BE RECEIVED MONDAY
THRU THURSDAY. IF A CBC IS ALSO REQUIRED A SEPARATE
LAVENDER TOP EDTA TUBE MUST BE SUMBITTED.
INCLUDES: CD3 / CD4 / / CD8 / CD16 / CD56 / CD19
CPT 86360 / 86359 / 86379 / 86064
SPECIMEN: 5 ML LAVENDER TOP EDTA TUBE.
SHIP TEMPERATURE:
NOTE: DUE TO SHORT STABILITY SPECIMEN CALL LAB 24 HR PRIOR
FOR PICKUP SERVICE. SPECIMEN SHOULD BE RECEIVED MONDAY
THRU THURSDAY. IF A CBC IS ALSO REQUIRED A SEPARATE
LAVENDER TOP EDTA TUBE MUST BE SUMBITTED.
INCLUDES: CD3 / CD4 / / CD8 / CD16 / CD56 / CD19
CPT 86360 / 86359 / 86379 / 86064
62
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
396
LYSOZYME SPOT URINE
85549
321
MACRODANTIN LEVEL
(NITROURANTOIN)
82491
293
MACROPROLACTIN
84146
8169
MACROSCOPIC XM PARASIT
87169
4735
MAGNESIUM
83735
MAGNESIUM SPOT URINE
83735
185
MAGNESIUM URINE 24 HRS
83735
7750
MALARIA AB
86750
243
MANGANESE 24HR URINE
83785
4785
MANGANESE BLOOD PLASMA
83785
77
MANGO F91
184
86003
86765
7765
MEASLES (RUBEOLA) IGG
4825
MERCURY BLOOD
83825
4830
MERCURY: URINE
QUANTITATIVE
83825
SPECIMEN: URINE CONTAINER STERIL
CPT 84146 x 2
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 5 ML URINE ( 24 HRS )
SCHEDULE: DAILY
NOTE: REQUEST 24 HRS URINE COLLECTION VOLUME
SPECIMEN: 20 ML URINE ( 24 HRS ) NO PRESERVATIVE
SPECIMEN: ROYAL BLUE EDTA WHOLW BLOOD
SCHEDULE: MONDAY & THURSDAY (AM )
SPECIMEN: 7 ML WHOLE BLOOD EDTA (ROYAL BLUE TOP)
SPECIMEN: 30 ML URINE (24 HRS ) OR RANDOM URINE
(PATIENT SHOULD REFRAIN FROM EATING FISH, SUCH AS
SWORDFISH, TUNA, AND SHARK AT LEAST 3 DAYS PRIOR TO
SPECIMEN COLLECTION).
CPT 83825,82570
63
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
4835
METANEPHRINES 24 HR
FRACC
83835
227
METANEPHRINES PLASMA
83835
295
METANEPHRINES RANDOM
URINE
83835
4840
METHADONE
83840
303
METHAMPHETAMINE URINE
80101
4051
METHEMOGLOBIN
83051
4921
METHLY MALONIC ACID
RAMDOM URINE
83921
242
METHYL MALONIC ACID
SERUM
83921
7005
MIA TEST ALLERGY
86005
3044
MICROALBUMIN 24 HRS
82043
3043
MICROALBUMIN RANDOM
82043
7376
MICROSOMAL ANTIBODY
86376
281
MICROSPORIDIUM STOOL
87015
SPECIMEN: 10 ML URINE 24 HR(CONTAINER: PLASTIC WITH 25 ML
6N HCL)
NOTE: RECORD VOLUME ON THE REQUEST FORM
SPECIMEN: 2 ML PLASMA LAVENDER-TOP ( EDTA )
SCHEDULE: DAILY CPT 80101
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY IS REQUIRED
SPECIMEN: 6 ML WHOLE BLOOD HEPARIN
SPECIMEN: 5 ML RANDOM URINE NO PRESERVATIVE
SPECIMEN: PLASMA GREEN TUBE
SPECIMEN: SERUM
SCHEDULE: 1-2 WEEK, SEND OUT
SPECIMEN: 5 ML 24 HRS URINE NO PRESERVATIVE
SCHEDULE: DAILY
NOTE: RECORD TOTAL 24 HRS URINE VOLUME ON THE REQUEST
FORM.
SCHEDULE: DAILY
SCHEDULE: DAILY
CONTAINER: 6% - 10% FORMALINA PARAPACK (ROSE)
CPT: 87015 / 87207
64
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
78
MILK (COW) F2
86003
93
MITES ALLERGEN PANEL
86003
92
MOLDS ALLERGEN PANEL
86003
7308
MONO TEST
86308
98
MOUSE EPITHELIUM
82139
8081
MRSA CULTURE
87081
8641
MRSA SCREEN PCR
87641
4891
MTHR MUTATION
81291
4872
MUCIN CLOT SYNOVIAL FLUID
ROPES TEST
83872
4865
MUCOPOLYSACCARIDES,
ACID: URINE/QUANTI.
