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Activated Partial Thromboplastin Time 037

Component

Activated Partial Thromboplastin Time

Specimen/Stability

Full Plasma Citrated Blue Tube
Room Temp.- 24 Hrs
Frozen (-20°C)- 2 weeks
Note: Specimen will be discarded after 7 days of storage.

Collection notes

1. Draw blood into a buffered citrate collection tube (light blue top)filled to proper level. Do not overfill.
2. The blood-to-coagulant ratio should be 9:1; inadequate filling of the collection device will decrease this ratio and may lead to inaccurate results.
3. Invert gently to mix
4. Keep sample at room temperature.

Clinical Utility

This test measures the integrity of intrinsic and common pathway and monitoring heparin therapy.

Reference Range

25.0 – 35.0 seconds

Critical Results

> 60.0 seconds

Schedule

Sunday-Friday

Reported

Same day

AFP
See Alpha-Fetoprotein Tumor Marker, #197
Albumin 101

Component

Albumin

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 days, Refrigerated – 30 Days
Note: Specimen will be discarded after 14 days of storage.

Collection notes

1 mL serum separated within 1 hr of collection; avoid hemolysis.

Clinical Utility

Serum Albumin is used for the diagnosis of numerous diseases. Elevated levels of Albumin could be a result of dehydration. Low levels of Albumin may be caused by kidney or liver disease, infection, or severe burns.

Reference Range

M/F3.5 – 5.7 g/dL

Schedule

Sunday-Saturday

Reported

Same day

Alkaline Phosphatase 102

Component

Alkaline Phosphatase

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

1 mL serum separated within 1 hr of collection; avoid hemolysis.

Clinical Utility

Evaluate hepatobiliary disease, bone disease associated with increased osteoblastic activity, and possible metastatic disease; detect cirrhosis, alcoholism, primary and metastatic neoplasia in liver and bone, healing infarct of heart and lung, infectious mononucleosis and many other entities. Transient elevations may be found during healing of bone fractures and the third trimester of pregnancy. Bone growth in children accounts for their alkaline phosphatase elevation.

Reference Range

34.0 – 104.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

Allergy Panel – Eastern 0223

Component

Tree

Ash,White
Box Elder
Cottonwood, Eastern
Elm, White
Hickory, Shellbark
Oak, White

Grass

Bermuda
Cocklebur
English Plantain
Lamb’s Quarters
Mugwort
Ragweed, Short
Sweet Vernal
Timothy

Dust

House
Mite (D farine)

Dander

Dog
Cat

Insect

Cockroach Mix

Mold

Alternaria
Aspergillus
Cladosporium
Penicillum

Food

Almond
Corn
Egg, White
Garlic
Milk
Orange
Peanut
Potato
Rice
Shellfish Mix
Soybean
Wheat
Yeast, Baker’s

Specimen/Stability

2 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 7 Day(s), Frozen – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Reference Range

kUA/l Clinical Implications
<0.35 Normal 0.35 - 0.70 Low Level 0.70 - 3.50 Moderate Level 3.50 - 17.50 High Level > 17.50 Very High Level

Schedule

Monday-Friday

Reported

Next day

Alpha-Fetoprotein Tumor Marker 197

Component

Alpha-Fetoprotein

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 7 Day(s), Frozen – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Monitor the course of liver or testicular cancer, patient response to treatment, and disease recurrence. Alpha-fetoprotein (AFP) is elevated in the serum of more than 70% of patients with hepatocellular carcinoma (HCC) and 70% of patients with non-seminomatous testicular carcinoma.In non-seminomatous testicular carcinoma, tumor recurrence is often accompanied by a rise in AFP. THIS TEST SHOULD NOT BE USED FOR SCREENING NEURAL TUBE AND OTHER BIRTH DEFECTS.

Reference Range

0.0 – 9.0 ng/mL

Schedule

Sunday-Saturday

Reported

Same day

ALT (SGPT) 106

Component

Alanine Transaminase (ALT)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Avoid repeated freeze-thaw cycles.

Clinical Utility

Most commonly used and most prevalent in liver disease assessment. ALT = Alanine Aminotransferase. In comparison AST (aspartate amino transferase) is present to the sane extent in heart, skeletal muscle, and liver. AST and ALT increase rapidly during the onset of viral jaundice and remain elevated for 1-2 weeks. In toxic hepatitis, ALT and AST are elevated, but LD (lactate dehydrogenase) is elevated to an even greater extent as a result of hepatic cell necrosis. ALT and AST serum activities are elevated in myocardial infarction, renal infarction, progressive muscular dystrophy, and numerous diseases that only secondarily affect the liver, such as Gaucher’s Disease, Niemann-Pick disease, infectious mononucleosis, myelocytic leukemia, diabetic ketacidosis, and hyperthyroidism.

Reference Range

7.0 – 52.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

Amylase 105

Component

Amylase

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis.

Clinical Utility

Amylases are enzymes that degrade complex carbohydrate molecules into smaller components. Amylase is produced by the exocrine pancreas and the salivary glands to aid in the digestion of starch. It is also found in the liver and in the lining of the fallopian tubes. Amylase is increased in serum and urine of patients suffering from pancreatitis. In acute pancreatitis a transient rise in serum amylase activity occurs within 2 to 12 hours of the onset; levels return to normal by the third or fourth day. The magnitude of elevation of serum enzyme activity is not related to the severity of pancreatic involvement; however, the greater the rise, the greater the probability of acute pancreatitis.

Reference Range

29.0 – 103.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

ANA Screen 301

Component

Antinuclear Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Screening test for the detection of antibodies to nuclear antigens.Over 96% of patients with systemic lupus erythematosus (SLE) have values above 7.5 IU/mL.Less that 3-4% of healthy patients display ANA concentrations of 7.5 IU/mL or higer. For specific antibodies associated with SLE and other autoimmune diseases, Specialty offers ANALyzer without ANA.

Reference Range

Negative

Schedule

Monday-Saturday

Reported

Same day

Apoliproprotein A1 354

Component

Apoliproprotein A1

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 1 Month(s), Frozen – 1 Year
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Apolipoprotein A1 is the primary protein associated with HDL cholesterol. Like HDL cholesterol, increased concentrations are associated with reduced risk of cardiovascular disease.

Reference Range

100 – 200 mg/dL

Schedule

Monday-Saturday

Reported

Same day

Apoliproprotein B 355

Component

Apoliproprotein B

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 1 Month(s), Frozen – 1 Year
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Apolipoprotein B (APO B) has been reported to be a powerful indicator of CAD. In some patients with CAD, APO B is elevated even in the presence of normal LDL cholesterol.

Reference Range

50 – 155 mg/dL

Schedule

Monday-Saturday

Reported

Same day

APTT 037
See Activated Partial Thromboplastin Time, #037.
AST (SGOT) 107

Component

Aspartate Aminotransferase (AST)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Avoid repeated freeze-thaw cycles.

Clinical Utility

Serum AST is one group of enzymes which catalyzes the interconversion of amino acids and keto acids by transfer of amino groups. Transaminases are widely distributed in body tissues with significant amounts found in the heart and liver. Lesser amounts are also found in skeletal muscles, kidneys, pancreas, spleen, lungs and brain. Injury to these tissues result in the release of the AST enzyme to general circulation.

