Test Index

test index

Over 100 years of combined experience

STARTS WITH: 1 - B

1,5-anhydroglucitrol (1,5-AG)

TEST NAME:  1,5-anhydroglucitrol (1,5-AG)
TEST NUMBER:  XXXX
CPT CODE:  84378
CLINICAL SIGNIFICANCE: Intermediate term monitoring of glycemic control in people with diabetes.  1,5-AG is in almost all foods and remains constant in the blood.  If a diabetic’s glucose exceeds >180 mg/dL for a period of time (1 -2 weeks) the 1,5-AG is excreted through the urine and as a result the 1,5-AG is decreased.
 SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.

STABILITY:
Room temperature:  2 hours
Refrigerated:  7 days

REFERENCE RANGES: 
Male:                    10.7-32.0 µg/mL
Female:                6.8-29.3 µg/mL
REFERENCES:
Diazyme Laboratories, Inc package insert 71566 Rev B. 12-12-17. Poway, CA

Adrenocorticotropic Hormone (ACTH)

TEST NAME:  Adrenocorticotropic Hormone (ACTH)
TEST NUMBER: 
CPT CODE:  82024
CLINICAL SIGNIFICANCE:  Measurements of ACTH are used in the differential diagnosis and treatment of certain disorders of the adrenal glands such as Cushing’s syndrome, adrenocortical insufficiency and the ectopic ACTH syndrome.
ACTH levels fluctuate; high levels are secreted in the morning and low levels
are secreted in the evening. Based on such circadian rhythm, it is recommended that blood be
collected in the early morning for ACTH analysis. Furthermore, ACTH levels increase under
various types of stress. Stress reinforces the synthesis of CRH and antidiuretic hormone (ADH) or
vasopressin. The increased ADH enhances the stimulation of CRH to release ACTH.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Plasma
CONTAINER/TUBE:                                         
Preferred: EDTA Tube (Lavender top)
Min Volume: 3 mL
Collection Instructions:
1. EDTA tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated for up to 5 hours.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  5 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
7.4-64.3 pg/mL
REFERENCES:
  1. ACTH REV-025221-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Thyroid Peroxidase Antibodies (TPO) (anti-microsomal antibody)

TEST NAME:  Thyroid Peroxidase Antibodies (TPO) (anti-microsomal antibody)
TEST NUMBER:  XXXXX
CPT CODE:  86376
CLINICAL SIGNIFICANCE: Quantitative measurement of anti-thyroid peroxidase antibodies. 
Increased levels of thyroid autoantibodies are found in a variety of thyroid disorders including Hashimoto’s disease, Graves Disease, myxedema, asymptomatic arthritis, and certain malignancies. 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES:  <10.1 IU/mL
REFERENCES:
  1. AIA 2000 Assay Specifications sheet AIA-Pack Anti-TPO., REV-020290-0513., Tosoh Bioscience,
Inc, South San Francisco, CA.
  1. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

Apolipoprotein (APO) AI

TEST NAME:  Apolipoprotein (APO) AI
TEST NUMBER:  XXXX
CPT CODE:  82172
CLINICAL SIGNIFICANCE:  Assessment of coronary heart disease.  Coronary disease is consistent with lower levels of APO A1.
 SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum Separator Tube
Acceptable: Red Top
Min Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  3 days
Refrigerated:  3 Days
 
CAUSES FOR REJECTION:  Use of glass container tubes and serum not separated from clot/Red cells within 2 hours after collection.
 
REFERENCE RANGES:  115-224 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, AU632.04, May 2017. Brea, CA
  2. Alexander, M., Adler, J. (2016 Dec.). Serum APO A-1 and its Role as a Biomarker of Coronary Artery Disease. Retrieved 2/6/2019 from www.ncbi.nlm.nih.gov/pmc/articles/PMC5262432

Apolipoprotein (APO) B

TEST NAME:  Apolipoprotein (APO) B
TEST NUMBER:  XXXX
CPT CODE:  82172
CLINICAL SIGNIFICANCE:  Apo B measurements are superior to traditional lipid profiles in predicting vascular heart disease and cardiovascular disease risk.
Increased levels of APO B correlate with increased CVD risk even in the presence of low LDL-C.
 SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum Separator Tube
Acceptable: Red Top
Min Volume: 1 mL
Collection Instructions:
1. Patient should be fasting
2. Serum gel tubes should be centrifuged within 2 hours of collection.
3. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature: 24 hours
Refrigerated:  72 hours
 
CAUSES FOR REJECTION:  Use of glass container tubes and serum not separated from clot/Red cells within 2 hours after collection.
 
