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Laboratory Tests Available

Note:  This listing of tests is not all inclusive.  These are the tests performed at the Evans lab and the most commonly requested ship out tests.  If you have specific questions about availability of a test please call Shipping at 526-7053.

Click on a letter to take you to that section of the listing.  You can also search this page by pressing Ctrl-F.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

 

A

ABO/RH - Routine Blood Type

Lab: Blood Bank/7999

Request Form: SF 556 or CHCS

Specimen: Purple top tube

 

Abscess Anaerobic Culture

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Pus, tissue, etc. obtained from an abscess, biopsy, aspirate, drainage, exudate, lesion, or wound. To ensure proper growth of organisms, specimens for

anaerobic culture should have an order for aerobic culture from same site.

Container: Anaerobic Culturette available from MDS

Reference Range: No growth of anaerobic bacteria 5 days

 

Abscess Culture, Routine

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Pus from aspiration

Reference Range: No growth 48 hours

 

Accutane

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, protect from light

Reference Range: See Lab Report

 

ACE (Angiotensin 1 converting enzyme)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 Green Top Tube

Reference Range: See Lab Report

 

ACEAB (Anti Centromere)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Red Top/SST/2ml serum

Reference Range: Negative

 

Acetaminophen, Serum (ACTMN)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Collection: Routine venipuncture, Toxicity, 4 hr post-ingestion should be drawn.

Reference Range: Therapeutic: 10-20 mcg/ml; toxic: > 150 mcg/ml

 

Acetone, Serum (SKETO)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Blood

Container: Red top/SST

Reference Range: Negative in normal nutritional states

 

Acetylcholine Receptor Antibodies/Myasthenia Gravis (ACET)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST - Bring to Lab STAT

Reference Range: See Lab Report

 

Acid-Fast Stain

Synonyms: AFB Smear, AFB Stain, Atypical Mycobacterium Smear, Mycobacterium

Stain, TB Stain.

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Sputum, Tissue, CSF, Random Urine

Reference Range: No mycobacteria identified

 

Acid Phosphates, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red Top/SST Has to be run within 1 hour of being drawn

Reference Range: 0.0 - 0.8 IU/L

 

ACTH (Adrenocorticotropic Hormone)

Lab: Shipping/ 7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 Lavender (4ml), Bring to Shipping STAT

Reference Range: 9-52 pg/ml

 

Activated Partial Thromboplastin Test (APTT)

Lab: Hematology/ 4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Blue top tube. The specimen volume must be at least 90% of expected fill,

but not more than 100% of expected fill. Fill to the level indicated by the black line on

the collection tube.

Collection: Routine venipuncture. If multiple tests are being drawn, draw coagulation

studies last. 

Reference Range: Reported with patient results, Approx. 25-35 seconds. Established and rechecked periodically. Sent with report. Therapeutic range: Patients on heparin

therapy is approx. 50-80 seconds. Recommended test for monitoring Heparin Therapy.

 

Acyclovir

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

A-DBL (Anti DNS double stranded)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube 2 ml serum

Reference Range: < 100 IU/ml

 

Adrenocorticotricotropic Hormone - See ACTH

AFB, Fluid

Lab: Shipping/7053

Request Form: Micro 2 (SF 554)

Specimen: Screw Top sterile tube

Reference: Range Negative

 

AFB, ACID, Sputum

Lab: Shipping/7053

Request Form: Micro 2 (SF 554)

Specimen: Sputum in falcon collection kit or specimen cup, Refrigerate

immediately, all cultures requesting AFB work-up get an Acid Fast Stain

 

Albumin, Serum (ALB)

Lab: Chemistry/7064

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: 3.4-5.0 G/dl

Albumin, Prealbumin, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Serum

Reference Range: See Lab Report

 

Alcohol, Blood

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red Top/SST (medical) or gray top tube (legal)

Collection: DO NOT prepare venipuncture site with any alcohol containing swab, use

iodine. Deliver specimen immediately to laboratory following collection.

Reference Range: Negative. 0.00

 

Aldolase, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Aldosterone, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Aldosterone, Urine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine collection, no preservative, refrigerate during collection

Reference Range: See Lab Report

 

Alkaline Phosphates, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 35-100 IU/L

 

Alpha-1 Antitrypsin

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Fasting is required

Reference Range: See Lab Report

 

Alpha-1 Antitrypsin Phenotyping

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT, Fasting required

Reference Range: See Lab Report

 

Alpha Fetoprotein, Serum Maternal

Lab: Chemistry

Request Form: FC Meddac Form 412 (MSAFP)

Specimen: SST/Red top Patient must be in the gestational window of 15-20 weeks.

Reference Range: 0-15 ng/ml

 

Alpha-Tocopherol (Vitamin E)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to shipping STAT

Reference Range: See Lab Report

 

Amikacin (Peak and Trough)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Amino Acid Screen (Blood, Urine)

Lab: Shipping/7053

Request Form: Misc.

Specimen: 1 lavender top or random urine; bring to Shipping STAT; fasting required

Reference Range: Sent with results

 

Amiodarone (Cardarone)

Lab: Shipping/7053

Request Form: Miscellaneous SF 557)

Specimen: SST, collect 8-10 hours post dose of just before next dose

Reference Range: See Lab Report

 

Amitriptyline (Elavil, Nortriptyline)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain red top

Reference Range: See Lab Report

 

Ammonia, Plasma

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: Green top tube, Put on ICE immediately, bring to lab STAT. Patient

should not clench fist.

Reference Range: 11-35uMOL/L

 

Amniotic Fluid, OD Scan, Delta OD 450

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 5 ML Must have gestation on lab slip, protect from light

Reference Range: See Lab Report

 

Amphetamines

Lab: Chemistry/7064

Request Form: Miscellaneous (SF 557)

Specimen: Urine

Reference Range: Negative

 

Amylase, 24 Hour Urine

Lab: Chemistry/7064

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 hour urine, entire collection, keep specimen refrigerated

Reference Range: Included with final report

 

Amylase, Urine, Random

Lab: Chemistry/7064

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random urine or timed urine i.e. 2, 12, or 24 hour interval. A timed 2 hour urine collection is preferred

Reference Range: No established ranges for random urine. 2Hour - 4-30 IU/2hrs

 

Amylase, Serum

Lab: Chemistry/7064

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top tube

Reference Range: 34 - 124 IU/L

 

Ampicillin Level

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top, use aseptic procedure, send to lab STAT to freeze

Reference Range: Sent with results

 

ANA-C, ANA Complete or ANA Profile, Includes DNA, Sm., RNP, & SS-B Antibodies

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 SST

Reference Range: See Report

 

Anafranil

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: See Lab Report

 

Androstenedione

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top send to lab STAT

Reference Range: See Lab Report

 

Angiotensin-1-Converting Enzyme (ACE)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 green top

Reference Range: See Lab Report

 

Anticardiolipin Antibodies (ACA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Antibody Identification

Lab: Blood Bank/7999

Request Form: Miscellaneous (SF 557)

Specimen: Purple top tube

Reference Range: Report includes interpretation

 

Antibody Screen (Coombs Indirect)

Lab: Blood Bank/7999

Request Form:  Miscellaneous (SF 557) or CHCS 

Specimen:  Purple top tube

Reference Range:  Report includes interpretation

 

Anti ACL-70 (scl 70) Scleroderma antibody, serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Anti Centromere (ACEAB)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Anti DNA (A - DBL)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Anti-Glomerular Basement Membrane

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative: < 1:4 IFA Titer

 

Anti - HAV (M) Antibody to Hepatitis A Antigen, IgM Specific - HAV

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HBC (Total) Convalescent Phase, Antibody to Hepatitis B Core

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HBC (IgM) Acute Phase Antibody to Hep B Core

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HBe (Hepatitis Be Antibody) HBeAB

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HBs, Antibody to Hep B Surface

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HCV, Antibody to Hep. C

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HD, Antibody to Hep D

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Anti - HTLV 1, Antibody to HTLV

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Antigliadin IgG & IgA

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: Negative

 

Anti - Hyaluronidase (AHT)

Lab: Shipping/7053

Request Form: Misc.

