Bone Marrow

Centralized Core Laboratory - : Hematology

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Bone Marrow
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

BNMRW

Test Workstation :

SPHEM

Specimen Type:

Bone Marrow Aspirate and/or Biopsy

Tube Type:

Specimen container

Collection Volume:

See Special Instructions

Cause for Rejection:

Dry Tap"; clotted specimen"

Storage:

Ambient

Availability:

Mon-Fri (0800-1530); Sat-Sun (1000-1400)

Methodology:

Microscopic evaluation of Wright's stained coverslip preparation

Special Instructions:

Hem Onc Physician must schedule procedure with CCL (x38416), indicating any cultures, biopsy, chromosome studies, immunological tests or other special orders. Nursing station must call CCL when the physician arrives to perform the procedure.Must fill out appropriate testing requisition

Lab/Phone:

330-543-8416

TAT:

48-72 hours

Additional Info:

Reference range is available on patient report

CPT Code:

Synonyms:

Bone Marrow Aspirate; Bone Marrow Biopsy

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Bone Marrow

Centralized Core Laboratory - : Hematology

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