Reference Range

13.0 – 39.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

Beta-HCG (Pregnancy) 147

Component

Beta-HCG, Total (Pregnancy)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Avoid repeated freeze-thaw cycles.

Clinical Utility

Primarily used for the confirmation of pregnancy. Urine hCG tests usually suffice for diagnosis of normal pregnancy when it has progressed beyond the first week after the first missed period. However, qualitative serum pregnancy tests can detect pregnancy earlier, and quantitative serum tests have advantages for prognosis of early pregnancy. Detectable amounts of hCG (approx. 5 IU/L) are present 8 to 11 days after conception, which is the 3rd week of pregnancy as measured from the last menstrual period. The peak of immunological hCG start to decline at about 8 to 10 weeks and is about 100,000 IU/L/Subsequently concentrations of hCG start to decline slowly in urine and or abnormal intrauterine pregnancies. hCG levels can range from 0 to 200,000 IU/L with a geometric mean of about 1000 IU/L. In about 1% of patients with ectopic pregnancy, the hCG is undetectable using serum tests capable of measuring as little as little as 5 IU/L.

Reference Range

Female: < 5.0 mIU/mL

Schedule

Sunday-Saturday

Reported

Same day

Bicarbonate 130

Component

Bicarbonate

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

To avoid loss of bicarbonate do NOT aliquot the specimen. Submit a spun SST for analysis.

Clinical Utility

Alterations of bicarbonate and carbon dioxide dissolved in plasma are characteristic of acid-base imbalance. Bicarbonate ions make up all but about 2 mmol/L of the total carbon dioxide of plasma. Total carbon dioxide in plasma is in physical solution, bound loosely to amine groups in proteins, as bicarbonate or other undissociated bicarbonates and carbonates as well as carbonic acid. When acid-base imbalance is suspected, evaluation of blood gases and pH is required to provide a definitive picture of the overall pattern of imbalances.

Reference Range

21.0 – 31.0 mmol/L

Critical Result

< 10 mmol/L > 40 mmol/L

Schedule

Sunday-Saturday

Reported

Same day

Bilirubin Direct 113

Component

Bilirubin Direct

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

To avoid loss of Bilirubin wrap the specimen in aluminum foil. Submit a spun SST for analysis.

Clinical Utility

While total bilirubin provides a total amount of both conjugated (direct) and unconjugated (indirect) bilirubin, bilirubin fractionation provides more information concerning which form is primarily responsible for the increase. The most commonly occurring form of unconjugated bilrubinemia is seen in newborns. This is due to the premature breakdown of erythrocytes and ineffective erythropoiesis in the absence of any liver abnormality. In the genetic diseases Crigler Najjar syndrome and Gilbert’s syndrome, bilirubin cannot be conjugated at the normal rate, causing increases in unconjugated bilirubin. Conversely, plasma concentrations of conjugated bilirubin increase to abnormal values when any portion of the biliary tree becomes blocked or abnormally permeable, retarding the passage of bilirubin and all other components of bile.

Reference Range

0.0 – 0.2 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Bilirubin Total 129

Component

Bilirubin Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

To avoid loss of Bilirubin wrap the specimen in aluminum foil. Submit a spun SST for analysis.

Clinical Utility

Measurements of the level of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gallbladder obstruction. The assessment of direct biluirubin is helpful in the differentiation of hepatic disorder. The increase in total bilirubin associated with obstructive jaundice is primarily due to the direct (conjugated) fraction. Both direct and indirect bilirubins are increased in the serum with hepatitis. In the newborn patient with hemolytic jaundice and neonatal jaundice, the increase in the total bilirubin is primarily due to the indirect (unconjugated) bilirubin fraction. This jaundice may be caused by Rh, ABO, or other blood group incompatibilities, by hepatic immaturity, or by hereditary defects in bilirubin conjugation.

Reference Range

0.3 – 1.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

BUN 136

Component

Urea Nitrogen

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Avoid repeated freeze-thaw cycles.

Clinical Utility

Most commonly used and most prevalent in liver disease assessment. ALT = Alanine Aminotransferase. In comparison AST (aspartate amino transferase) is present to the sane extent in heart, skeletal muscle, and liver. AST and ALT increase rapidly during the onset of viral jaundice and remain elevated for 1-2 weeks.I n toxic hepatitis, ALT and AST are elevated, but LD (lactate dehydrogenase) is elevated to an even greater extent as a result of hepatic cell necrosis. ALT and AST serum activities are elevated in myocardial infarction, renal infarction, progressive muscular dystrophy, and numerous diseases that only secondarily affect the liver, such as Gaucher’s Disease, Niemann-Pick disease, infectious mononucleosis, myelocytic leukemia, diabetic ketacidosis, and hyperthyroidism.

Reference Range

7.0 – 25.0 mg/dL

Critical Result

> 90 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

C-Reactive Protein, High Sensitivity (Inflammation) 1536

Component

C-Reactive Protein High Sensitivity

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Lipemic, icteric, or hemolyzed samples are not suitable for analysis.

Clinical Utility

CRP is an acute reactant, which can be used as a general screening aid for inflammatory diseases, infections, and neoplastic diseases. In addition to its usual value as an acute phase reactant, CRP in large concentration (>5.0 mg/L) predicts progression of erosions in rheumatoid arthritis. Elevated serum CRP is characteristic of bacterial, but not viral, meningitis or meningoencephalitis. It may be useful in monitoring the clinical course of these illnesses. CRP concentrations characteristically return to normal after 7 days of appropriate treatment or bacterial meningitis if no complications develop.Serial monitoring of serum and CSF CRP concentrations may be useful clinically.

Reference Range

< 1.0 mg/L

Schedule

Monday-Saturday

Reported

Same day

CA 125 684

Component

CA 125

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Monitor the course of ovarian cancer, patient response to treatment, and disease recurrence. Serum CA 125 concentrations are elevated in about 80% of women with carcinoma of the ovary, 26% of women with benign ovarian tumors and 66% of women with non-neoplastic conditions, but in only 3% of normal healthy women. CA 125 should not be used alone to diagnose or screen for cancer, but it is useful for monitoring patients with an established diagnosis of a gynecological malignancy that is associated with elevated CA 125 at diagnosis.

Reference Range

0.6 – 35.0 U/mL

Schedule

Sunday-Saturday

Reported

Same day

CA 15-3 529

Component

CA 15-3

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Elevated serum CA 15-3 concentrations are found in 5% of stage I, 29% of stage II, 32% of stage III, and 95% of stage IV carcinoma of the breast. Most (96%) patients with a CA 15-3 increase of greater than 25% have disease progression. Most (nearly 100%) patients with a CA 15-3 decrease of greater than 50% are responding to treatment.

Reference Range

1.0 – 25.0 U/mL

Schedule

Sunday-Saturday

Reported

Same day

CA 19-9 284

Component

CA 19-9

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Useful for monitoring gastrointestinal, pancreatic, liver, and colorectal malignancies.

Reference Range

0.0 – 35.0 U/mL

Schedule

Sunday-Saturday

Reported

Next day

Calcium 103

Component

Calcium (Ionized)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Use only SST for collection. Centrifuge after clotting. Do not remove stopper or expose to air. Ambient or refrigerated only. Frozen or aliquoted specimens are not acceptable.