Specimen: SST

Reference Range: See Lab Report

 

Antinuclear Antibody (ANA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: Sent with Report

 

Antistreptolysin O Titer, Serum

Lab: Chemistry/ 7064

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: < 200 reported as negative

 

Anti-Neutrophilic Cytoplasmic Ab (ANCA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: C-ANCA: < 1:20 IFA Titer; P-ANCA: < 1:20 IFA Titer

 

Anti-Platelet Associated Antibodies (IgG, IgM)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 Yellow (ACD Solution A); Collect Mon-Wed before 1400 ONLY

Reference Range: See Lab Report

 

Anti-Straitional Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Anti Thyroglobulin (Antibody) TGA

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red top

Reference Range: See Lab Report

 

Anti Thyroid Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Antithrombin III (AT III) ATT 3

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 blue tops (citrate)

Reference Range: See Lab Report

 

ASAB (Anti Striational Antibodies)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: See Lab Report

 

Aspergillus (Aspergillosis) Comp Fix (EPI - Fungal Profile)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

Remarks: Done only if positive by immunodiffusion

 

Autologous Blood Collection

Lab: Blood Bank /7999

Request Form: Penrose-St. Francis Physician Order Form

Specimen: 450 ML, Blood bag, drawn by Blood Bank at Penrose Hospital

 

Autopsy

Lab: 7349/7374/7895

Request Form: SF 523 (Authorization for Autopsy)

Bacterial Antigen Screen, CSF/Urine

 

Synonyms: Directogen, Latex Agglutination, Bacterial Antigen Screen

Lab: Microbiology/7677

Request Form: CHCS

Specimen: CSF - 1 ml/Urine - 3 ml

Reference Range: Negative

 

B

Benzodiazepine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Random Urine

Reference Range: Sent with report

 

BHCG, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Request Form: Chemistry/misc.

Specimen: SST/Red top tube

Reference Range: Non-pregnant range < 2

 

Bile Acids

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, bring to Shipping STAT, fasting required

Reference Range: Fasting: < 0-60 mcg/dl; Postprandial values are approximately

three times the fasting level

 

Bile, Urine (Ictotest)

Lab: Urinalysis/6614

Request Form: Hematology/ SF 877

Specimen: Fresh random urine

Reference Range: Negative

 

Bilirubin, Direct

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top/1 bullet

Reference Range: 0.0 - 0.5 mg/dl

 

Bilirubin, Neonatal

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: 1 bullet

Reference Range: 0-1 day=2-6 mg/dl; 1-2 days=6-10 mg/dl; 2-5 days=4-8 mg/dl

 

Bilirubin, Total (Adult)

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 0.0-1.5 mg/dl

 

Biopsy Culture, Routine

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Surgical tissue, bone marrow, biopsy material, etc.

Collection: The surgical specimen should be separated whenever possible from portion submitted to Anatomic Pathology utilizing sterile technique, although the operative

suite is the preferred site. Division of the specimen should be performed in

consultation with the Pathology staff and performed by a pathologist on request. The

specimen will be divided in the lab for fungal culture and KOH preparation,

mycobacteria culture and smear, routine bacterial cultures and Gram stain only if

specimen is accompanied by a requisition for each procedure and specimen has

adequate volume for all tests. Specimens for anaerobic culture should be placed in a

sterile container  or anaerobic transport swab and brought to the laboratory within one half hour.

Reference Range: No growth

 

Blastomyces Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Bleeding Time (Modified Ivy Bleeding Time)

Lab: Hematology/6937

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: Hematology performs on patient, Routine basis

Reference Range: 2.5-9.5 Min. Standard deviation of approx. 1 min occurs between

different laboratories.

 

Blood Culture

Lab Microbiology/6618

Request Form: CHCS

Specimen 5 ml/bottle, 2 ml/bottle for peds. Two sets/one hour interval.

Collection Bottles: Bact/Alert. Blood cultures should be drawn prior to initiation of

antimicrobial therapy. The time of collection must be indicated on the bottles and the

lab slip. Strict aseptic technique is essential. Remove the plastic cap from the blood

culture bottles, wipe the stoppers with a alcohol pad and allow to dry, collect 10 ML of

blood in a sterile syringe, discard needle, replace with a needle and inoculate 5 ML of

blood into each bottle, the first bottle should be the anaerobe, and the last bottle filled

should be the aerobic.

Reference Range: Negative - 5 days

Blood Type - See ABO/RH

 

Body Fluid Culture, Routine

Lab: Microbiology/6618

Request Form: CHCS

Specimen: Aseptically aspirated body fluid, sterile tube or syringe

Collection: Specimen must be transported to laboratory immediately after collection.

Contamination with normal flora from skin, rectum, vaginal tract, or other body

surface should be avoided.

Reference Range: No Growth 72 hours

 

Body Fluids Analysis i.e. Pleural, Peritoneal, Pericardial, Synovial

Lab: Hematology/4-4097

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: 3-5 ml, Lavender top, mix well, Bring to Laboratory STAT

Reference Range:  See Lab Report                                

 

Bone Marrow Aspiration and Biopsy

Lab: Hematology/Call 4-4097 to set time

 

Bone Marrow Culture, Anaerobic-Aerobic

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Bone Marrow

Reference Range: No growth

 

Bordetella Pertussis/Smear

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 Smears/Nasopharyngeal or Throat swabs placed in transport media

++++Must be received at Penrose within 4 hours to set up++++

Reference Range: Negative

 

Bronchial Aspirate Culture

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Tracheal aspiration, bronchoscopy specimen, or transtracheal aspirate

Reference Range: No growth normally, Tracheal aspirate and bronchoscopy specimens usually are contaminated with normal flora.

 

Brucella Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

BUN, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top tube

Reference Range: 6-20 MG/DL

 

BUN, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: 24 hour urine

Reference Range: 15-24 G/24hrs

 

BUN/Creatinine Ratio

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 6-20 MG/DL

 

C

 

Caffeine, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with results

 

Calcitonin

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top; Bring to Shipping STAT

Reference Range: See Lab Report

 

Calcium, Ionized

Lab: Shipping/7053; Chemistry does a calculated ionized CA

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: Patient should be fasting, Check with chemistry to see if a calculated

ionized CA can be substituted. SST

Reference Range: Sent with report

 

Calcium, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 8.6-10.7 MG/DL

 

Cannabinoids (THC)

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: Random urine, 20 ML

Reference Range: Negative

 

Carbamazepine (Tegretol)

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 4-12 MCG/ML

 

Carbon Dioxide, Total

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 23-33 MMOL/L

Carbon Monoxide (Carboxyhemoglobin)

Done in Respiratory Therapy

 

Carcinoembryonic Antigen (CEA)

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 0-5 NG/ML

 

Cardiac Enzyme Profile (CPK, LDH, CKMB, LDH1, Index)

Lab: Chemistry/6615

Request Form: FC MEDDAC FORM 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: CPK - MALE = 61-224 IU/L; LDH - 96-176 IU/L; FEMALE

38-173 IU/L; CKMB - 0.0-4.7 mg/dl; LDH1 - 25-70 IU/L; Index - 0.0-2.5

 

Carnitine, Total & Free

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, bring to Shipping STAT

Reference Range: See Lab Report

 

Carotene

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, protect from light, bring to Shipping STAT, fasting required

Reference Range: See Lab Report

 

Catecholamines, Free (CATE) Includes Epinephrine, Norepinephrine, Dopamine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Various medications may alter the level in vivo. Also individuals with

hypertension may show elevations up to twice normal. 24 hour urine needs

preservative from lab.