83864
79
MUCOR RACEMOSUS M4
86003
PANEL INCLUDES:ACACIA, ALTERNARIA FUMIGATUS, BERMUDA
GRASS, CT/HAIR DANDER EPITHELIUM, CLADOSPORIUM HERBARUM,
COCKROACH, CORN
PANEL INCLUDES:ALTERNARIA TENUIS, ASPERGILLUS FUMIGATUS,
CLADOSPORIUM HERBARUM, FUSARIUM MOLINIFORME, MUCOR
RACEMOUS, PENICILLUM NONATUM, PHOMA BETAE
SCHEDULE: DAILY
SPECIMEN: 4 ML PLASMA HEPARIN GREEN TOP TUBE
SCHEDULE: 1 TO 2 WEEK, SEND OUT
SPECIMEN: SWAB CULTURETTE NASAL NOSTRILS
SCHEDULE: 3 DAYS
SPECIMEN: SWAB CULTURETTE NASAL NOSTRILS
SHIP TEMPERATURE: ROOM TEMPERATURE 24 HRS; OVER 24 HRS
2-8°C
SCHEDULE: 24 HRS
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER-TOP ( EDTA ) TUBE
SCHEDULE: 1 -2 WEEK, SEND OUT
CPT 83891 / 83892 X 2 / 83894 / 83898 X 2 / 83912
SPECIMEN: 2 ML SYNOVIAL FLUID CONTAINER: GREEN-TOP
(HEPARIN) OR LAVENDER-TOP (EDTA)
NOTE: PREFERABLY FIRST MORNING VOID. FREEZE INMEDIATELY
65
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
MULTI
229
MULTIPLE SCLEROSIS
7735
MUMPS AB
86735
195
MUMPS ANTIBODY IGM
86735
6549
MURAMIDASE
85549
196
MUSK ANTIBODY
7249
MYASTHENIA GRAVIS
EVALUATION PROFILE
MULTI
1065
MYASTHENIA GRAVIS PANEL
MULTI
316
MYCOPHENOLIC ACID
(CELLCEPT)
82542
8582
MYCOPLASMA AB IGG
87582
7738
MYCOPLASMA AB
PNEUMONAIE IGM
86738
899
MYELIN ASSOCIATED
GYCOPROTEIN (MAG)
4876
MYELOPEROXIDASE AB
83876
4875
MYOGLOBIN RANDOM URINE
83874
SPECIMEN AND SHIP TEMPERATURE:
2 TUBES WITH 2 ML SERUM – REFRIGERATED
1 TUBE WITH 1 ML CSF – REFRIGERATED
1 TUBE WITH 1 ML CSF – FROZEN
NOTE: COLLECT SERUM AND CSF AT THE SAME TIME.
CPT 82040 / 82042 / 82784 x 2 / 83916
(INCLUDES: ACETYLCHOLINE RECEPTOR Ab ANTIMUSCLE Ab)
CPT: 83519X3 / 86255
INCLUDES: ACETHYLCHOLINE BINDING & ANTI SMOOTH MUSCLE
CPT: 83519X3,86255
SPECIMEN: 2ML SERUM
SCHEDULE: 1 WEEK-SEND OUT
SCHEDULE: WEDNESDAY (AM) (P–ANCA CPT 83876)
66
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
4874
MYOGLOBIN SERUM
83874
328
MYOTONIC DISTROPHY DNA
1188
MYSOLINE/ PRIMIDONE
9255
NEUROMIELITIS IGG
1299
NEURONTIN
82491
8021
NEUTROPHIL AB BY FLOW
CYTOMETRY
86021
7021
NEUTROPHIL FLOW
CYTOMETRY GRANULOCYTES
86021
4885
NICKEL BLOOD
83885
4887
NICOTINE
83887
380
NICOTINE QUANTI SERUM
7315
NMP22 BLADDER TUMOR
MARKER ELISA QTY
86294
228
NMR LIPID PROFILE
80061
1182
NORTRIPTYLINE
80182
230
N-TELOPEPTIDE RANDOM
URINE
82523
80188
SCHEDULE: 25-30 DAYS
NOTE: SEND MONDAY TO WENDSDAY
CPT: 80188 / 80184
SCHEDULE: 3 DAYS (CPT 80188 / 80184)
SPECIMEN: 2 ML SERUM OR PLASMA (EDTA)
SPECIMEN: RED TOP TUBE WITHOUT SEPARATOR
SCHEDULE: 8-10 DAYS, SEND OUT , SEND OUT
SPECIMEN: 2 ML PLASMA ROYAL BLUE-TOP ( EDTA ) TUBE
SCHEDULE: DAILY
SCHEDULE: 1 WEEK
SPECIMEN: 10 ML URINE.
CONTAINER: NMP22 URINE COLLECTION KIT
SPECIMEN: 3 ML SERUM NO GEL-BARRIER TUBE
NOTE: 12 - 14 HRS FASTING IS REQUIRED.
