C3, Complement
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. C3, Complement | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
C3
Test Workstation :
ACHM5
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Collection Volume:
2.0 mL (minimum 1.0 mL)
Storage:
Shipping-Send Refrigerated; Storage- Room Temp: 4 days; Refrigerated: 8 days; Frozen 8 days
Availability:
24 hours/day, 7 days/week
Methodology:
Roche-Immunoturbidometric
Lab/Phone:
330-543-8417
TAT:
4 hours
Additional Info:
Ref. range is age dependent; avail on patient report
CPT Code:
86160