Reference Range: Sent with report

 

Catecholamines, Fractionated Plasma, Includes Dopamine, Epinephrine, &

Norepinephrine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 green top tubes (heparin), patient to remain in supine position for 30

minutes prior to collection

Reference Range: See Lab Report

 

Catheter Tip Culture, routine

Lab: Microbiology/7677

Request Form: CHCS

Collection: Avoid contamination with normal flora from skin or other body surfaces.

Deliver specimen to lab within 2 HRS of collection. Make direct smear of any exudate

from catheter site after catheter has been removed.

Reference Range: No growth

 

C-DIFF (Clostridium Difficle Toxin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 10 grams of stool in sterile specimen container

Reference Range: Sent with results

 

CEA See Carcinoembryonic Antigen

Celontin (Methsuximide or Normethylsuximide)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top

Reference Range: See Lab Report

 

Cerebrospinal Fluid CSF

Lab: Hematology/4-4097; Microbiology/7677; Chemistry/6615

Request Form: For Hem and Chem, use FC MEDDAC FORM 119 (Lab Requisition

Form); For Micro (gram stain/culture and sensitivity) use Micro I (SF 553)

Specimen: CSF At least 1 ML in each of 3-4 sterile tubes BRING TO LAB STAT

Reference Range: Hematology = See Lab Report,  Microbiology - No organisms seen; Chemistry - Protein:

20-70 MG/DL; Glucose: 2/3 of serum value

 

Cerebrospinal Fluid CSF - Culture

Lab: Microbiology/7677

Request Form: CHCS

Specimen: 1.0 ML CSF, Contamination with normal flora from skin or other body

surfaces must be avoided.

Reference Range: No growth in 72 hours

 

Ceruloplasmin (Cerul)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, fasting required

Reference Range: See Lab Report

 

Chlamydia (Antibody)

Lab: Shipping/7053

Request Form: CHCS

Specimen: SST

Reference Range: See Lab Report

 

Chlamydia (EIA)

Lab: Microbiology/7677

Request Form: Miscellaneous (SF 557)

Specimen: Chlamydia collection swab, urethral, eye, vaginal, cervical

Reference Range: Non-reactive

 

Chlordiazepoxide (Librium)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top tube, protect from light

Reference Range: Sent with results

 

Chloride, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 101-111 MMOL/L

 

Chloride, 24 hour urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 hour urine

Reference Range: 110-250 MMOL/24 HRS

 

Chloramphenicol (Chloromycetin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Red Top Tube Only

Reference Range: See Lab Report

 

Cholesterol

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: 120-200 MG/DL

 

Cholinesterase, RBC

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 - 7 ML lavender top

Reference Range: Sent with report

 

Chromosome Analysis, Blood

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557), Must give reason for testing

Specimen: Adults: 1 green top; Infants: 1, 3ml green top, Bring to Shipping

STAT

Reference Range: See Lab Report

 

Clonazepam (Klonopin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top

Reference Range: See Lab Report

 

Clostridium Difficle Toxin

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 10 ml (10 grams) stool in sterile specimen container

Reference Range: Sent with report

 

CMV Cultures (Cytomegalovirus)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

Remarks: Must be sent in viral transport tube. (green cap) Specimen source must be

included on lab slip. Body fluids including CSF and urine should be sent undiluted. Do

not freeze any of the above. CMV profile, both IGG and IGM, are preferred.

Clinical history not needed.

 

Cocaine, Urine

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: Urine

Reference Range: Negative

 

Coccidioides (Complement Fixation)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

Remarks: Done only if POSITIVE by immunodiffusion

 

C, Esterase

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

C-Peptide

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference: See Lab Report

 

C-Reactive Protein (CRP)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: < 0.5 MG/DL

 

C 3 Complement, Serum

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: 75-135 MG/DL

 

C 4 Complement, Serum

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: 10-40 MG/DL

 

CA 15-3

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: See Lab Report

 

CA 19-9

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: < 33 U/ml

 

CA - 125

Lab: Shipping

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: See Lab Report

 

Complement (CH-50)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: 189-420 units

 

Coccidioidomycosis (Coccidioides)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Colorado Tick Fever

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST tube

Reference Range: Sent with report

 

Complement, Serum

Lab: Chemistry/7064

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: Comp. C3: 75-135 MG/DL Comp C4: 10-40 MG/DL

 

Complete Blood Count (CBC)

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender top - Mix specimen well

Reference Range: Sent with report, Changes with age & sex

 

Conjunctival Culture, Routine

Lab: Microbiology/7677

Request Form: CHCS

Collection: Specimen should be delivered to the lab within 2 hrs of collection. Collect the specimen by swabbing, pass moistened swab 2 times over lower

conjunctiva. Avoid eyelid border and lashes. SCRAPINGS: Use local anesthetic and

platinum spatula. Rub spatula with scrapping gently over small area on slide. If too

dry use very small amount of sterile water. Indicate if it is the right eye or the left eye

on the slide and slip.

 

Coombs Direct

Lab: Blood Bank/7999

Request Form: SF 556

Specimen: Lavender top tube, Cord blood preferred on newborns

Reference Range: Negative

 

Coombs Indirect (Antibody Screen)

Lab: Blood Bank/7999

Request Form: SF 556

Specimen: Lavender Top Tube

Reference: Negative

 

Copper, Urine or Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, Royal blue top (no additive)

Reference Range: Sent with report

 

Cord Blood Work up

Lab: Blood Bank/7999

Request Form: SF 556, mark ABO, Rh, Coombs direct

Specimen: Purple top,  cord blood

Reference Range: Direct coombs Negative

 

Cortisol, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red top; draw at 0800 & 1600 to evaluate baseline diurnal variation.

Reference Range: AM: 5.5-20.0 UG/DL PM: 2.0-10.0 UG/DL

 

Cortisol, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 hour urine specimen

Reference Range: See Lab Report

 

Creatine Phosphokinase - CPK, CK

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: MALE: 55-170 IU/L; FEMALE: 30-135 IU/L

 

Creatinine, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top tube

Reference Range: 0.5-1.3 MG/DL

 

Creatinine Clearance - CrCl

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Urine

Reference Range: MALE: 97-137 ml/MIN; FEMALE: 88-128 ml/MIN

 

Cryofibrinogen (Qualitative)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 Plain Red Top Tube

Reference Range: Negative

 

Cryoprecipitate Call Blood Bank and notify, not stocked in house

Lab: Blood Bank/7999

Request Form: SF 518

Specimen: Red top tube, must have date and time of collection on tube.

 

Cryptococcal - Antigen

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST/Spinal Fluid

Reference Range: Negative

 

Cycloserine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: See Lab Report

 

Cyclosporine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 5 ML Lavender top

Reference Range: Sent with report

 

Cystine, Quantitative

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 Hour urine

Reference Range: 10-100 mg/24 hr

Remarks: Needs 25ml of 6N HCL added to container

Cytology: See Anatomic Pathology SOP.