CPT: 80061 / 83704
SYNONYMS: AVENTYL / PAMELOR
SPECIMEN: 10 ML RANDOM URINE OF THE MORNING
CPT: 82570 / 82523
67
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
331
NTX 24HRS
82523
231
NTX SERUM
82523
376
OAK (RED)
1055
OB PANEL
80055
4916
OLIGOCLONAL IMMUNE
83916
5376
OLIGOSACCHARIDES RANDOM 84376
URINE
4925
OPIATE(S) DRUG AND
METABOLITES EACH PROC
4919
ORGANIC ACIDS QUAL EA
SPEC
80101
83919
4918
ORGANIC ACIDS TOTAL QUAN
EA SPEC
83918
383
OROTIC ACID URINE
4930
OSMOLALITY BLOOD
83930
4935
OSMOLALITY URINE SPOT OR
24 HRS
83935
6555
OSMOTIC FRAGILITY
85555
4937
OSTEOCALCIN
83937
8177
OVA&PARASITS DIR SMRS
CONCENTRATION&ID
87177
SPECIMEN: 20 ML URINE ( 24 HRS ) NO PRESERVATIVE
SPECIMEN: 3 ML SERUM + 2 ML WHOLE BLOOD EDTA
SCHEDULE: DAILY
SPECIMEN: 2 ML SERUM + 2 ML CSF
NOTE: COLLECTED AT THE SAME TIME
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 10 ML 24 HRS OR RANDOM URINE
SCHEDULE: DAILY
SPECIMEN: 1 WHOLE BLOOD GREEN-TOP ( HEPARIN ) TUBE &
WHOLE BLOOD (EDTA) TUBE
SCHEDULE: DAILY
SCHEDULE: DAILY
68
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
7265
OVARY ANTIBODIES
4945
OXALATE 24 HR
83945
319
OXALATE URINE RANDOM
83945
80
PALM, QUEEN T72
86003
201
PAPPA
62
PARANEOPLASTIC SYNDROME
MULTI
4965
PARATHYROID PANEL
MULTI
7747
PARVOVIRUS IGG IGM
86747
379
PCA3
81
PENICILLIUM NOTATUM M1
4948
PERCOCET OXYCODONE
(PERCODAN)
6008
PERIPHERAL SMEAR, MNL
DIFFIAL W
86003
85008
SPECIMEN: 2ML SERUM
SHIP TEMPERATURE:REFRIGUERATE
SPECIMEN: 10 ML URINE WITH 25 ML OF 6N HCL 24 HRS
COLLECTION.
NOTE: MEASURE AND RECORD TOTAL URINE VOLUME.
SCHEDULE: 2-3 WEEKS
CPT: 82397 Y 84163
CPT 8359 X 5, 86256,83520
INCLUDES: PTH INTACT, CREATININE, CALCIUM, PHOSPHORUS
CPT: 83970, 82565, 84100, 82310
CPT 86747 X 2
SPECIMEN: SPECIAL KIT APTIMA
SCHEDULE: 2-3 WEEKS
CPT: 83891X2, 83896X2, 86898X2, 83902X2, 83912X1, 83913X1
SCHEDULE: DAILY
69
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
335
PEROXISOMAL PANEL
187
PH 24 HOURS URINE
83986
4986
PH BODY FLUID NOS
83986
182
PH STOOL
83986
4992
PHENCYCLIDINE
80101
1184
PHENOBARBITAL
80184
8905
PHENOSENSE ENTRY (TM)
87905
8909
PHENOSENSE INTEGRASE TM
HIV
MULTI
1186
PHENYTOIN FREE
80186
85
PHOMA BETAE M13
86003
5066
PHOSPHATASE ACID
PROSTATIC
84066
5060
PHOSPHATASE ACID TOTAL
84060
5075
PHOSPHATASE ALKALINE
84075
278
PHOSPHATIDYLSERINE IGG /
IGA / IGM
86148
SPECIMEN: 5ML SERUM
SCHEDULE: DO NOT USE SERUM SEPARATOR TUBES
DO NOT INGEST ALCOHOL 24HRS BEFORE SAMPLE
SYNONIM: VERY LONG CHAIN FATTY ACID
SCHEDULE: DAILY
SPECIMEN: URINE, STOOL OR ANY BODY FLUID
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
NOTE: CHAIN OF CUSTODY DOCUMENTATION REQUIRED.
SCHEDULE: DAILY
SCHEDULE: 4-6 WEEKS; SEND OUT
CPT87903 87904X10
SCHEDULE: 4-6 WEEKS; SEND OUT
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
70
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5105
PHOSPHORUS 24 HR URINE
84105
5100
PHOSPHORUS SERUM
84100
189
PHOSPHORUS SPOT URINE
84105
83
PIGWEED, ROUGH W14
86003
82
PINE, AUSTRALIAN T73
86003
84
PLANTAIN, ENGLISH W9
86003
6415
PLASMINOGEN ACTIVATOR
85415
6421
PLASMINOGEN ACTIVITY
85421
6049
PLATELETS
85049
7022
PLATELETS AB SERUM
86022
6249
PNEUMOCOCCAL ABS
324
PNEUMOCYSTIC CARINI AG
DETECTION
3441
POLYCHLORINATEDBIPHENYLS
(PCB) AROCLORS
82441
5110
PORPHOBILINOGEN URINE
QUAN 24 HR
84110
SPECIMEN: 10 ML 24 HRS URINE COLLECTION
CONTAINER: PLASTIC CONTAINER REQUEST URINE VOLUME.
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 2 ML PLASMA BLUE-TOP ( SODIUM CITRATE) TUBE
SPECIMEN: 2 ML PLASMA BLUE-TOP (SODIUM CITRATE) TUBE.