Clinical Utility

Evaluate nonbound calcium, calcium metabolism, physiologically active calcium fraction, hyperparathyroidism, ectopic hyperparathyroidism. Occasionally useful when hypercalcemia coexists with abnormal protein state such as myeloma. Useful in assessing active calcium fraction in hypoproteinemia and acidosis when calcium is low. Used in evaluation of PTH assay results.

Reference Range

8.6 – 10.3 mg/dL

Critical Result

< 7.0 mg/dL > 13.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

CEA 383

Component

CEA

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage

Collection notes

Use only SST for collection. Centrifuge after clotting. Do not remove stopper or expose to air.

Clinical Utility

Carcinoembryonic antigen (CEA) monitors the course of adenocarcinoma of the lung, patient response to treatment, and disease recurrence. CEA has broad tumor specificity; CEA elevation is seen in cancers of the colon, rectum, stomach, breast, lung, pancreas, etc.

Reference Range

0 – 3.0 ng/mL

Schedule

Sunday-Saturday

Reported

Same day

Chemistry Panel
See Metabolic Panel Basic and Comprehensive, #11 and #12
Chloride 135

Component

Chloride

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage

Collection notes

Use only SST for collection. Centrifuge after clotting. Do not remove stopper or expose to air.

Clinical Utility

Serum chloride is the major extracellular anion and counter-balances the major cation, sodium, maintaining electrochemical neutrality of the body fluids. Two thirds of the total anion concentration in extracellular fluids is chloride and it is significantly involved in maintaining proper hydration and osmotic pressure. Movement of chloride ions across the red blood cell membrane is essential for the transport of bicarbonate ions in response to chaning concentrations of carbon dioxide. Chloride measurements aid in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.

Reference Range

98.0 – 107.0 mmol/L

Critical Value

< 80.0 mmol/L | > 115.0 mmol/L

Schedule

Sunday-Saturday

Reported

Same day

Cholesterol Evaluation 38

Component

Reference Range

Triglycerides M/F: < 150.0 mg/dL Cholesterol, Total M/F: < 200.0 mg/dL HDL-C M: > 35.0 mg/dL F: > 45.0 mg/dL
LDL-C (calc) M/F: 0.0 – 130.0 mg/dL
Cholesterol/HDL-C Ratio M: 0.0 – 4.97 mg/dL F: 0.0 – 4.44 mg/dL
VLDL M/F: 0.0 – 38.0 mg/dL

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Patient should be fasting 10-16 hrs to collection of specimen. State patient’s age and gender on test requisition form.

Schedule

Sunday-Saturday

Reported

Same day

Complete Blood Count + Diff 20

Component

Reference Range

Critical Range
WBC M/F: 3.8 – 10.5 10^3/uL< 2.0 10^3/uL | >30.0 10^3/uL
RBC Total Count M: 4.2 – 5.8 10^6/uL< 2.0 10^6/uL | > 8.0 10^6/uL
F: 3.8 – 5.2 10^6/uL< 2.0 10^6/uL | > 8.0 10^6/uL
Hemoglobin M: 3.0 – 17.0 g/dL< 7.1 g/dL | > 21.9 g/dLF: 11.5 – 15.5 g/dL< 7.1 g/dL | > 21.9 g/dL
Hematocrit M: 13.0 – 17.0 g/dL< 7.1 g/dL | > 21.9 g/dLF: 11.5 – 15.5 g/dL< 7.1 g/dL | > 21.9 g/dL
MCV M: 80.0 – 94.0 fl
F: 80.0 – 90.0 fl
MCH M/F: 23.0 – 53.0 pg
MCHC M/F: 32.0 – 36.0 g/dL
RDW M/F: 11.5 – 15.5 %
Platelet Count M/F: 150.0 – 400 10^3uL <50.0 10^3uL | > 800 10^3uL
MPV M/F: 7.4 – 10.4 fl
Segmented Neutrophils % M/F: 40.0 – 75.0 %
Segmented Neutrophils # M/F: 1.80 – 7.40 10^3uL
Lymphocytes % M/F: 13.0 – 44.0 %
Lymphocytes # M/F: 1.0 – 3.0 10^3uL
Monocytes % M/F: 2.0 – 11.0 %
Monocytes # M/F: 0.0 – 0.9 10^3uL
Eosinophils % M/F: 0.0 – 6.0 %
Eosinophils # M/F: 0.0 – 0.5 10^3uL
Basophils % M/F: 0.0 – 2.0 %
Basophils # M/F:0.0 – 0.2 10^3uL
RBC Morphology

Specimen/Stability

4 mL Whole Blood EDTA; Lavender Tube
Ambient – 14 Hour(s), Refrigerated – 24 Hour(s)

Clinical Utility

Evaluate anemia, leukemia, reaction to inflammation and infections, peripheral blood cellular characteristics.

Schedule

Sunday-Saturday

Reported

Same day

Cortisol (Serum) 141

Component

Cortisol

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage

Collection notes

Acetic and boric acid are acceptable additives. Add 12.5 mL of 50% acetic acid or 5 g of boric acid at the start of a 24 hour collection. Measure the total volume, mix the specimen and transfer the aliquot to a clean, leak proof screw cap tube. Record the total volume on specimen container and requisition form.

Clinical Utility

Asses adrenal function; particularly useful in the diagnosis of Cushing syndrome. Recent data suggest that urinary free cortisol concentrations can be significantly altered in patients taking inhaled corticosteroids.

Reference Range

6.7 – 22.6 ug/dL

Schedule

Monday, Wednesday, Friday

Reported

Next day

Creatinine 112

Component

Creatinine

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Icteric samples are not acceptable.

Clinical Utility

Total creatine kinase is made up of the various isoenzyme components (CK-MM, CK-MB, and CK-BB). Increases in any one or more of these three isoenzymes will contribute to an increase in total creatine kinase. If total creatine kinase is elevated, consider running CK Isoenzymes to determine which component is elevated and also Troponin I, to rule out cardiac muscle injury, for clinical relevance of each isoenzymes.

Reference Range

0.6 – 1.3 mg/dL

Critical Value

> 10.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Creatine Kinase 110

Component

Creatine Kinase Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Icteric samples are not acceptable.

Clinical Utility

Total creatine kinase is made up of the various isoenzyme components (CK-MM, CK-MB, and CK-BB). Increases in any one or more of these three isoenzymes will contribute to an increase in total creatine kinase. If total creatine kinase is elevated, consider running CK Isoenzymes to determine which component is elevated and also Troponin I, to rule out cardiac muscle injury, for clinical relevance of each isoenzymes.

Reference Range

30.0 – 223.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

HSCRP
See C-Reactive Protein High Sensitivity, #1536.
Digoxin 148

Component

Digoxin

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

The test to measure digoxin is ordered at the beginning of drug therapy to ensure correct dosage. Digoxin takes approximately one to two weeks to reach a steady level in the blood and in the target organ, the heart. A test done at that time will reflect more accurately whether a person is receiving the right amount of digoxin.