 

Cytomegalo Virus (CMV Titre)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

D

 

Dalmane (Flurazepam or Desalkylflurazepam)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 Plain Red Top Tube

Reference Range: See Lab Report

 

Darvon (Propozyphene & Norpropozyphene)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top tube or random urine

Reference Range: See Lab Report

 

D-dimer (quantitative)

Lab:  Hematology/4-4097

Request Form:  FC MEDDAC Form 119(Lab Requisition Form)

Specimen:  Glue top tube.  the specimen volume must be at least 

90% of expected fill, but not more than 100% of expected fill.  

Fill to the level indicated by the black on the collection tube line

Reference Range:  See Lab Report

 

Dengue

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST tube

Reference Range: Sent with report

 

Desalkylflurazepam (Flurazepam or Dalmane)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top

Reference Range: See Lab Report

 

Desipramine, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red top tube, do not use barrier tube (SST)

Reference Range: Sent with report

 

DHEAS

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, fasting required

Reference Range: See Lab Report

 

Dialysis Fluid, Peritoneal, Routine Culture

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Peritoneal dialysis fluid

Reference Range: No growth 72 hours

 

Diazepam (Valium)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top tube

Reference Range: Sent with report

 

Digoxin, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: Adult - 0.8-2.0 NG/ML

 

Dilantin (PTN, Phenytoin)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 10-20 MCG/ML

 

Disopyramide (Norpace)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top tube

Reference Range: See Lab Report

 

DNA Antibody Double - Stranded (Anti DNA Antibody)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Doxepin (Sinequen Level)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Red Top Tube Only

Reference Range: See Lab Report

 

Drug Screen

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random urine

Reference Range: Negative

 

Drug Screen (Medical/Legal) ALL AIR/LAND CRAFT ACCIDENTS GO TO AFIP

Lab: Shipping/7053

Request Form : Chain of custody form

Specimen: 2-15 ml Red tops, 2-7 ml Gray tops, 3-5 ml purple tops, 500-100 ml

random urine

 

E

 

Ear Culture, Routine

Lab: Microbiology/7677

Request Form: CHCS

Collection: INTERNAL: Cleanse external canal with mild antiseptic. Insert

sterile funnel and swab or aspirate specimen from eardrum or beyond. If eardrum is

not perforated, the specimen should be collected by a physician trained in this

procedure. EXTERNAL: Cleanse external canal with mild antiseptic, Swab, scrape, or

aspirate specimen from active margin, including fresh secretion from deeper areas.

Reference Range: No growth 48 hours

 

Elavil See Amitriptyline

Electrolytes, Serum

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: SST/Red top

Reference Range: Sodium 135-145 MMOL/L, Potassium 3.6-5.0 MMOL/L, Chloride 101-111 MMOL/L, CO2 21-31 MMOL/L

 

Electrolytes, Urine

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: 24 hr urine

Reference Range: Sodium 40-220 MMOL/24 hrs, Potassium 25-120 MMOL/24 hrs,

CL 110-250 MMOL/24 hrs

 

ENA (Extractable Nuclear Antibody)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Eosinophil Smear

Lab: Hematology/4-4097

Request Form: Miscellaneous (SF 557)

Specimen: Smear made from swab of nasal secretion, no fixation

Reference Range: No eosinophil identified

 

Epstein Barr Virus, Antibodies (EBV)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Esterase (C1 Esterase)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1-15 ML Red top

Reference Range: Sent with report

 

Estradiol/Estrogen/17 Beta Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: plain red top tube

Reference Range: Sent with report

 

Ethosuximide (Zarontin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: See Lab Report

 

Extractable Nuclear Antibody (ENA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

F

 

Factor 5 or Factor VII, VIII

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 blue top (citrate) for each factor ordered; Bring to Shipping STAT

Reference Range: Sent with results

 

Febrile Agglutinins

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Fecal Fat (Lipid, Quant.) 24hr, 48hr and 72hr

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Obtain container and instructions from shipping.

Reference Range: Sent with report

 

Fecal Leukocyte Stain, Wright Stain

Lab: Hematology/4-4097

Request Form: Miscellaneous (SF 557)

Specimen: A slide that has stool smeared on it

Reference Range: No leukocytes present

 

Felbamate

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: See Lab Report

 

Ferritin, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top

Reference Range: MALE: 30-284 NG/ML; FEMALE: Premenopausal 6-81 NG/ML;

Postmenopausal 14-186 NG/ML

 

Fetal Maternal Hemorrhage (FMH or Kleihauer-Beteke)

Lab: Shipping/7053 - NOTE: If ordered as part of an RhIG workup, test is done by Blood Bank 7999

Request Form: SF 556

Specimen: Lavender top

Reference Range: Negative

 

Fibrinogen

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Blue top tube.  The specimen vilume must be at least 90% of expected fill,

 but not more than 100% of expected fill,  Fill to the level indicated by the black line on 

collection tube.

Reference Range: Sent with report.

 

Fiorinal see Butalbital

Fluorescent Treponemal Antibody, CSF (FTA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 3 ML spinal fluid

Reference Range: Nonreactive

 

Florescent Treponemal Antibody, Serum (FTA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Fluoride (ION-Selective Electrode)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1-15 ml plain red top

Reference Range: See Lab Report

 

FMH - See Fetal Maternal Hemorrhage

 

Folate, Folic Acid

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Request Form: SST Tube

Reference Range: Sent with report

 

Follicle Stimulating Hormone, Serum, FSH

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: Male: 30-284 MIU/ml; Female: Follicular=3.6-16 MIU/ml; Mid-

cycle=8.1-28.9 MIU/ml; Luteal=1.8-11.7 MIU/ml; Menopausal=22.9-167 MIU/ml

 

Free T4, (Free Thyroxine) Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: 0.7-1.85

 

Fresh Frozen Plasma - Call Blood Bank and notify

Lab: Blood Bank/7999

Request Form: SF 518 - one for each unit

Specimen: Red top tube, must have date and time of collection on tube.

 

FTA-ABS, CSF

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 3 ML Spinal Fluid

Reference Range: Nonreactive

 

FTA-ABS, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Nonreactive

 

Fungal Culture: Check with Micro/7677

 

G

 

G6PD See Glucose 6 Phosphate Dehydrogenase

 

Gamma GlutamylTranspeptidase (GGT, GT)

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: 8-69 IU/L

 

Gastric Aspirate Culture

Lab: Microbiology/7677

Request Form: CHCS

Collection: Gastric aspirate must be obtained before feeding infant. Deliver specimen

to the lab within 1 hour.

Reference Range: Ng 72 hrs

 

Gastrin

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT, fasting is required

Reference Range: See Lab Report

 

Gentamicin

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Trough: <2.0 MCG/ML; Peak: 4-8 MCG/ML

 

Genital Culture, Routine

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Swab of vagina, cervix, discharge, aspirated endocervical, endometrial,

prostatic fluid, or urethral discharge.

Collection: FEMALE: DO NOT use lubricant on speculum. Cervical mucous should

be removed first before inserting swab from Culturette into endocervical canal, move

swab from side to side allowing several seconds for absorption of organisms by the

swab. Return swab to the transport tube, label and crush ampule to release transport

media. MALE: Using small wire swab gently scrape the anterior urethral mucosa to

collect specimen of urethral discharge.