SCHEDULE: DAILY
NOTE: SUBMIT SPECIMEN MONDAY THROUGH THURSDAY (AM)
SPECIMEN: SPUTUM
TEST INCLUDES: AROCLORS 1242 & 1248
NOTE: WRAP TUBE WITH ALLUMINUM FOIL AND PROTECT FROM
LIGHT
71
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5106
PORPHOBILINOGEN URINE
RANDOM URINE
84106
5120
PORPHYRINS URINE QUAN 24
HR
84120
5119
PORPHYRINS URINE RANDOM
84120
5132
POTASSIUM SERUM
PLASMA/WHOLE BLOOD
84132
183
POTASSIUM SPOT URINE
84133
424
POTASSIUM STOOL
5133
POTASSIUM URINE
202
PRADER WILLI SYNDROME
5134
PREALBUMIN
84134
2025
PREGNANCY URINE
84703
5138
PREGNANETRIOL
84138
5140
PREGNENOLONE
84140
3309
PROCALCITONIN
84145
5144
PROGESTERONE
84144
84133
SPECIMEN: 10 ML RANDOM URINE PROTECTED FROM LIGHT.
SPECIMEN: 20 ML URINE 24 HRS URINE CONTAINER PROTECTED
FROM LIGHT. WRAP CONTAINER IN A ALUMINIUM FOIL.
CPT MULTIPLE 84120 / 84110 / 84578 / 82570
SPECIMEN: 5 ML RANDOM URINE PROTECTED FROM LIGHT.
INCLUDE : COPROPORPHYRIN & UROPORPHYRIN
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: STOOL SPECIMEN CONTAINER
SPECIMEN: 10 ML 24 HRS URINE COLLECTIONS.
SCHEDULE: DAILY
NOTE: RECORD 24 HRS URINE TOTAL VOLUME
SPECIMEN: EDTA WHOLW BLOOD
SCHEDULE: DAILY
CONTAINER: PLASTIC URINE CONTAINER
NOTE: INDICATE 24 HRS VOLUME
CPT 82570 / 84138
SCHEDULE: 1 WEEK
SPECIMEN: 2 ML SERUIM
SPECIMEN: 2 ML SERUIM
72
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5206
PROINSULIN
84206
5146
PROLACTIN
84146
801
PROLIF CELL NUCLEAR AG
AUTO ANTIBODY
86255
407
PROPOXYPHENE PPX URINE
80101
339
PROTEIN 12 HRS URINE
84156
393
PROTEIN 14 3 3 JACON
DISEASE
5156
PROTEIN 24 HR URINE
84156
6303
PROTEIN C ACTIVITY
(FUNTIONAL)
85303
6302
PROTEIN C AG
85302
5180
PROTEIN ELECTROPHORESIS
24 HR URINE
84166
2465
RANDOM URINE
84166
5165
SERUM
84165
6306
PROTEIN S ACTIVITY
(FUNCTIONAL)
85306
6305
PROTEIN S ANTIGEN
85305
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 2ML SERUM
SPECIMEN 1ML SERUM
SCHEDULE: DAILY
NOTE: RECORD 12 HRS URINE VOLUME
SPECIMEN: CEREBROSPINAL FLUID
SCHEDULE: DAILY
SPECIMEN: 2 ML PLASMA LIGHT BLUE-TOP (SODIUM CITRATE) TUBE.
SPECIMEN: 2 ML PLASMA LIGHT BLUE-TOP (SODIUM CITRATE)
CPT 85306
SPECIMEN: 2 ML PLASMA LIGHT BLUE-TOP (SODIUM CITRATE)
73
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5157
PROTEIN TOTAL BODY FLUID
84157
5155
PROTEIN TOTAL SERUM
84155
SPECIMEN: 1 ML SYNOVIAL FLUID OR OTHER FLUID.
SCHEDULE: DAILY
SCHEDULE: DAILY
74
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
193
PROTEIN URINE SPOT
82042
5195
PROTEIN: SPINAL FLUID
84157
249
PROTEINASE 3 (PR3)
86256
5202
PROTOPORPHYRIN RBC QUAN
84202
5152
PSA COMPLEX
84152
5154
PSA FREE (PSA & PSA
COMPLEX)
MULTI
5153
PSA TOTAL
84153
6610
PT
85610
6611
PT 50/50
85611
4970
PTH INTACT
83970
4968
PTH RELATED PEPTIDE
83519
6730
PTT
85730
6732
PTT 50/50
85732
381
PYRIDIUM CROSSLINK URINE
82523
SCHEDULE: DAILY
SPECIMEN: 1 ML CSF CLEAN PLASTIC TUBE
SCHEDULE: DAILY
NOTE: USUALLY THREE CLEAN STERILE TUBES ARE USED FROM
LUMBAR TRAY FOR COUNT AND CULTURE IN ADDITION TO PROTEIN
AND GLUCOSE WITH COLLECTION OF 1 ML IN EACH TUBE LABELED
#1, #2, #3 .TUBE #1 IS USED FOR PROTEIN AND GLUCOSE.
SPECIMEN: 7 ML WHOLE BLOOD LAVENDER ( EDTA) + ROYAL BLUETOP
SCHEDULE: DAILY
SCHEDULE: DAILY.
CPT: 84154,84153
SCHEDULE: DAILY
SPECIMEN: 2 ML PLASMA LIGHT BLUE-TOP TUBE.
