Centralized Core Laboratory - Summa Akron City Hospital :
Send Out
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. Digoxin
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
DIGOX
Test Workstation :
SUMMA
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
3.0 mL
Minimum Volume:
2.0 mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Multi point Immuno-Rate
Special Instructions:
Do not administer isotopes 24 hours prior to collection. Do not draw specimen close to the administration of Digiband. Note date, time, and amount of last dose.
Lab/Phone:
330-543-8418
TAT:
24 hours
Additional Info:
Therapeutic range: 0.8-2.0 ng/mL
CPT Code:
80162
Synonyms:
Lanoxin
Digoxin
Test ID/Workstation :
DIGOX
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
3.0 mL
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Multi point Immuno-Rate
Special Instructions:
Do not administer isotopes 24 hours prior to collection. Do not draw specimen close to the administration of Digiband. Note date, time, and amount of last dose.
Lab/Phone:
330-543-8418
TAT:
24 hours
Additional Info:
Therapeutic range: 0.8-2.0 ng/mL
CPT Code:
80162
Synonyms:
Lanoxin
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