Reference Range

0.8 – 2.0 ng/mL

Schedule

Monday, Wednesday, Friday

Reported

Next day

Dilantin
See Phenytoin, Free, #151
Drug of Abuse Screen Urine 33

Component

Opiates
Cocaine Metabolites
Benzodiazepines
Cannabinoids
Amphetamines
Barbiturates
Methadone
Phencyclidine

Specimen/Stability

1 mL Urine; Sterile Urine Container
Ambient – 7 Day(s), Frozen – 30 Day(s)

Clinical Utility

Screening for drug use

Reference Range

Negative

Schedule

Tuesday, Thursday, Saturday

Reported

Same day

ESR (Erythrocyte Sedimentation Rate) 246

Component

ESR

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Lipemic, icteric, or hemolyzed samples are not suitable for analysis.

Clinical Utility

ESR is an acute reactant, which can be used as a general screening aid for inflammatory diseases, infections, and neoplastic diseases. In addition to its usual value as an acute phase reactant, ESR in large concentration (>5.0 mg/L) predicts progression of erosions in rheumatoid arthritis. Elevated ESR is characteristic of bacterial, but not viral, meningitis or meningoencephalitis.It may be useful in monitoring the clinical course of these illnesses. ESR concentrations characteristically return to normal after 7 days of appropriate treatment or bacterial meningitis if no complications develop.

Reference Range

M: 0.0 – 15.0 mm/Hour
F: 0.0 – 20.0 mm/Hour

Schedule

Monday-Saturday

Reported

Same day

Estradiol 185

Component

Estradiol

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Assess hypothalamic and pituitary function; assess ovarian failure and follicular maturation. In males, E2 measurements may be helpful in the assessment of unexplained gynecomastia. In females, E2 measurements are frequently utilized to document hypoestrogenism in cases of delayed puberty, primary and secondary amenorrhea, and menopause. Monitor ovulation induction to stimulate follicle development in patients being treated for infertility. Serum estradiol levels are performed to correlate the number and maturity of the stimulated follicles and to avoid over stimulation.

Reference Range

M: 7.63 – 42.6 pg/mL
F: 12.5 – 166.0 pg/mL

Schedule

Sunday-Saturday

Reported

Same day

Ferritin 115

Component

Ferritin

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Evaluate microcytic anemia, iron storage diseases, iron metabolism disease. Useful for the differential diagnosis of anemia of chronic disease (ACD) versus iron deficiency anemia.

Reference Range

M: 23.9 – 336.2 ng/mL
F: 11.0 – 306.8 ng/mL

Schedule

Sunday-Saturday

Reported

Same day

Folate 163

Component

Folate

Specimen/Stability

2 (1) mL Serum Separator Tube
Refrigerated – 48 Hour(s), Frozen – 2 Month(s)

Clinical Utility

Most useful when ordered with vitamin B12 and red cell folic acid; detect folate deficiency; monitor therapy with folate; evaluate megaloblastic and microcytic anemia. In mild folate and vitamin B12 deficiencies, serum folate and serum vitamin B12 can be normal. Homocysteine and methylmalonic acid are more sensitive indicators of mild deficiencies of these vitamins.

Reference Range

> 6.59 ng/mL

Schedule

Sunday-Saturday

Reported

Same day

Follicle-Stimulating Hormone 139

Component

Follicle-Stimulating Hormone

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Excessive Follicle-Stimulating Hormone (FSH) in hypogonadism indicated gonadal insufficiency. Pituitary function test, useful to distinguish primary gonadal failure from secondary (hypothalamic/pituitary) causes of menstrual disturbances and amenorrhea. Inadequate corpora lutea are related to low FSH levels. Useful in defining menstrual cycle phases in infertility evaluation of women and testicular dysfunction in men.

Reference Range

M: 1.27 – 19.26 mIU/mL
F: 3.85 – 22.51 mIU/mL

Schedule

Sunday-Saturday

Reported

Same day

Food Allergy Panel 0891

Component

Wheat IgE
Peanut IgE
Milk IgE
Shrimp IgE
Egg White IgE
Codfish IgE
Corn IgE
Sesame Seed IgE
Soybean IgE
Clam IgE
Walnut IgE
Scallop IgE

Specimen/Stability

1 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 5 Day(s), Frozen – 3 Months(s)

Clinical Utility

Screening for allergens

Reference Range

< 0.35 kUA/l

Schedule

Tuesday, Thursday, Saturday

Reported

Same day

Fructosamine 626

Component

Fructosamine

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid Hemolysis

Clinical Utility

Because the Half-life of serum proteins (average 17 days) is shorter than that of hemoglobin (average 60 days), fructosamine measurements offer the advantage of monitoring glucose status over a shorter time frame (1-3 weeks) than glycated hemoglobin (6-8 weeks).Serum fructosamine has been shown to be more sensitive than glycated hemoglobin in detecting deterioration in diabetic control after discontinuing oral hypoglycemic drugs. The fructosamine assay may be run every 2-3 weeks to monitor short-term changed in diabetic control. In addition, the fructosamine concentration determined on a single random sample provides a simple and reliable assessment of glucose homeostasis.

Reference Range

205.0 – 285.0 umol/L

Schedule

Sunday-Saturday

Reported

Same day

FSH
See Follicle-Stimulating Hormone #139
Gamma-glutamyl Transferase (GGT) 116

Component

GGT

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis.Avoid repeated freeze-thaw cycles.

Clinical Utility

GGT is useful in the evaluation of obstructive liver diseases, being more organ specific than Alkaline Phosphatase (ALP). GGT is also elevated in chronic alcoholics, when other tests are normal. Disproportionate elevation of ALP and GGT indicates drug induced cholestasis. GGT is also increased during antiepileptic therapy.

Reference Range

9.0 – 64.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

Glomerular Filtration Rate (GFR), Estimated 1325

Component

Creatinine
Glomerular Filtration Rate(calculation)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Glomerular Filtration Rate (GFR) is the index of kidney function.

Schedule

Sunday-Saturday

Reported

Same day

Glucose 117

Component

Glucose

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Serum glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of pancreatic islet cell carcinoma and of carbohydrate metabolism disorders such as diabetes mellitus, neonatal hypoglycemia and idiopathic hypoglycemia.

Reference Range

55.0 – 100.0 mg/dL

Critical Value

< 51.0 mg/dL | > 449.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

HBV
See Hepatitis B Virus Antibodies; Antigens
HCV
See Hepatitis C Virus for antibody, antigen.
Hemoglobin A1c 119

Component

Hemoglobin A1c

Specimen/Stability

0.5 mL Whole Blood EDTA; Lavender
Refrigerated – 7 Day(s)

Clinical Utility

Monitoring the long term blood glucose control in diabetic patients.

Reference Range

> 5.7%

Schedule

Monday-Saturday

Reported

Same day

Hepatic Function Panel 27

Component

Albumin
Bilirubin Total
Bilirubin Direct
Alkaline Phosphatase
Aspartate Transaminase (AST)
Alanine Transaminase (ALT)
Total Protein

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Sample must be protected from light in foil-wrap or amber tube. 1 mL serum separated within 1 hr of collection; avoid hemolysis.

Schedule

Sunday-Saturday

Reported

Same day

Hepatitis A Virus Total Antibodies 324

Component

Hepatitis A Virus Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Evaluate hepatitis A

Reference Range

Nonreactive

Schedule

Sunday-Saturday

Reported

Same day

Hepatitis Profile 0254

Component

Hepatitis A Virus Antibodies
Hepatitis B Virus Core Total Antibodies
Hepatitis B Virus Surface Antibodies
Hepatitis B Virus Surface Antigen
Hepatitis C Virus Total

Specimen/Stability

1.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

**All positive HBsAG results are confirmed by neutralization and can require up to 2 mL of additional specimen. Sample requirement must be met to prevent a QNS (Quantity Not Sufficient) result.