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: GREEN TOP TUBE
SCHEDULE: DAILY
SCHEDULE: DAILY
75
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5210
PYRUVATE
84210
378
PYRUVATE KINASE
84220
1194
QUINIDINE
80194
146
RA BODY FLUID
86431
RA FACTOR IGM
86431
RABIES TITER RESPONSE
86382
86
RAGWEED, WESTERN W2
86003
7004
RAST PR PANEL
MULTI
204
REDUCING SUBSTANCES
URINE
81002
8214
REDUCING SUBSTANCES:
STOOL
84377
1069
RENAL FUNCTION PANEL
80069
5244
RENIN ACTIVITY
84244
160
7382
SPECIMEN: 1 GRAY-TOP (SODIUM FLUORIDE) TUBE WHOLE BLOOD
SCHEDULE: 1 WEEEK, SEND OUT
SPECIMEN: SERUM
SPECIMEN: 2 ML SYNOVIAL FLUID
SPECIMEN:SERUM
SHIP TEMPERATURE:FROZEN
SCHEDULE:1 MONTH,SEND OUT
SCHEDULE: 1 WEEK
INCLUDES PANEL: MANGO, D FARINAE MITE, ACACIA
ALTERNARIA TENUIS, PALM, QUEEN, ASPERGILLUS FUMIGATUS,
PHORNA BETAE, CLADOSPORIUM HERBARUM, FUSARIUM
MONILIFORME ,MUCOR RACERNOSUS, CORN, ENGLISH PLANTAIN
PENICILLIUM NOTATUM, WHOLE EGG, LAMBS QUARTER
AUSTRALIAN PINE, MILK (COW), WHEAT, BERMUDA GRASS ,
PIGWEED, ROUGH ,RAGWEED, WESTERN, CAT HAIR / DANDER
STANDARD, DOG EPITHELIA, COCKROACH, AMERICAN
CPT 86003 x 14
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY. INCLUDES: ELECTROLITOS/CA/PO4/FBS/BUN/ CRE
/ ALB
SPECIMEN: 3 ML PLASMA
76
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
6045
RETIC COUNT
85044
239
RETICULIN ANTIBODY IGA
86255
283
RETICULIN ANTIBODY IGG
7430
RHEUMATOID FACTOR
QUANTI
86430
7431
RHEUMATOID FACTOR
QUANTITATIVE (Rf IgG)
86431
342
RIBOSOMAL P AB
205
RISPERIDONE
82542
6245
RISTOCETIN CO FACTOR= VWF
ACTIVITY
85245
8425
ROTAVIRUS STOOL
87425
8280
RSV AG DETECTION
87280
RUBELLA AB IGG
86762
7764
RUBELLA, IgM
86762
7766
RUBEOLA
ANTIBODIES(MEASLES); IgM
86765
7671
SACCHAROMYCES CEREVISIAE
(IGG IGA)
86671
1196
SALICYLATE / ASPIRIN
80196
7762
SPECIMEN: 1 WHOLE BLOOD (EDTA) TUBE
SCHEDULE: DAILY
SCHEDULE: 7–10 DAYS, SEND OUT.
CPT: 86255 x 2
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: 1 - 2 WEEK, SEND OUT. CPT 83516
SHIP TERMPERATURE: REFRIGERATE
SCHEDULE: DAILY
SPECIMEN: NASOPHARYNGEAL ASPIRATES OR STERILE SWAB
NASAL
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: THURSDAY (AM)
77
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
8197
SCHISTOSOMA SP IGG
87197
7333
SCLERODERMA-70
86235
8172
SCOTH TAPE PINWORM
87172
6651
SEDIMENTATION RATE
85651
5255
SELENIUM
84255
10310 SEMEN ALYS MOTILITY&CNT X
W/HUHNER TST
89320
10320 SEMEN ANALYSIS VOLUME
COUNT MOTILITY DIF
89320
5260
SEROTONIN
84260
5270
SEX HORMONE BNDNG
GLOBULIN
84270
5450
SGOT
84450
5460
SGPT
84460
5275
SIALIC ACID (LIPID
ASSOCIATED)
84275
6660
SICKLING RBC
85660
SCHEDULE: 3-5 DAYS. CPT 86682
ENTEROBIUS VERMICULARIS OR SCOTCH TAPE TEST
SPECIMEN: COLLECT SPECIMEN AS SOON AS POSSIBLE AFTER
PATIENT ARISES AND PRIOR TO DEFECATION OR BATHING. PAT THE
PERIANAL AREA WITH STICKY SIDE OF CELLOPHANE TAPE,
ATTACH TO A GLASS SLIDE AND SHIP SLIDE IN A MAILER.
SCHEDULE: DAILY
SPECIMEN: 1 WHOLE BLOOD (EDTA) TUBE.
SCHEDULE: DAILY
SPECIMEN: SEMEN FLUID IN STERILE SPECIMEN CONTAINER
SCHEDULE: DAILY
SPECIMEN: EJACULATE SEMEN FLUID
CONTAINER: STERILE SPECIMEN CONTAINER
SCHEDULE: DAILY
NOTE: THE PATIENT ABSTAIN FROM SEXUAL ACTIVITY FOR THREE
DAYS.SEND WITHIN 1/2 HRS AFTER TAKEN. CONTACT LAB
FOR ADDITIONAL INFORMATION.
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: 1 WEEK
SCHEDULE: DAILY
78
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
1195
SIROLIMUS
80195
139
SJOGREN'S ANTIBODY SS-A
86235
140
SJOGREN'S ANTIBODY SS-B
86235
1020
SMA 20
8206
SMEAR ACID FAST BACILI
(AFB)
87206
8202
SMEAR G.C.