 

Giardia Antigen Test (GAG)

Lab: Microbiology/7677

Request Form: CHCS

Specimen: Stool specimen collected in 10% formalin, Cary-Blair, clean vials (available through MDS)

Reference Range: Negative

 

Glucagon

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Lavender Top Tube, Bring to Shipping STAT, fasting required

Reference Range: 20-100 pg/ml

 

Glucose 6 Phosphate Dehydrogenase

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 Yellow top (ACD)

Reference Range: See Lab Report

 

Glucose - Fasting, 2 hr PP, 1 hr, 24 hr urine, CSF

Lab: Chemistry

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube, 24 Urine, CSF

Reference Range: Fasting: 65-115 MG/DL; 2 Hour PP: 70-140 MG/DL;

1 Hour: 65-135 MG/DL; 24 Hour urine: to 0.5 G/24 hrs; CSF: 2/3 of serum value

 

Glycosylated HGB See Hemoglobin A1C

 

Gram Stain

Lab: Microbiology/7677

Request Form: Micro 1 (SF 553)

Specimen: Duplicate of specimen appropriate for routine culture of the smear

Reference Range:  N/A

 

H

 

Haloperidol (Haldd)

Lab: Shipping/7053

Request Form: CHCS

Specimen: Plain Red Top Tube

Reference Range: 1-30 ng/ml

 

Haptoglobin, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Patient must be fasting, SST Tube

Reference Range: See Lab Report

 

HAV (Anti-Hav, Hepatitis IGM Specific)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Sent with report

 

HCG, Serum (Humanchorionic Gonadotropih)

Lab:  Urinalgsis/6614 

Request Form:  FC MEDDAC Form 119(lab requisition Form)

Specimen:  SST/Red Top

Reference Range:  Negative or Positive

 

HCG, Urine (Human Chorionic Gonadotropin)

Lab: Urinalysis/6614

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random Urine

Reference Range: Negative or Positive

 

Heavy Metal Screen (Mercury Urine)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 Hour urine collection only

Reference Range: Sent with report

 

HLA DB-2

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 Yellow Top Tube with ACD Saline

Reference Range: See Lab Report

 

Hematocrit

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender Top

Reference Range:  See Lab Report

Hemoglobin A1C (Glycosylated HGB A1C)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender Top

Reference Range: %GHB: 4.8-7.8 %A1C: 4.4-6.4

 

Hemoglobin Electrophoresis

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 Lavender Tops

Reference Range: Sent with report

 

Hemoglobin, Plasma

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender Top

Reference Range:  See Lab Report

 

Hepatitis A - See Anti HAV

 

Hepatitis B Antigen (Surface Antigen)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube/Red top

Reference Range: Negative

 

Hepatitis Be Antigen (HBeAG)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Hepatitis C - See Anti HCV

 

Hepatitis D (DOG) Also see Anti HD

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube/Red top

Reference Range: Negative

 

Hepatitis Panel including Hep C Antibody and Hep B Antigen, Hep B Core Antibody

and Hep B Surface Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube/Red top

Reference Range: Negative

 

Herpes Culture

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Obtain viral culturettes from MDS, not Laboratory. Write on request if

patient is pregnant and source of specimen

Reference Range: Sent with report

 

Herpes Titer

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Top

Reference Range: Herpes I, II IgG <0.91 EU/ml & Herpes I, II IgM <1:5

IFA Titer

 

Heterophile Titer

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Hexosaminidase A (Tay-Sachs Screen)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: Sent with report

 

5-HIAA, QUANTITATIVE See Hydroxyindole Acetic Acid

High Density Lipoprotein Cholesterol (HDL)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube, Patient must be fasting

Reference Range: 30-85 MG/DL

 

Histology, Routine

Lab: Histology/7308

Request Form: SF 515

Specimen: Use container of appropriate size, place biopsy specimen in 10% formalin solution. Use approximately 10 times as much formalin solution, making sure

specimen is totally covered.

 

Histoplasma

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Sent with report

 

HIV (Screen for Aids Antibody)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 HIV Tube/SST Tube

Reference Range: Negative

 

HLA-B27 (B27)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 Yellow tubes (ACD); Bring to Shipping STAT

Reference Range: Negative

 

Homocystine Qualitative (Cystine)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, needs preservative from lab (10g Boric Acid)

Reference Range: Negative

 

Homogentisic Acid, Urine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 50 ML Random urine

Reference Range: Negative

 

Homovanillic Acid (HVA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 Hour urine, needs preservative from lab (10g Boric Acid)

Reference Range: 3-8 mg/24 hours

 

H. Pylori (Helicobacter)

Lab: Microbiology/7677

Request Form: CHCS

Specimen: SST/RT

Reference Range: Negative

 

Human Growth Hormone (HGH)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube, Patient must be fasting

Reference Range: Sent with report

 

Hydroxyproline

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 Hour urine, needs preservative from lab (10g Boric Acid)

Reference Range: See Lab Report

 

5 Hydroxyindole Acetic Acid (5-HIAA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Dietary Restriction - Pineapples, bananas, eggplant, kiwi fruit, plums,

tomatoes, walnuts and grapefruit for 72 hours PRIOR to 24 hour urine collection,

needs preservative from lab (10g Boric Acid)

Reference Range: Sent with report

 

17-Hydroxy-Corticosteroids (17 OH)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, needs preservative from lab (10g Boric Acid)

Remarks: Not valid during pregnancy or if patient is taking oral contraceptives.

Reference Range: Sent with report

 

I

 

Ibuprofen

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Red Top Tube

Reference Range: See Lab Report

 

IgA

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: MALE: 100-490 MG/DL; Female: 85-450 MG/DL

 

IgE

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: See Lab Report

 

IgG

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 800-1700 MG/DL

 

IgG Subclass (1,2,3 & 4)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Sent with report

 

IgM

Lab: Chemistry/7053

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: MALE: 5-320 MG/DL; FEMALE: 60-370 MG/DL

 

Imipramine (Tofranil, Presamine)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain red top tube

Reference Range: See Lab Report

 

Immunoelectrophoresis (IEP)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, 24 hour urine collection

Reference Range: See Lab Report

 

India Ink (CSF) ((not done see Cryptococcus. Antigen))

Lab: Microbiology/7677

 

Infectious Mononucleosis

Lab: Microbiology/7677

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red top/SST tube

Reference Range: Negative

 

Influenza A, B, Viral Isolation

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Viral swab, throat washing, transtracheal aspirate, pleural fluid. Collect

throat swab on patients with upper respiratory symptoms. Postmortem: lung

Reference Range: Sent with report

 

INR

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Blue top tube.  The specimen volume must be at least 90% of expected fill,

but not more than 100% of expected fill.  Fill to the level indicated by the black line

on the collection tube.

Reference Range: Coumadin Therapy 2.0 - 3.0 Heart valve replacement 2.5 - 3.5

 

Insulin, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube; Bring to Shipping STAT

Reference Range: Sent with report

 

Insulin Antibodies (Bovine and Porcine) Serum or Plasma

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST; Bring to Shipping STAT

Reference Range: See Lab Report

 

Iron

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: MALE: 76-198 MCG/DL; FEMALE: 26-170 MCG/DL

 

Isopropyl Alcohol

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1-7 ML gray top (Unopened), Do not prepare venipuncture with alcohol

Reference Range: See Lab Report

 

17-Ketosteroids, total (17-KS)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, needs preservative from lab (10g Boric Acid)

Reference Range: Sent with report

 

K

 

Kleihauer-Betke (Fetal Maternal Hemorrhage)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Lavender Top

Reference Range: Sent with report

 

KOH Preparation

Lab: Microbiology/7677

Request Form: Micro 2 (SF 554)

Specimen: Physician should collect scrapings adequate to put in sterile container.