Schedule

Sunday-Saturday

Reported

Same day

Hepatitis B Virus Core Total Antibodies 321

Component

Hepatitis B Virus Core Total Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Used in the differential diagnosis of hepatitis B infection in conjunction with other serologic markers.

Reference Range

Nonreactive

Schedule

Sunday-Saturday

Reported

Same day

Hepatitis B Virus Surface Antigen 319

Component

Hepatitis B Virus Surface Antigens

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

**All positive HBsAG results are confirmed by neutralization and can require up to 2 mL of additional specimen. Sample requirement must be met to prevent a QNS (Quantity Not Sufficient) result.

Clinical Utility

Hepatitis B surface antigen is the earliest indicator of the presence of acute infection. Also indicative of chronic infection.

Reference Range

Nonreactive

Schedule

Sunday-Saturday

Reported

Same day

Hepatitis B Virus Surface Total Antibodies 320

Component

Hepatitis B Virus Surface Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Presence of hepatitis B surface antibody is an indicator of clinical recovery and subsequent immunity to hepatitis B virus. This test is useful for evaluation of possible immunity in individuals who are at increased risks for exposure to the hepatitis B, i.e, hemodialysis unit personnel, venipuncturists, etc. Evaluation of the need for hepatitis B immune globulin after needle stick injury. Evaluation of the need for hepatitis B vaccine, and to follow immune status after hepatitis B vaccine.

Reference Range

< 8.5 mIU/mL

Schedule

Sunday-Saturday

Reported

Next day

Hepatitis C Virus Antibodies 971

Component

Hepatitis C Virus Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Confirmatory testing by RIBA is only recommended when the MEIA screen is ‘weekly positive’ (i.e. S/CO <10.0). RIBA results are reported as positive, indeterminate or negative in this assay. Patients with positive HCV antibodies by MEIA should be evaluated with a sensitive qualitative nucleic acid test for HCV RNA (Hepatitis C Virus RNA DetectR) to rule out active infection.

Reference Range

Nonreactive

Schedule

Tuesday-Saturday

Reported

Same day

Hgb A1c
See Hemoglobin A1c, #119
Homocysteine 677

Component

Homocysteine

Specimen/Stability

2 (1) mL Serum Separator Tube
Ambient – 48 Hour(s), Refrigerated – 14 Day(s), Frozen – 2 Month(s)

Collection notes

Patient should be fasting for 12 hours overnight, prior to collection. Specimen (plasma or serum) must be centrifuged within one hour of collection. Longer storage of whole blood samples at room temperature has been found to increase Homocysteine concentration in the plasma. Serum values are expected to be higher than plasma values.Slightly higher Homocysteine values are observed in non-fasting patients.

Clinical Utility

Evaluate homocystinuria. Predictor of risk for ischemic stroke and myocardial infarction. Homocysteine is elevated in patients with cobalamin and/or folate deficiency, and is more sensitive than serum cobalamin and serum folate concentrations in diagnosing these vitamin deficiencies.

Reference Range

4.0 – 15.4 umol/L

Schedule

Sunday-Saturday

Reported

Same day

IgA 701

Component

IgA Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Evaluate humoral immunity; monitor therapy in IgA myeloma.Selective IgA deficiency has an increased association with allergies, recurrent sinopulmonary infection, autoimmune disease, and the HLA A28, B14 or A1, B14 types. IgA deficiency accompanied by a deficiency of subclass IgG2 is associated with recurrent sinopulmonary infections.

Reference Range

66.0 – 433.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

IgE 138

Component

IgE

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Immunoglobulin E (IgE) is firmly bound to mast cells and only trace amounts are normally present in serum. When antigen (allergen) cross-links two IgE molecules, the mast cell is stimulated to release histamine and other vasoactive amines.These vasoactive amines are responsible for the vascular permeability and smooth muscle contraction occurring in such allergic reactions as hay fever, asthma, urticaria, and eczema.

Reference Range

1.31 – 165.3 IU/mL

Schedule

Sunday-Saturday

Reported

Same day

IgG 703

Component

IgG Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Evaluate humoral immunity; monitor therapy in IgG myeloma; quantitate IgG; evaluate patients, especially children and those with lymphoma, with propensity to infections. In congenital hypogammaglobulinemia, the IgG is less than 200 mg/dL by 6 months of age. Acquired hypogammaglobulinemia may occur at any age and has IgG concentrations less than 500 mg/dL.IgG concentrations may also be decreased in combines cell-mediated and antibody immunodeficiencies.

Reference Range

635.0 – 1741.0 mg/dL

Schedule

Monday-Saturday

Reported

Same day

IgM 705

Component

IgM Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Evaluate humoral immunity; establish the diagnosis and monitor therapy in macroglobulinemia of Waldernstrom or plasma cell myeloma. IgM levels are used to evaluate likelihood of in utero infections or acuteness of infection.

Reference Range

45.0 – 281.0 mg/dL

Schedule

Monday-Saturday

Reported

Same day

Immunoglobulin Quantitative Profile 1045

Component

IgG Total
IgM Total
IgA Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Selective IgA deficiency characterized by IgA less than 5 mg/dL with other immunoglobulins normal or increased, is associated with allergies, recurrent sinopulmonary infection, autoimmune disease and HLA A28, B14 or A1.

Schedule

Monday-Saturday

Reported

Same day

Iron 120

Component

Iron

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Separate serum/plasma from the clot within 1 hour after collection. Morning specimen preferred.

Clinical Utility

Aid in the evaluation of a number of conditions involving red cell production and destruction, iron metabolism, or iron transport.

Reference Range

50.0 – 212.0 ug/dL

Schedule

Sunday-Saturday

Reported

Same day

Iron Binding Capacity 121

Component

Iron
Iron Binding Capacity Total
% Saturation

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Separate serum/plasma from the clot within 1 hour after collection. Morning specimen preferred.

Clinical Utility

Increased total iron binding capacity is often seen in iron deficiency states, parental iron administration, pregnancy without iron supplements, and hepatitis or hepatic necrosis. Decreased concentrations are often seen in chronic disorders, kwashiorkor, chronic iron overloading, and malignancies.

Reference Range

250.0 – 410.0 ug/dL

Schedule

Sunday-Saturday

Reported

Same day

Iron Binding Capacity Plus % Saturation 0696

Component

Iron
Iron Binding Capacity Total

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Separate serum/plasma from the clot within 1 hour after collection. Morning specimen preferred.

Clinical Utility

Increased total iron binding capacity is often seen in iron deficiency states, parental iron administration, pregnancy without iron supplements, and hepatitis or hepatic necrosis. Decreased concentrations are often seen in chronic disorders, kwashiorkor, chronic iron overloading, and malignancies.

Reference Range

M: 20.0 – 50.0 %
F: 20.0 – 55.0 %

Schedule

Sunday-Saturday

Reported

Same day

Lactate Dehydrogenase 123

Component

Lactate Dehydrogenase

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis.

Clinical Utility

Assessment of myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary embolus, malignancy, and muscular dystrophy.