87205
8205
SMEAR GRAM STAIN
87205
8209
SMEAR LEUKOCYTES
87209
8207
SMEAR MALARIA
87207
10190 SMEAR NASAL EOSINOPHILS
89190
8211
SMEAR PRIM W/INTERPT;
WET & DRY
87210
8200
SMEAR: NASAL
89190
8201
SMEAR: URINE FOR EOS
89190
8203
SMEAR: WRIGHT'S STAIN
87999
364
SNP MICROARRAY ANALISIS
SCHEDULE: WEDNESDAY
SCHEDULE: DAILY
SPECIMEN: FIRST MORNING SPUTUM
SCHEDULE: 3 DAYS
SPECIMEN: VAGINAL SWAB
SCHEDULE: DAILY
SPECIMEN: SWABS, SPUTUM, BRONQUIAL, WASHING, BODY FLUIDS,
URINE OR TISSUE.
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 1 WHOLE BLOOD (EDTA) TUBE.
SCHEDULE: DAILY
SPECIMEN: NASAL SWAB (RIGHT & LEFT)
SCHEDULE: DAILY
SPECIMEN: 1 g FRESH STOOL OR OTHER FLUID
SCHEDULE: DAILY
SPECIMEN: SWAB (RIGHT & LEFT)
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 1 WHOLE BLOOD (EDTA)
SCHEDULE: DAILY
SPECIMEN: GREEN WHOLE BLOOD (EDTA)
79
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
186
SODIUM 24 HRS URINE
84300
5295
SODIUM SERUM PLASMA OR
WHOLE BLOOD
84295
5300
SODIUM SPOT URINE
84300
5302
SODIUM STOOL
84302
7253
SOLUBLE LIVER ANTIGEN AB
(SAL/LP)
83516
294
SOLUBLE TRANSFERRIN
RECEPTOR
5305
SOMATOMEDIN
289
SOTALLOE
10325 SPERM ANTIBODIES
387
SPUTUM CYTOLOGY
3355
STONE ANALYSIS (CALCULUS)
84305
89325
82355
10055 STOOL LEUKOCYTES
89055
3274
STOOL OB IMMUNICHEMICAL
82274
3270
STOOL OB PEROXIDASE
82270
SPECIMEN: 24 HR URINE COLLECTION, NO PRESERVATRIVE.
SCHEDULE: DAILY
NOTE: RECORD TOTAL VOLUME.
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN DEBE SER LIQUIDA
SPECIMEN: SERUM
SPECIMEN: EXPECTORATED SPUTUM
SCHEDULE: 2 WEEK
PRIMARY CALCULUS IN STERILE CONTAINER. DO NOT WRAP
SPECIMEN IN TAPE OR LIQUID.
SCHEDULE: DAILY
SPECIMEN: 2 g FRESH STOOL NO DIET
SCHEDULE: DAILY
SPECIMEN: COLLECT FRESH STOOL IN DRY CONTAINER. PATIENT
SHOULD EXCLUDE. RED MEAT 3 DAYS BEFORE COLLECTING.
SCHEDULE: DAILY
80
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
8880
STREPTOCOCCUS GROUPING
8899
STREPTOCOCCUS
PNEUMONIAE AG
STREPTOCOCCUS
PNEUMONIAE IGG 14
SEROTYPE
397
87880
87899
7591
STREPTOZYME ELISA
7319
STRONGILOIDES AB
83519
6661
SUGAR WATER TEST
85999
5392
SULFATE URINE 24 HR
84392
260
SULFONIL UREA
82541
10060 SYNOVIAL CRYSTAL ID
89060
7593
SYPHILIS TEST QUANTITATIVE
86593
5481
T3 FREE
84481
5482
T3 REVERSE
84482
5480
T-3 TOTAL RIA
84480
5479
T3-UPTAKE
84479
5439
T4 FREE
84439
5440
T-4 FREE EQ DIALYSIS
84440
SPECIMEN: 2 ML SERUM / CSF/URINE
SPECIMEN: 3 ML SERUM + 7 ML WHOLE BLOOD (EDTA)
SCHEDULE: DAILY
SPECIMEN: 2 ML SYNOVIAL FLUID LAVENDER-TOP (EDTA) TUBE.
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
SCHEDULE: DAILY
81
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5436
T4 TOTAL
84436
1197
TACROLIMUS (PROGRAF)
80197
5402
TESTOSTERONE FREE
84402
5403
TESTOSTERONE TOTAL
84403
905
TESTOSTERONE WEAKLY
BOUND
7774
TETANUS AB IGG
86774
96
TETANUS/DIPHTERIA
86674
1198
THEOPHYLLINE
80198
5430
THIOCYANATE
84430
3542
THIOPURINE
METHYLTRANSFERASE (TPMT)
82542
6670
THROMBIN TIME
85670
6705
THROMBOPLASTIN
INHIBITION TEST
85705
5445
THYROID STIMULATING
IMMUNOGLOBULIN (TSI)
84445
7800
THYROGLOBULIN AB
86800
386
THYROGLOBULIN LYMPH
NODE ASPIRATE
SCHEDULE: DAILY
SCHEDULE: THURSDAY &FRIDAY (AM)
SCHEDULE: 1N WEEK, SEND OUT
SCHEDULE: DAILY
SCHEDULE: 8-10 DAYS SEND OUT
SPECIMEN: 8 ML SERUM GREEN WHOLE BLOOD
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: LYMPH NODE COLLECTION KIT AND SALINE VIAL
PLEASE REFER TO THE LYMPH NODE ASPIRATE COLLECTION KIT FOR
DETAILED INSTRUCTIONS AND SALINE SOLUTION VIAL.
