Drugs of Abuse Screen, Ur Mahoning Valley
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Drugs of Abuse Screen, Ur Mahoning Valley | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
DRGTM
Test Workstation :
MACH3
Specimen Type:
Urine
Tube Type:
Urine Container
Collection Volume:
10.0 mL
Minimum Volume:
2 mL
Preferred Volume:
10 mL
Storage:
Shipping: Send Refrigerated; Storage: Refrigerated and tested within 5 days
Availability:
24 Hours/day, 7 days/week
Methodology:
Roche-KIMS and Homogenous Enzyme Immunoassay
Special Instructions:
None
Lab/Phone:
330-746-9623
Additional Info:
Reference range: None Detected
CPT Code:
80307
Panel Includes:
Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Methadone, Opiates, Oxycodone, PCP-Phencyclidine, and THC-50.