Reference Range: No fungal elements identified

 

L

 

Lactic Acid

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Grey top tube, draw without tourniquet, put on ice, bring to Chemistry STAT within 30 minutes.

Reference Range: 0.5-2.2 MMOL/L

 

Lactate Acid Dehydrogenase (LDH)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube, draw without tourniquet, put on ice, bring to Lab STAT.

Reference Range: 96-176 IU/L

 

Lactate Acid Dehydrogenase Isoenzymes #1

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red Top Tube

Reference Range: 25-70 IU/L

 

LAP (Leukocyte Alkaline Phosphates)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 2 green top tubes (heparin); Bring to Shipping STAT

Reference Range: Sent with report

 

Lead (Graphite Farnace AA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Royal blue (metal free/heparin)

Reference Range: See Lab Report

 

Lead (OSHA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Lavender top tube

Reference Range: See Lab Report

 

Lead Urine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 Urine

Reference Range: See Lab Report

 

Legionella Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: < 1:64 titer

 

Leukocyte Alkaline Phosphates See LAP

 

LGV

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Librium See Benzodiazepine

 

Lidocaine (Xylocaine)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain red top tube

Reference Range: Sent with report

 

Lipase, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: 4-24 IU/DL

 

Lipid Profile

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube, patient must be fasting 12-14 hrs

Reference Range: Chol: < 200 MG/DL Trig: 38-190 MG/DL HDL: 30-85

MG/DL LDL-Chol: 50-130 MG/DL VLDL-Chol: 10-28 MG/DL

 

Lipoprotein Electrophoresis

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Sent with report

Remarks: Patient must be fasting 12-14 hours before test

 

Lithium, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: 0.5-1.5 MEQ/L

 

Liver Profile

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: ALB: 3.5-4.8 G/DL; TP: 6.0-8.0 G/DL; ALK PHOS: 37-107 IU/L; SGOT: (AST) 8-47 IU/L; SGPT: (ALT) 0-55 IU/L; LDH: 96-176 IU/L; GGT:

8-69 IU/L; TBIL: 0.0-1.5 MG/DL; DBIL: 0.0-0.6 MG/DL

 

L/S Ratio

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 5-10 ML Amniotic Fluid, Specimen must be free of blood. Protect from light. Must be tested within 4 hrs. of aspiration. Note on lab slip gestational age.

Reference Range: Sent with Report

 

Lupus Anticoagulant

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 5 ml Blue Top (90% full)

Reference Range: Sent with report

 

Luteinizing Hormone, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: MALE: 0.9-10.9 MIU/ML; FEMALE: Follicular 1.1-11.1 MIU/ML; Mid-cycle 17.5-72.9 MIU/ML; Luteal 0.4-15.1 MIU/ML; Post-menopausal

6.8-46.6 MIU/ML

 

Lyme Disease Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Lysozyme, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain red top tube, Bring to Shipping STAT

Reference Range: 4.8 - 13.0 mcg/ml

 

M

 

Magnesium, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST Tube

Reference Range: 1.5-2.3 MG/DL

 

Malaria Smear

Lab: Hematology/4-4097

Request Form: Miscellaneous (SF 557)

Specimen: Lavender Top

Reference Range: No organisms present

 

Measles Antibody Titer IgG (Rubella Titer)

Lab: Shipping/7053

Request Form: Misc.

Specimen: SST Tube

Reference Range: Sent with report

 

Mercury (HG)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Dark blue tube (metal free/heparin)

Reference Range: See Lab Report

 

Mercury, Urine (Heavy Metal Screen)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine or random collection

Reference Range: Sent with report

 

Metanephron

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, needs preservative from lab (10g Boric Acid)

Reference Range: Sent with report

 

Methsuximide See Celontin

 

Methylphenidate (Ritalin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: 5-23 ng/ml

 

Minimal Inhibitory Concentration (MIC)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Isolation plate of organism, SST Tube, By Consult: Must know all

antibiotics and all drugs patient is receiving

Reference Range: Sent with report

 

Microsomal Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Sent with report

 

Mitochondrial Antibodies

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Negative

 

Mucopolysaccharides, Urine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 10 ML random urine

Reference Range: See Lab Report

 

Multiple Sclerosis (Panel #2)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube, 3 ML CSF in 3 aliquots

Reference Range: Sent with report

 

Mumps Titer

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative: < 1.0 Index; Positive: > 1.0 Index

 

Muramidase, Serum see Lysozyme

 

Mycoplasma Pneumoniae

Lab: Microbiology/7677

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red Top Tube

Reference Range: Negative

 

Myelin Basic Protein, CSF

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 ml CSF, Bring to Shipping STAT

Reference Range: 0-4.0 ng/ml

 

N

 

NAPA

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST/Red top tube

Reference Range: 4-10 UG/ML

 

Neisseria Gonorrhoea Culture

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Body fluid discharge, pus, swab of genital lesions, urethral discharge. Thayer-Martin plate, Culturette is brought to laboratory as soon as possible for plating.

Collection: Do not collect urethral specimens until at least one hour after urinating.

Collection directly from male urethral discharge is desirable. Collect anorectal

specimens from the crypts just inside the anal ring: anoscopy useful. Prostatic fluid

yields fewer positives than does urethral culture.

Urethra: Strip the urethra toward the orifice to express exudate. Use a sterile swab to

obtain the specimen.

Vagina: Use a speculum, moistened only with warm water, not lubricant.

Obtain a specimen from the posterior vaginal vault or from the vaginal orifice if the

hymen is intact.

 

Neisseria Gonorrhoea Smear

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Smear made of discharge

Reference Range: No gram-negative diplocci seen

 

Neurontin

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: See Lab Report

 

Nitrite, Urine

Lab: Urinalysis/6614

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random clean catch urine

Reference Range: Negative

 

Norpace Level (Disopyramide)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Red Top Tube Only

Reference Range: See Lab Report

 

Nortriptyline (Elavil, Amitriptyline)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain red top tube

Reference Range: Sent with report

 

O

 

Occult Blood, Fat detection, Hemoccult

Lab: Microbiology/7677

Request Form: Parasitology SF 552

Specimen: Fresh stool

Reference Range: Negative or trace

 

OD Scan (Delta OD 450)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 5 ML amniotic fluid, must have on lab slip gestation, protect from light

Reference Range: Sent with Report

 

Opiates, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Urine

Reference Range: Negative

 

Organic Acids, Urine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 20 ML random urine

Reference Range: None detected

 

Osmolality, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 275-295 MOSM/KG

 

Osmolality, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Urine

Reference Range: 300-750 MOSM/KG

 

Ova and Parasites, Stool

Lab: Microbiology/661

Request Form: Parasitology SF 552

Specimen: Kits available from clinics, fill stool to line

Reference Range: No ova or parasites seen

 

Oxalate/Citrate, Urine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, needs preservative from lab (16 g. KBS)

Reference Range: 0-40 MG/24 HOUR

 

P

 

Packed Red Cells, Transfusion

Lab: Blood Bank/7999

Request Form: SF 518, 1 form for each unit

Specimen:  6.5 mL purple top tube, must be labeled with a TYPENEX band

 

Parainfluenza

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, acute & convalescent required

Reference Range: < 1:8 titer

 

Parathyroid Hormone (PTH)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: Sent with report

 

Pepsinogen 1

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with Report

 

Pertussis Culture

Lab: Shipping/7053

Request Form: Micro 1 (SF 553) or Miscellaneous (SF 557)

Specimen: Culturette with source. Treat as STAT. Will not survive > 4 hours

Reference Range: Sent with report

 

Pertussis, Serum (Bordetella Pertussis AB)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: < 2

 

Phenobarbital, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 15-40 MCG/ML

 

Phenylalanine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: < 4 MG/DL

 

Phenytoin (PTN) See Dilantin

 

Phosphorus, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 2.5-4.9 MG/DL

 

Phosphorus, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 hour urine

Reference Range: 0.3-1.3 G/24 HRS

 

Pinworm Preparation

Lab: Microbiology/7677

Request Form: Parasitology SF 552

Specimen: Pinworm vials/paddles are supplied

Collection: Specimen is best obtained few hours after the patient has retired or the

first thing in morning before patient has moved. Pinworms migrate from anus during periods of rest and lay eggs around anal opening. Pinworm paddle, provided through MDS, must be used.

