HCG, Serum
| 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. HCG, Serum | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
HCGS
Test Workstation :
MMCHM
Specimen Type:
Blood
Tube Type:
Red top ( no anticoagulant ) tube
Collection Volume:
4.0 mL ( minimum 1.5 mL)
Storage:
Refrigerated
Availability:
Daily; 24 hours; STAT
Methodology:
Monoclonal and polyclonal antibody reaction
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Reference range is not applicable
CPT Code:
84703
Synonyms:
BHCG Serum; Serum Pregnancy Test
