Porphyrins, Stool
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Porphyrins, Stool | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
PORST
Test Workstation :
CLEVE
Specimen Type:
Stool
Tube Type:
Stool container
Collection Volume:
5 grams from a random stool specimen
Minimum Volume:
1 gram from a random stool specimen
Cause for Rejection:
Liquid stool; Timed stool collections
Storage:
Critical Frozen
Availability:
Sent to reference lab
Methodology:
High Performance Liquid Chromatography (HPLC)
Special Instructions:
Collect random stool in a clean airtight container. PROTECT FROM LIGHT. Sample should be kept FROZEN during collection. Deliver sample to the lab ASAP after collection.
For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
3-8 days
Additional Info:
Reference range is available on patient report
CPT Code:
84126