Reference Range: No pinworms identified

 

Plague AB Titer

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Acute and Convalescent required - 14 days apart

Platelet Aggregation Test cannot be done by our reference lab, see pathologist

 

Platelet Count

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender top, mix gently

Reference Range: 130-400

 

Platelet Concentrate (Apheresis platelets) for Transfusion call Blood Bank to notify, not stocked in lab

Lab: Blood bank/7999

Request Form: One SF 518 for each dose of apheresis platelets (equivalent to 6-8 doses of random donor platelets)

Specimen: 6.5 mL purple top tube - must be labeled with a TYPENEX band

 

Polio Virus AB (Comp Fix)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Acute and Convalescent required

Reference Range: < 1:8 titer

 

Porphobilinogen, Urine (qual.)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Three serial samples of first morning void. *** Protect From Light ***

Reference Range: Negative

 

Porphyrin, Urine see Porphobilinogen, urine

 

Post Vasectomy (Semen)

Lab: Microbiology/7677

Request Form: Misc (SF 557) or FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Semen

Reference Range: 0 Sperm Seen

 

Potassium, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 3.5-5.3 MMOL/L

 

Potassium, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random or timed urine

Reference Range: 80-200 MMOL/24 HRS

 

Primidone

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red Top Tube Only

Reference Range: 5-15 MCG/ML

 

Procainamide, Serum

Lab: Chemistry/6615

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: 4-10 MCG/ML

 

Progesterone

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Prolactin, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: Male: 1.8-14.4 MIU/ML Female: 3.6-14.8 MIU/ML

 

Prostatic Acid Phosphates (PAP)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: 0-2.8 ng/ml

 

Prostatic Specific Antigen: PSA

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 0.0-4.0 NG/ML

 

Protein, Body Fluid

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Body fluid, i.e. pleural, synovial

Reference Range: No reference ranges available.

 

Protein, Bence-Jones

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 HOUR urine

Reference Range: Sent with report

 

Protein C

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 7 ml blue top; Bring to Shipping STAT

Reference Range: 70-140%

 

Protein, Cerebrospinal Fluid

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: CSF

Reference Range: Infant, < 1 month: 20-70 MG/DL Adult: 20-70 MG/DL

 

Protein Electrophoresis (SPEP)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Protein S

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Blue Top (Citrate), Bring to Shipping STAT

Reference Range: See Lab Report

 

Protein, Screening, Urine

Lab: Urinalysis/6614

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Urine

Reference Range: Negative

 

Protein, Total, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 6.0-8.0 G/DL

 

Prothrombin Time (PT)

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Blue top tube.  The specimen volume must be at least 90% of expected fill,

but not more than 100% of expected fill.  Fill to the level indicated by the black line

on the collection tube.

Collection: Routine venipuncture. If multiple tests are being drawn, draw coagulation

studies last. 

Reference Range: Approximately 9 - 12 seconds. Established and rechecked

periodically and sent with report.

 

Protoporphyrin Zinc (ZPP)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 7 ML lavender top, protect form light

Reference Range: < 35 MCG/DL

 

Pyridoxal Phosphate (Vitamin B 6, plasma)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Lavender top tube, protect from light, Bring to Shipping STAT

Reference Range: 3.6-22.0 ng/ml

 

Pyruvate Kinase Screen

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Call lab for specific instructions, or have lab draw blood

Reference Range: Sent with report

 

Q

 

Quinidine, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 2-5 MCG/ML

 

R

 

Rabies Titer

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST Tube

Reference Range: Sent with report

 

RBC Folate

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Lavender Top Tube, protect from light

Reference Range: > 145 ng/ml cells

 

Red Blood Cells for Transfusion - See packed Red cells

 

Reducing Substance (Clinitest)

Lab: Urinalysis/6614

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random clean catch urine

Reference Range: Negative

 

Renin (Angiotensin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Pre-chilled EDTA tube, Bring to Shipping STAT

Reference Range: See Lab Report

 

Respiratory Syncytial Virus (RSV)

Lab: Microbiology/7677

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Transtracheal nasal aspirate placed in viral transport vial

Reference Range: Negative

 

Reticulocyte Count

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender top tube

Reference Range: See Lab Report

 

 

Rheumatoid Factor

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: < 20

 

Rh Immune Globulin, (Rhogam - Rh Negative Patient) ABO/Rh and antibody screen must also be requested 

Lab: Blood Bank/7999

Request Form: SF 556

Specimen: Purple top tube

 

Rh Typing - See ABO/Rh

 

Ritalin (Methylphenidate)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain red top tube

Reference Range: 5-23 ng/ml

 

Rocky Mountain Spotted Fever

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, acute & convalescent recommended. Convalescent not required.

Reference Range: Sent with report

 

Rotavirus

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1 Gram stool or rectal swab, Bring to Shipping STAT

Reference Range: Negative

 

RPR

Lab: Microbiology/7677

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red top/SST

Reference Range: Nonreactive

 

Rubella Screen

Lab: Microbiology/7677

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Red top/SST

Reference Range: Immune or not immune

 

Rubella Titer, IgG

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Acute and convalescent required; Draw conv. 14-21 days after acute.

Reference Range: Sent with report

 

S

 

Salicylate

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: Therapeutic: 15-30 MG/ML Toxic: > 30 MG/DL

 

Salmonella Enteritidis

Lab: Microbiology/7677

Request Form: Micro 1 (SF 553) or Miscellaneous (SF 557)

Specimen: Stool

Reference Range: Negative

 

Semen Analysis

Lab: Microbiology/7677

Request Form: Miscellaneous (SF 557)

Specimen: Fertility purposes needs appointment made through laboratory

Reference Range: 50-150 million for fertility

 

Serum Aspartate Aminotransferase (AST, GOT, SGOT)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 8-42 IU/L

 

Serum Alanine Aminotransferase Reagent (GPT)

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 0-55 IU/L

 

Sickle Cell Preparation

Lab: Hematology/4-4097

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Lavender top

Reference Range: Negative

 

Sinequen Level See Doxepin

 

Smooth Muscle Antibody

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Sodium, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 hour urine

Reference Range: 80-200 MMOL/24 hrs

 

Sodium, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 135-145 MMOL/L

 

Somatocedin C

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: 123-463 ng/ml

 

Specific Gravity, Urine

Lab: Urinalysis/6614

Request Form: Miscellaneous (SF 557)

Specimen: Random or timed urine

Reference Range: 1.002-1.035

 

Spinal Fluid (Histology)

Lab: Histology/7308

Request Form: SF 541

Specimen: 1-2 ML spinal fluid (No fixative) BRING TO SHIPPING STAT

 

Sputum Culture, routine

Lab: Microbiology/7677

Request Form: 2-SF 553, one for gram stain

Specimen: Sputum, first morning specimen preferred

Collection: The patient should be instructed to brush his/her teeth and rinse well with

water before attempting to collect the specimen to reduce the possibility of

contamination. After the specimen has been collected, cap the cup. Specimen MUST

be properly labeled and accompanied by properly completed Microbiology slip.