Reference Range

140.0 – 271.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

LDH
See Lactate Dehydrogenase, #123
LDL, Direct 3351

Component

LDL Direct

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Use only SST for collection. Centrifuge after clotting. Do not remove stopper or expose to air. Ambient or refrigerated only. Frozen or aliquoted specimens are not acceptable. Avoid hemolysis.

Clinical Utility

LDL cholesterol is a key factor in the pathogenesis of atherosclerosis and coronary artery diseases (CAD), while HDL cholesterol has often been observed to have a protective effect. Even within the normal range of total cholesterol concentrations, an increase in LDL cholesterol can produce an associated increased risk for CAD. LDL cholesterol binds to receptor sites on macrophages in blood vessel walls, inciting several changes to the blood vessel wall, which enhance atherosclerotic plaque development.

Reference Range

0.0 – 100.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Lipase 124

Component

Lipase

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – Several Weeks
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Grossly icteric specimens will be rejected.

Reference Range

11.0 – 82.0 U/L

Schedule

Sunday-Saturday

Reported

Same day

Lithium 739

Component

Lithium

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Do not use serum separator tubes. Serum from red top tube without serum separator is acceptable. Do not use Lithium Heparin anticoagulant. The concentration of lithium in the serum varies with the time after the dose, therefore, blood for lithium determination (through values) should be collected at a standard time, preferably 8 – 12 hours after the last dose.

Reference Range

0.6 – 1.2 mmol/L

Critical Value

> 2.0 mmol/L

Schedule

Sunday-Saturday

Reported

Same day

Lyme IgG/IgM 0651

Component

Lyme IgG EIA
Lyme IgM EIA

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 7 Day(s), Frozen – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Whole-cell sonicate (WCS) Borrelia burgdorferi antigens are utilized to measure both IgM and IgG antibody responses to B. burgdorferi in human serum, using an enzyme-immunoassay methodology (EIA).

Clinical Utility

Aid in the diagnosis of infection with the Lyme disease agent.

Reference Range

< 0.8

Schedule

Monday, Wednesday, Friday

Reported

Same day

Magnesium 125

Component

Magnesium

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Use fresh, nonhemolyzed fasting serum collected by standard venipuncture technique. Separate serum from the clot immediately to avoid false elevations due to elution of magnesium from the red cells. Hemolyzed specimens are unacceptable. Draw blood using a “clean stick” technique to avoid falsely increased values due to the admixture of blood with tissue fluid.

Clinical Utility

Magnesium is a cofactor for more than 300 enzymes in the body. It is an activator of many enzyme systems, is important in oxidation phosphorylation, glycolysis, cell replication, nucleotide metabolism, and protein biosynthesis. Reducing serum magnesium levels results in increased neuromuscular excitable because magnesium inhibits the entry of calcium into neurons.

Reference Range

1.9 – 2.7 mg/dL

Critical Value

< 0.8 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Measles IgG & Antibodies 990

Component

Measles IgG Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

The Presence of measles specific-IgM or –IgG antibodies would suggest previous immunization or exposure to the measles virus. In non-immunized individuals, the detection of measles specific-IgM antibodies would suggest an acute infection or when paired acute and convalescent specimens (two to three weeks apart) are evaluated with a 4-fold or greater rise in measles specific-IgG antibodies, an acute infection is suggested. An acute infection should be corroborated with clinical presentation. Please note that results from a single IgM assay should not be used as the sole determinate of an acute infection, as IgM test results may yield positive results and low levels of IgM antibody can persist for more than 12 months post infection. If an acute infection is indicated, submit an additional specimen in two or more weeks for IgM and IgG testing.

Reference Range

< 0.9

Schedule

Sunday-Saturday

Reported

Same day

Metabolic Panel, Basic 11

Component

Sodium
Potassium
Chloride
Bicarbonate
Glucose
Urea Nitrogen
Creatinine
BUN/Creatinine Ratio
Calcium (Total)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

To avoid loss of bicarbonate, do NOT aliquot the specimen. Submit a spun SST for analysis. The patient should fast 10 – 16 hours prior to collection of specimen. State patient’s age and gender on test requisition form. Avoid hemolysis and gross lipemia.

Schedule

Sunday-Saturday

Reported

Same day

Metabolic Panel, Comprehensive 12

Component

Sodium
Potassium
Chloride
Bicarbonate
Glucose
Urea Nitrogen
Creatinine
Calcium (Total)
Total Protein
Albumin
Alkaline Phosphatase
Aspartate Transaminase (AST)
Alanine Transaminase (ALT)
Bilirubin Total
BUN/Creatinine Ratio
Globulin Total
A/G Ratio

Specimen/Stability

1 mL Serum Separator Tube
Ambient – 24 Hour(s), Refrigerated – 72 Hour(s), Frozen – 2 Month(s)

Collection notes

Sample must be protected from light in foil-wrap or amber tube. To avoid loss of bicarbonate do NOT aliquot the specimen. Submit a spun SST for analysis. The patient should fast 10 – 16 hours prior to collection of specimen. State patient’s age and gender on test requisition form.

Schedule

Sunday-Saturday

Reported

Same day

Microalbumin Urine Random 212

Component

Microalbumin Urine

Specimen/Stability

1 mL Urine; Sterilized Urine Container/Tube
Ambient – 5 Day(s), Refrigerated – 14 Day(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

After voided midstream urine collection is complete, mix the specimen and transfer a 10 mL aliquot of urine to a clean leakproof container with a screw cap. Transfer tubes are available from Enigma. Refrigerated specimen is preferred (store at 2-8 C). Ship within 24 hours of collection by overnight courier.

Clinical Utility

Microalbuminuria is used as an indicator of increased risk to develop renal disease in diabetics and as a predictor of morality due to cardiovascular disease.

Reference Range

< 20.0 mg/L

Schedule

Monday-Saturday

Reported

Same day

MMR 0396

Component

Measles IgG Antibodies
Mumps IgG Antibodies
Rubella IgG Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Schedule

Sunday-Saturday

Reported

Same day

Mumps IgG Antibodies 9650

Component

Mumps IgG Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

The presence of mumps specific-IgG antibodies would suggest previous immunization or exposure to the mumps virus. In non-immunized individuals, when paired acute and convalescent specimens (two to three weeks apart) are evaluated with a 4-fold or greater rise in mumps specific-IgG antibodies, an acute infection is suggested and should be corroborated with clinical presentation.

Reference Range

> 10.0 IU/mL

Schedule

Sunday-Saturday

Reported

Same day

Parathyroid Hormone 787

Component

Parathyroid Hormone, Intact

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

PTH-Intact measures only the biological active hormone and provides a more precise assessment of parathyroid function in patients with renal disease and those with age-related diseases of glomerular filtration. Intact PTH contains 84 amino acids with biological activity residing in the N-terminal third of the molecule. Therefore, synthetic PTH containing the first 34 amino acids has full biological activity. An inverse relationship exists between PTH secretion and free calcium, since free calcium, since free calcium in blood and intracellular fluid is the primary physiological regulator of PTH secretion. PTH influences both calcium in blood and phosphate homeostasis through actions on bone, kidney, and (indirectly) on 1,25 hydroxyvitamin D, which stimulates the intestinal absorption of both calcium and phosphate. Generally less than 5 to 25% of total immunoreactive PTH is intact hormone. The remaining 75 to 95% is inactive midregion/carboxyl fragments. In hypercalcemia, secretion of these inactive forms persist. While secretion of intact hormone is greatly reduced or absent.