REASONS FOR REJECTION: NONSALINE SAMPLES
82
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5432
THYROGLOBULIN
QUANTITATIVE
84432
172
THYROID AB PANEL
MULTI
1091
THYROID PANEL
1092
THYROID PANEL & TSH
(T3 T4 T7 & TSH)
84999
7699
THYROID PEROXIDASE
86376
7802
THYROTROPIN RECEPTOR ABS
83520
5441
THYROTROPIN-RELEASING
HORMONE
80438
5442
THYROXINE BNDNG
GLOBULIN (TBG)
84442
206
TISSUE TRANSGLUTAMINASE
IGA
83516
207
TISSUE TRANSGLUTAMINASE
IGG
83516
384
TITANIUM
264
TOBRAMYCIN LEVEL
80200
1200
TOBRAMYCIN PEAK
80200
151
TOBRAMYCIN TROUGH
80200
SCHEDULE: DAILY
SCHEDULE: DAILY
NOTE: THYROGLOBULIN AB & MICROSOMAL AB
CPT: 86800 ; 86376
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: GRAY TOP TUBE WITH TRASILOL
SPECIAL KIT TRANSPORT
SCHEDULE: TUESDAY (AM)
SCHEDULE: TUESDAY (AM)
SPECIMEN: ROYAL BLUE EDTA
SCHEDULE: DAILY
SCHEDULE: DAILY
NOTE: PLEASE LABELS TUBES APPROPRIATELY AS PEAK
SCHEDULE: DAILY
NOTE: PLEASE LABEL TUBE APPROPRIATELY AS TROUGH
83
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
1201
TOPIRAMATE (TOPOMAX)
80201
131
TORCH PANEL IGG
MULTI
130
TORCH PANEL IGM
MULTI
7317
TOXOCARA ANTIBODY
86317
7778
TOXOPLASMA AB IGM
86778
7777
TOXOPLASMA AB IGG
86777
5478
TRIGLYCERIDES
84478
9184
TRILEPTAL OXCARBAZEPINE
82491
8908
TROFILE DNA HIV
87999
8910
TROPHILE TM
5484
TROPONIN
84484
5485
TRYPSIN SERUM
84485
311
TRYPTASE SERUM
5443
TSH
84443
SCHEDULE: MONDAY TUESDAY & FRIDAY (AM)
PANEL INCLUDE: TOXOPLASMA IGG / RUBELLA IGG /CMV IGG/HSV
IGG
INCLUDE: TOXOPLASMA IgM / RUBELLA IgM / CMV IgM / HSV IgM
SCHEDULE: MONDAY (AM)
SCHEDULE: DAILY
SCHEDULE: DAILY.
SCHEDULE: DAILY
84
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
366
UREAPLASMA /MYCOPLASMA
HOMINIS CULTURE
87109
5550
URIC ACID SERUM
84550
5560
URIC ACID SPOT URINE
84560
191
URIC ACID URINE 24 HR
84560
2000
URINALYSIS
81000
9108
URINE CYTOLOGY
88108
5578
UROBILINOGEN URINE QUAL
84578
1164
VALPROIC ACID / DEPAKOTE /
DEPAKANE
80164
1202
VANCOMYCIN
80202
209
VANCOMYCIN PEAK LEVEL
80202
210
VANCOMYCIN TROUGH
80202
5585
VANILLYLMANDELIC ACID 24
HR URINE
84585
SPECIMEN: SEMEN/URINE COLLECT SPECIMEN CONTAINER
MALE: URETHRAL SPECIMEN ON VIRAL CULTURE
FEMALE:VAGINAL AND URETHRAL ON VIRAL CULTURE
SCHEDULE: 8-10 WEEKS
NOTE: STABILITY TIME:72 HOURS
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: 20 ML URINE 24 HRS COLLECTION NO PRESERVATIVES.
SCHEDULE: DAILY
NOTE: STATE URINE VOLUME ON THE REQUEST FORM.
SCHEDULE: DAILY
SPECIMEN: 60 ML RANDOM URINE WITH SACCOMANNO
SCHEDULE: DAILY
SCHEDULE: DAILY
SPECIMEN: DAILY
SCHEDULE: DAILY
NOTE: PLEASE LABEL TUBES APPROPRIATELY AS ''PEAK”
SCHEDULE: DAILY
NOTE: PLEASE LABEL TUBES APPROPRIATELY AS ''TROUGH”
SPECIMEN: 15 ML URINE 24 HR CONTAINER, COLLECT URINE WITH
25 ML OF 6N HCL, RECORD URINE VOLUME ON TEST REQUEST
FORM PATIENT SHOULD AVOID ALCOHOL, COFFEE, TEA,
TOBACCO AND STREMOUS EXCERCISE.
