Creatine Kinase
| 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. Creatine Kinase | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
CK
Test Workstation :
MACH3
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Collection Volume:
500 uL microtainer; 1.5 mL macrotainer
Minimum Volume:
500 uL microtainer; 1.5 mL macrotainer
Preferred Volume:
500 uL microtainer; 1.5 mL macrotainer
Storage:
Shipping: Send Refrigerated; Storage: Room Temp: 2 days; Refrigerated: 7 days; Frozen: 4 weeks
Availability:
24 Hours/day, 7 days/week
Methodology:
Roche-Enzymatic UV
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference range:
Newborn birth through day 4 = 72-585 IU/L
5 days through end of life = 24-195 IU/L
CPT Code:
82550