Reference Range

15.0 – 65.0 pg/mL

Schedule

Sunday, Tuesday, Saturday

Reported

Same day

Phenytoin, Free 151

Component

Phenytoin Free

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Elimination half-life of Phenytoin is 7-42 hours, and steady-state levels are reached at 7-10 days after initiation of therapy.

Reference Range

10.0 – 20.0 ug/mL

Schedule

Sunday-Saturday

Reported

Same day

Phosphorus 127

Component

Phosphorus

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Use only SST for collection. Centrifuge after clotting. Do not remove stopper or expose to air. Ambient or refrigerated only. Frozen or aliquoted specimens are not acceptable.

Clinical Utility

Evaluate nonbound calcium, calcium metabolism, physiologically active calcium fraction, hyperparathyroidism, ectopic hyperparathyroidism. Occasionally useful when hypocalcaemia coexists with abnormal protein state such as myeloma. Useful in assessing active calcium fraction in hypoproteinemia and acidosis when calcium is low. Used in evaluation of PTH assay results.

Reference Range

2.5 – 5.0 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Potassium 134

Component

Potassium

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Do not allow serum/plasma to remain on the cells after centrifugation. Potassium from the red cells will diffuse into the serum, giving falsely elevated results. Gross lipemic specimens should be cleared by ultracentrifugation.

Clinical Utility

Potassium is the major intracellular cation. The concentration in erythrocytes is approximately 23 times the concentration in plasma. Decrease of extracellular potassium is characterized by muscle weakness, irritability, and paralysis; fast heart rates and specific conduction effects are apparent on electrocardiographic examination. Plasma potassium levels less than 3.0 mmol/L are associated with marked neuromuscular symptoms and evidence of a critical degree of intracellular depletion. Abnormally high extracellular potassium levels produce symptoms of mental confusion, weakness, numbness, and tingling of the extremities. The symptoms are apparently at potassium levels greater than 7.5 mmol/L; levels greater than 10.0 mmol/L are in most cases fatal.

Reference Range

3.5 – 5.1 mmol/L

Critical Value

< 3.0 mmol/L | > 5.9 mmol/L

Schedule

Sunday-Saturday

Reported

Same day

Prolactin 181

Component

Prolactin

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Collect 3-4 hours after patient has awakened

Clinical Utility

First test for work-up of galactorrhea (inappropriate lactation). Pituitary function test useful in the detection of Prolactin secreting pituitary tumors (microadenomas, macroadenomas) with or without galactorrhea, with or without structural evidence of sellar enlargement. An adult female premenopausal patient having amenorrhea and galactorrhea is highly suspect of pituitary prolactinoma and is a candidate for radiologic evaluation of the pituitary as well as serum prolactin levels. Elevated Prolactin may be associated with corpus luteum insufficiency or anovulation. Sequelae of hyperprolactinemia include amenorrhea, anovulation, and decreased bone density. Prolactin greater than 200 ng/mL in a non-pregnant woman is suggestive of a pituitary microadenoma; milder degrees of hyperprolactinemia (20-200 ng/mL) suggest compression of the pituitary stalk by a macroadenoma.

Reference Range

M: 2.64 – 13.13 ng/mL
F: 3.34 – 26.72 ng/mL

Schedule

Sunday-Saturday

Reported

Same day

Protein Electrophoresis, Serum 578

Component

Reference Range

Protein Total 6.40 – 8.30 g/dL
Albumin 3.70 – 4.70 g/dL
Alpha 0.20 – 0.40 g/dL
Alpha 0.60 – 1.00 g/dL
Beta 0.60 – 1.00 g/dL
Gamma 0.60 – 1.40 g/dL
A/G Ratio 1.00 – 2.50 ratio
Protein Electrophoresis Interpretation

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Plasma and hemolyzed serum are not suitable for analysis. Split into 2 plastic tubes.

Clinical Utility

Evaluate serum protein, nutritional status; work up liver disease, including chronic active hepatitis; useful in the evaluation of myeloma, macroglobulinemia of Waldenstrom,, collagen diseases, and monoclonal gammopathies; evaluate inflammatory states; evaluate low back pain, arthritis,amyloidosis; evaluate lymphoma, leukemia, anemia.

Schedule

Tuesday-Saturday

Reported

Same day

Prothrombin Time 036

Component

Prothrombin Time
International Normalized Ratio

Specimen/Stability

3 mL Plasma Citrated Blue Tube
Room Temp.- 4 Hrs
Refrigerated -16 Hrs

Collection notes

Draw blood into a buffered citrate collection tube (light blue top) filled to proper level. Do not overfill. The blood-to-coagulant ratio should be 9:1; inadequate filling of the collection device will decrease this ratio and may lead to inaccurate results. Invert gently 6 times to mix. Refrigerate immediately.

Clinical Utility

This test measures the integrity of extrinsic and common pathway.

Reference Range

10.2 – 12.0 seconds

Critical Value

> 35.0 seconds

Schedule

Monday-Saturday

Reported

Same day

PSA (Prostate-Specific Antigen) 196

Component

Prostate Specific Antigen

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

PSA is elevated in about 30% of all cases with nodular prostatic enlargement. If all malignant tissue is removed at the time of radical prostatectomy, PSA should decline to undetectable levels within 3 weeks of the operation. Recurrence should then be checked quarterly in the first year and then at intervals of 4-6 months in succeeding years.

Reference Range

0.0 – 4.0 ng/mL

Schedule

Sunday-Saturday

Reported

Same day

PTH, Intact Only 787
See Parathyroid Hormone
Rapid Plasma Reagin (RPR) 305

Component

Rapid Plasma Reagin

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Because RPR is a non-treponemal test, it is useful for screening, monitoring treatment and detecting reinfection.

Reference Range

Nonreactive

Schedule

Sunday-Saturday

Reported

Same day

Rheumatoid Factor 304

Component

Rheumatoid Factor

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Rheumatoid factor is essentially an IgM antibody that is directed toward IgG. Although it is a non-specific marker, it is associated with autoimmunity and rheumatoid arthritis. IgG antibodies may be altered to be recognized as “foreign,” resulting in an autoimmunity.

Reference Range

< 14.0 IU/mL

Schedule

Monday-Saturday

Reported

Same day

Rubella IgG Antibodies 311

Component

Rubella IgG Antibodies

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Presence of Rubella IgG antibodies indicates current or past infection or vaccination. Acute infections can be serologically confirmed by a significant (2 to 4-fold) rise in Rubella IgG antibody titer in acute and convalescent (collected >7 days after acute specimen) samples, or by the presence of Rubella IgM antibodies.

Reference Range

< 9.0 IU/mL

Schedule

Sunday-Saturday

Reported

Same day

Sodium 133

Component

Sodium

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Sodium measurements aid in the diagnosis and treatment of aldosteronism, diabetes insipidus, adrenal hypertension, Addison’s disease, dehydration, inappropriate antidiuretic hormone secretion, or other diseases involving electrolyte imbalance.