SCHEDULE: 3 DAYS
85
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
141
VANILYMANDELIC ACID
(VMA) RANDOM URINE
84585
7786
VARICELLA ZOSTER, IgM
86787
7787
VARICELLA-ZOSTER IGG
ANTIBODIES
86787
5586
VASOACTIVE INTESTINAL
PEPTIDE
84586
7592
VDRL (RPR)
86592
7595
VDRL LIQUIDO ESPINAL
86592
391
VEGF VASCULAR
ENDOTHELIAL GROWTH
FACTOR
3726
VERY LONG CHAIN FATTY
ACIDS
82726
8253
VIRAL TISSUE CULTURE (CSF)
87253
6810
VISCOSITY SERUM
85810
165
VIT B-12 & FOLATE (REF)
5590
VITAMIN A / RETINOL
84590
152
VITAMIN B1 (THIAMINE)
BLOOD
84425
5425
VITAMIN B1 (THIAMINE)
PLASMA
84425
3607
VITAMIN B12
(CYANOCOBALAMIN)
82607
SCHEDULE: 3 DAYS
SCHEDULE: 1 WEEK
SCHEDULE: DAILY
SPECIMEN: 1ML CSF REF
SCHEDULE: 5 - 10 DAYS; SEND OUT
SPECIMEN: 5 ML SERUM (WITHOUT SEPARATOR)
SPECIMEN: CSF IN THE STERILE SPECIMEN CONTAINER
SCHEDULE: DAILY
SPECIMEN: 2 ML SERUM (PROTECT FROM LIGHT)
SPECIMEN: 3 ML WHOLE BLOOD (EDTA) WRAP IN ALUMINUM FOIL
TO PROTECT FROM LIGHT.
SPECIMEN: 3 ML WHOLE BLOOD ( EDTA ) WRAP TUBE ALUMINIUM
FOIL TO PROTECT FROM LIGHT.
SCHEDULE: DAILY
86
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
5252
VITAMIN B2 (RIBOFLAVIN)
84252
5591
VITAMIN B3 (NIACIN)
84591
5207
VITAMIN B6 (PYRIDOXAL
PHOSPHATE)
84207
3180
VITAMIN C ASCORBIC ACID
BLOOD
82180
3306
VITAMIN D 25 HYDROXY
82306
3652
VITAMIN D1 25 DIHYDROXY
82652
5446
VITAMIN E
84446
5597
VITAMIN K
84597
4719
VLDL
83719
5600
VOLATILES BLOOD
84600
271
VOLATILES RANDOM URINE
6248
VON WILLBENBRAND PROFILE
MULTI
6246
VON WILLEBRAND FACTOR
AG
85246
6247
VON WILLEBRAND
MULTIMERS
85247
SHIP TEMPERATURE: FROZEN, PROTECT SPECIMEN FROM LIGHT
PROTECTED FROM LIGHT
SPECIMEN: 3
ML PLASMA (EDTA) PROTECT FROM LIGHT.
SPECIMEN: 2 ML SERUM, PROTECTED FROM LIGHT
SCHEDULE: MONDAY & WEDNESDAY
SPECIMEN: 2 ML SERUM PROTECT FROM LIGHT.
SPECIMEN: 4 ML PLASMA HEPARINIZED PROTECT FROM LIGHT.
SCHEDULE: DAILY
SPECIMEN: 7 ML WHOLE BLOOD GRAY-TOP TUBE.
CPT 85240 / 85245 / 85246
INCLUDE: FACTOR VIII / VWF ACTIVITY / VWF Ag
87
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
6048
WBC
85048
6007
WBC & DIFF
85007
87
WHEAT F4
86003
7790
WNV VIRUS AB IGG
86790
214
XYLOSE ABS TEST 25 GR URINE
84620
5621
XYLOSE ABSORPTION TEST
URINE 25G
84620
XYLOSE TEST PLASMA 25GR
84620
5622
84620
5620
XYLOSE URINE TEST 5GR
86790
352
YELLOW FEVER IGG
1168
ZARONTIN
5630
ZINC
84630
5635
ZINC URINE
84630
80168
SCHEDULE: DAILY
SPECIMEN: 1 WHOLE BLOOD LAVENDER-TOP (EDTA) TUBE
SCHEDULE: DAILY
SCHEDULE: 1 WEEK
SPECIMEN: 5 HRS COLLECTION AFTER 25 g XYLOSE
ADMINISTRATION. SEND 30 ML URINE, RECORD TOTAL
URINE VOLUME.
SPECIMEN: 5 HRS COLLECTION AFTER 25 g XYLOSE
ADMINISTRATION. SEND 30 ML URINE, RECORD TOTAL
URINE VOLUME.
SPECIMEN: PLASMA FROM GRAY TOP TUBE. ADMINISTER TO
FASTING ADULT PATIENT 25 GR XYLOSE OR TO A
FASTING CHILD 0.5 GR UP TO 25 GR OF XYLOSE / KG OF
WEIGHT. DRAW SAMPLE 1 HR AFTER XYLOSE IS
ADMINISTERED FOR ADULTS AND CHILDREN.
SPECIMEN: 30 ML URINE NO PRESERVATIVE. NOTE: RECORD FIVE
HOUR URINE TOTAL VOLUME ON THE REQUEST FORM
(SPECIFY DOSE 5 g OR 25 g)
SCHEDULE: 1 WEEK
SPECIMEN: 2 ML PLASMA ROYAL BLUE-TOP (EDTA) OR SERUM.
SPECIMEN: 24 HRS OR RANDOM URINE NO PRESERVATIVE.
88
I Fa x . 7 8 7 .8 8 0- 72 8 1
t .7 87 .8 80 .0 44 4
LIC # 774
CLI A # 40 - D 06 57 99 4
375
ZONIDASE
82542
SPECIMEN: 2 ML RED TOP TUBE W/O SEPARATOR
89

Laboratorio Clínico Toledo

Transcription

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