Creatinine Urine, Random
| 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. Creatinine Urine, Random | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
UCRRM
Test Workstation :
MACH3
Specimen Type:
Urine
Tube Type:
Urine container
Collection Volume:
1.0 mL Urine without preservatives
Minimum Volume:
500 uL urine
Preferred Volume:
1 mL urine
Storage:
Shipping- Send Refrigerated; Storage-Room Temp: 2 days; Refrigerated: 6 days; Frozen: 6 months
Availability:
24 hours/day, 7 days/week
Methodology:
Roche-Enzymatic colorimetric
Special Instructions:
Deliver promptly to the lab
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference interval:
Female: 28-217mg/dL
Male: 39-259mg/dL
CPT Code:
82570