Reference Range

136.0 – 145.0 mmol/L

Critical Value

< 125.0 mmol/L | > 155.0 mmol/L

Schedule

Sunday-Saturday

Reported

Same day

Testosterone, Total 187

Component

Testosterone

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Refrigerated – 7 Day(s), Frozen – 6 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Reliable indicator of LH secretion and Leydig cell function; evaluate gonadal and adrenal function; helpful in the diagnosis of hyprogonadism in males and hirsutism and virilization in females. Total testosterone includes free testosterone, weakly bound testosterone (bound to albumin), and tightly bound testosterone (bound to SHBG or sex hormone binding globulin).

Reference Range

M: 175 – 781 ng/dL
F: 10 – 75 ng/dL

Schedule

Sunday-Saturday

Reported

Same day

Thyroid Profile 29

Component

T3
Free T4
TSH

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Free thyroxine (Free T4) is used to evaluate thyroid function independent of binding protein status. T4 and T3 circulate in the blood as equilibrium mixtures of free and protein-bound hormones. Changes in concentration or affinity of TBG or other transport proteins profoundly affect the total hormone concentration in serum. The free hormone is independent of these binding protein variations and remains almost constant.

Schedule

Sunday-Saturday

Reported

Same day

Thyroid Stimulating Hormone (TSH) 146

Component

TSH

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Differential diagnosis of primary hypothyroidism and hyperthyroidism from normal; differential diagnosis of primary hypothyroidism from secondary and tertiary hypothyroidism; thyroid function test (TSH is high in primary hypothyroidism, low in hyperthyroidism); evaluate hypothyroid patients receiving replacement doses of various thyroid hormone preparations; detect hypopituitarism; follow up on low T4 newborn screen results.

Reference Range

0.34 – 5.60 uUI/mL

Schedule

Sunday-Saturday

Reported

Same day

Thyroxine, (T4) Free 252

Component

Thyroxine, (T4) Free

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Free Thyroxine (Free T4) is used to evaluate thyroid function independent of binding protein status. T4 and T3 circulate in the blood as equilibrium mixtures of free and protein-bound hormones. Changes in concentration or affinity of TBG or other transport proteins profoundly affect the total hormone concentration in serum. The free hormone is independent of these binding protein variations and remains almost constant.

Reference Range

0.61 – 1.12 ng/dL

Schedule

Sunday-Saturday

Reported

Same day

Total Protein 131

Component

Total Protein

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

The total serum protein level is the sum of all circulating proteins that are major components of blood. Serum total protein measurements are adjunct in the diagnosis and follow-up of a variety of diseases involving the liver, kidney, or bone marrow as well as other metabolic or nutritional disorders. The measurement of total protein in peritoneal and pleural fluid may be useful in differentiating between transudates and exudates. An elevated total protein level in synovial fluid confirms the presence of an inflammatory process.

Reference Range

6.0 – 8.3 g/dL

Schedule

Sunday-Saturday

Reported

Same day

Transferrin 231

Component

Transferrin

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Differential diagnosis of anemia; monitor its effectiveness of treatment for anemia.

Reference Range

203.0 – 362.0 mg/dL

Schedule

Monday-Saturday

Reported

Same day

Triglycerides 132

Component

Triglycerides

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Patient should be fasting 12 – 16 hours prior to collection of specimen. Avoid hemolysis.

Clinical Utility

In human nutrition, triglycerides are the most prevalent glycerol esters (fatty acid derivatives covalently linked to glycerol). They constitute 95% of tissue storage fat. After digestion, triglycerides are resynthesized in the epithelial cells and combines with cholesterol and apolipoproteins to form chylomicrons. A single cholesterol and triglyceride value more than 20% below the suggested age and sex-adjusted upper reference limits virtually eliminates a diagnosis of hyperlipoproteinemia in lipoprotein disorders. Increased triglyceride levels contribute to overall obesity and increase both atherosclerosis and risk for myocardial infarction due to arterial deposition of plaque.

Reference Range

< 150 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Triiodothyronine (T3) 980

Component

Triiodothyronine (T3)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Thyroid function test, particularly useful in the diagnosis of T3 thyrotoxicosis and confirmation of hyperthyroidism. Needed in patients with clinical evidence of hyperthyroidism, in whom thyroid profile is normal or borderline.

Reference Range

0.87 – 1.78 ng/dL

Schedule

Sunday-Saturday

Reported

Same day

TSH
See (Thyroid-Stimulating Hormone)
Uric Acid 137

Component

Uric Acid

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Avoid hemolysis. Avoid repeated freeze-thaw cycles

Reference Range

M: 4.4 – 7.6 mg/dL
F: 2.3 – 6.6 mg/dL

Schedule

Sunday-Saturday

Reported

Same day

Urinalysis 030

Component

Reference Range

Color yellow
Clarity clear
Glucose neg
Bilirubin neg
Ketones neg
Specific Gravity 1.003 – 1.029
Blood neg
PH 5.0 – 8.0
Protein neg
Urobilinogen 0.0 – 1.0 mg/dL
Nitrogen neg
Leokocytes neg Leu/uL

Specimen/Stability

20-50 mL Urine Container or Tube
Refrigerated – 72 hour(s),

Collection notes

Collect a freshly voided random urine sample and pour approximately 20-50mL into a properly labeled urine container or tube. Label should have patient name and requisition ID number.

Schedule

Sunday-Saturday

Reported

Same day

Valproic Acid 962

Component

Valproic Acid

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Serum separator tubes are not acceptable; use polypropylene tubes and ship on cold pack by overnight courier. Collect at trough concentration, i.e. within 30 minutes of next dose.

Reference Range

50.0 – 100.0 ug/mL

Critical Value

> 150.0 ug/mL

Schedule

Sunday-Saturday

Reported

Same day

Vitamin B12 & Folate 39

Component

Folate
Vitamin B12

Specimen/Stability

1 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

In mild folate and vitamin B12 deficiencies, serum folate and serum vitamin B12 can be normal. Homocysteine and methylmalonic acid are more sensitive indicators of mild deficiencies of these vitamins.

Schedule

Sunday-Saturday

Reported

Same day

Vitamin B12 162

Component

Vitamin B12

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Clinical Utility

Useful in detection of B12 deficiency as in pernicious anemia; diagnosis folic acid deficiency; evaluate hypersegmentation of granulocyte nuclei; follow up MCV > 100; diagnosis microcytic anemia; diagnosis megaloblastic anemia; evaluate alcoholism, prenatal care; evaluate malabsorption, neurological disorders, or the elevation of B12 as seen in liver cell damage or myeloid leukemia. In mild folate and vitamin B12 deficiencies, serum folate and serum vitamin B12 can be normal. Homocysteine and methylmalonic acid are more sensitive indicators of mild deficiencies of these vitamins.

Reference Range

180.0 – 914.0 pg/mL

Schedule

Sunday-Saturday

Reported

Same day

Vitamin D 25-OH 995

Component

Vitamin D (25-hydroxy)

Specimen/Stability

0.5 mL Serum; Serum Separator Tube (red-grey marble)
Ambient – 7 Day(s), Refrigerated – 1 Month(s)
Note: Specimen will be discarded after 14 days of storage.

Collection notes

Refrigerated 48hr; otherwise freeze serum.

Clinical Utility

Rule out vitamin D deficiency as cause of bone disease; differential diagnosis of hypercalcemia.

Reference Range

30.0 – 100.0 ng/mL

Schedule

Tuesday and Thursday

Reported

Same day