Creatinine Urine 24 hr
| 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 24 hr | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
UC24M
Test Workstation :
MACH3
Specimen Type:
Urine
Tube Type:
Urine Container
Collection Volume:
Entire 24 hour collection. See Special Instructions.
Minimum Volume:
Entire 24hr collection
Preferred Volume:
Entire 24hr collection
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:
Instruct patient on 24 hour urine collection. Refrigerate 24 hour urines during collection. Do not use urine preservatives. Mark each collection container with the following information required for resulting: patient demographic information and date and time collection was started and finished. Deliver specimens promptly to the lab.
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference range available on patient report. Female 740-1570 mg/24HR; Male 1040-2350 mg/24HR
CPT Code:
82340