 

Stool Culture Routine/Campylobacter/E. Coli 0157.H7

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Rectal swab, fresh random stool

Reference Range: Negative for Salmonella, Shigella, Campylobacter, and E. Coli

0157.H7

 

Stone Risk Analysis

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 24 hour urine, urine collection kits with instructions are provided by lab.

Reference Range: Sent with report

 

Sweat Chloride - Test scheduled through Pathology Secretary, call 6-7303 for instructions.

 

T

 

Tay-Sachs Screen (Hexosaminidase A)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: Sent with report

 

Testosterone, Serum

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

THAT Antibody (Anti-Thyroid Antibody)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Negative

 

Theophylline, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 10-20 MCG/ML

 

Throat Culture, Candida albicans

Lab: Microbiology/7677

Request Form: Microbiology II SF 554 or Misc.

Specimen: Throat swab, swab all suspicious lesions

Reference Range: No growth Candida albicans

 

Throat Culture, Neisseria gonorrhoea

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Throat swab, eye swab, or rectal

Collection: Specimen must be delivered to the lab within 2 hours of collection.

Must not be refrigerated. Both tonsillar pillars and oropharynx should be swabbed.

Reference Range: No Neisseria gonorrhoea isolated

 

Throat Culture, Routine

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Throat swab

Collection: Depress tongue and rub swab vigorously over each tonsillar area and

posterior pharynx. Any exudate should be touched and care taken to avoid the tongue

and uvula. Place in Culturette, crush ampule to ensure proper preservation.

Reference Range: Negative for group A beta-hemolytic streptococci

 

Thyroglobulin Antibody (TGA)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Thyroid Stimulating Hormone, TSH, ultrasensitive TSH

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 0.38-6.10 uIU/ML

 

Thyroxine T4 See Free T4

 

Thyroxin Binding Globulin (TBG)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Tissue exam: See Anatomic Pathology SOP

 

Tobramycin

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Plain Red Top Tube

Reference Range: See Lab Report

 

Tofranil See Imipramine

 

Torch Screen (Includes: Toxoplasma IgM, Rubella IgM, CMV, Herpes, IgG I & II)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: See Lab Report

 

Total T3

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST, Put in comments any THY medications

Reference Range: 80-200 NG/DL

 

Toxicology, Drug Screen, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random urine

Reference Range: Negative

 

Transferrin

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 230-430 MG/DL

 

Transfusion Reaction Work-up

Lab: Blood Bank/7999

Request Form: Transfusion Reaction Report form (MCXE FORM LAB 40-2b MAY, 2002)

Specimen: Red top tube, purple top tube, first voided urine

Reference Range: No evidence of hemolytic incompatibility

 

Triglyceride

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST, patient must be fasting

Reference Range: 38-190 MG/DL

 

Trypsin, Stool (Chymotrypsin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 10 g Stool, Bring to Shipping STAT

Reference Range: Sent with report

 

Tularemia

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Sent with report

 

Type and Crossmatch

Lab: Blood Bank/7999

Request Form: SF 518, one form for each unit.

Specimen:  6.5 mL purple top tube - must be labeled with a TYPENEX band

 

Type and Screen

Lab: Blood Bank/7999

Request Form: SF 518, one form for each unit.

Specimen: 6.5 mL purple top tube - must be labeled with a TYPENEX band

 

Tyrosine

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Green top tube (heparin), Bring to Shipping STAT, fasting required

Reference Range: 0.9-2.9 MG/DL

 

U

 

Umbilical Culture

Lab: Microbiology/7677

Request Form: SF 553

Collection: Cleanse site with soap and water; scrub with an alcohol swab and let dry,

then swab the cord stump or cut edge

Reference Range: No growth

 

Urea Nitrogen, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 5-25 MG/DL

 

Urea Nitrogen, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 hour urine

Reference Range: 15-24 G/24hrs

 

Uric Acid, Serum

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: MALES: 3.9-7.8 MG/DL FEMALES: 2.4-5.1 MG/DL

 

Uric Acid, Urine

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: 24 Urine

Reference Range: 250-750 MG/24 HRS

 

Urinalysis

Lab: Urinalysis/6614

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Random or Cath urine. When Cath is submitted, indicate on slip.

Reference Range: Sent with report

Collection Procedure: Thoroughly instruct patient for proper collection of

"Clean Catch" specimen. Wash hands thoroughly, wash penis or vulva using

downward strokes 4 times with 4 soapy sponges, then once with sponge wet with warm

water. Urethral meatus and perineum must be washed. Each sponge must be discarded

after one use. Urinate about 30ml (one ounce) directly into toilet or bedpan and then

stop; position container and take middle portion of urine sample. Screw cap securely

on container without touching inside rim. Apply completed patient label to patient cup,

not lid.

 

Urine Anaerobic Culture, Suprapubic Puncture

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Suprapubic urine aspirate only

Collection: Collect specimens from the prepared site using sterile techniques

Reference Range: No growth of anaerobic bacteria

 

Urine Culture

Lab: Microbiology/7677

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: Clean Catch, Cath urine. Early morning specimens are the best

Collection: No growth

 

Urobilinogen Screen, Qualitative

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 50 ML random urine, protect from light

Reference Range: Sent with Report

 

V

 

Vaginal Cuff Culture

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Postoperative vaginal cuff specimen

Collection: Contamination with normal flora from skin, rectum, vaginal tract or other

body surfaces should be avoided

Reference Range: Normal Flora

 

Valium See Diazepam

 

Valproic Acid

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: 50-100 MCG/ML

 

Vancomycin

Lab: Chemistry/6615

Request Form: FC MEDDAC Form 119 (Lab Requisition Form)

Specimen: SST

Reference Range: TROUGH: 5-10 MCG/ML PEAK: 30-40 MCG/ML

 

Varicella IgG (Chicken Pox)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST

Reference Range: Immune or Non-Immune

 

VDRL, CSF

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: 1.0 ml CSF

Reference Range: Nonreactive

 

Viral Culture

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Swab area where active lesion is with viral culturette, advise if pregnant.

Reference Range: Sent with report

 

Vitamin B-12 (Cobalamin)

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Protect from light

Reference Range: See Lab Report

 

Vitamin D, 1,25

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: 12-40 pg/ml

 

Vitamin E

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, Bring to Shipping STAT

Reference Range: 0.5-2.0 mg/dl

 

VMA Vanilyl Mandelic Acid

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: Patient should be off meds for 72 hrs, list meds on lab slip. Needs preservative. 24 hour urine diet restrictions: pineapples, bananas, eggplant, kiwi fruit,

plums, walnuts, tomatoes, and grapefruit.

Reference Range: Sent with report

 

W

 

Watson Schartz Screen: See Porphobilinogen

 

Wound Culture

Lab: Microbiology/7677

Request Form: SF 553

Specimen: Pus or other material properly obtained from a wound site or abscess

Reference Range: No Growth

 

X

 

Xylocaine See Lidocaine

 

Y

 

Yellow Fever

Lab: Shipping/7053

Request Form: Miscellaneous (SF 557)

Specimen: SST, acute and conv. required

Reference Range: Sent with report

 

Z

 

ZZP- ZNPP see Protoporphyrin zinc

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