REFERENCE RANGES:  60-130 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, AU633, Revised May 2017. Brea, CA
  2. Paramjit, K. Sandhu, 2016 Sep 1, Lipoprotein Biomarkers and Risk of Cardiovascular Disease:  A Laboratory Medicine Best Practices (LMBP) Systematic Review.  www.ncbi.nlm.nih.gov/pmc/articles/PMC5103618/

Aspartate aminotransferase (AST)

TEST NAME:  Aspartate aminotransferase (AST)
TEST NUMBER:  XXXX
CPT CODE:  84450
CLINICAL SIGNIFICANCE:  Diagnosing and monitoring of liver disease and myocardial infarction and certain muscular disease states.  A two to five fold increase of AST can be demonstrated in patients with metastatic carcinoma of the liver.  A ratio of greater than or equal to one of AST to ALT has a very high predictive value for detecting advanced fibrosis in the presence of chronic liver disease.  Increased AST levels are also present in neuromuscular diseases of non-neurogenic origin.
 SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum Separator Tube
Acceptable: Red Top
Min Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 Hours
Refrigerated:  1 week
 
CAUSES FOR REJECTION:  Lipemia and hemolysis
 
REFERENCE RANGES:  0-34 U/L
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT241, October 2016. Brea, CA
  1. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, St. Louis, Mo., Elsevier

BHGC

TEST NAME: Total Human Chorionic Gonadotropin (BHCG)
TEST NUMBER: 
CPT CODE:  84702
CLINICAL SIGNIFICANCE:  HCG is produced by the placenta shortly after implantation5-7 and increases at a geometric rate until it reaches a peak near the end of the first trimester. This makes it an excellent marker for the confirmation of pregnancy and/or monitoring its course thereafter when necessary.5,8 Other conditions associated with elevated serum or plasma HCG concentrations are neoplasms of
trophoblastic and non-trophoblastic origin.

Clinical applications of the HCG beta assay as a tumor marker include the diagnosis and
management of hydatidiform mole and choriocarcinoma. The HCG beta assay is a valuable
tool also in the diagnosis, staging and management of patients with testicular and ovarian germ-
cell tumors.14 Ectopic production of HCG beta has been reported in cases such as carcinoma of
the stomach, liver, pancreas, breast and in multiple myeloma and melanoma.15
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 2 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Male and Female: <5.0 mIU/mL = Negative
Gestational Age                               mIU/mL
1 week                                                 5 – 50
2 weeks                                               40 – 1,000
3 weeks                                               100 – 5,000
4 weeks                                               600 – 10,000
5 – 6 weeks                                         1,500 – 100,000
7 – 8 weeks                                         16,000 – 200,000
2 – 3 months                                       12,000 – 300,000                              
2nd trimester                                    24,000 – 55,000
3rd trimester                                     6,000 – 48,000
 
REFERENCES:
  1. Total BHCG REV-025261-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Blood Urea Nitrogen (BUN)

TEST NAME:  Blood Urea Nitrogen (BUN)
TEST NUMBER:  XXXX
CPT CODE:  84520
CLINICAL SIGNIFICANCE:  BUN measures urea, which is the major nitrogen containing metabolic by product of protein catabolism.  Used in conjunction with serum creatinine levels it can help be used as a crude discriminator between prerenal and intrinsic causes of reduced GFR.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  1 week
Frozen:  6 months
CAUSES FOR REJECTION: 
REFERENCE RANGES:  7-18 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT252, October 2016. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

STARTS WITH: C

CA 19-9 (Cancer Antigen 19-9)

TEST NAME:  CA 19-9 (Cancer Antigen 19-9)
TEST NUMBER: 
CPT CODE:  86301
CLINICAL SIGNIFICANCE:  Quantitative serial measurement of CA 19-9 is used to monitor patients who have been previously diagnosed with pancreatic cancer.
Cancer 19-9 is a tumor associated antigen that is normally present in bile and pancreatic secretions, but only small amounts are found normally in the blood stream.  Patients with pancreatic adenocarcinoma have elevated bloodstream levels and these levels are used to monitor and/or manage their cancer.
 
** Special Note:   Patients who are genotypically negative for the Lewis Blood Group do not possess the ability to produce the CA 19-9 antigen.  **
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
 
REFERENCE RANGES:  <47.0 U/mL
REFERENCES:
  1.   AIA-2000 Assay Specifications sheet, CA 19-9 REV-025271-0513, Tosoh Bioscience, Inc., South San Francisco, CA.

CA 125 (Cancer Antigen 125)

TEST NAME: CA 125 (Cancer Antigen 125)
TEST NUMBER: 
CPT CODE:  86304
CLINICAL SIGNIFICANCE:  Used for quantitative measurement of CA 125 antigen to determine recurrence of disease and to help predict survival.  CA 125 increased levels are associated with more than 80% of nonmucinous epithelial ovarian neoplasms.  Elevated levels of CA 125 are sometimes associated cancers of the pancreas, liver, colon, breast, lung and other gynecological neoplasms. 

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES:  0.0-35.0 U/mL
REFERENCES:
  1.  AIA-2000 Assay Specifications sheet CA 125 REV-025288-0513, Tosoh Bioscience, Inc., South San Francisco, CA.

CA 27.29

TEST NAME:  CA 27.29
TEST NUMBER: 
CPT CODE:  86300
CLINICAL SIGNIFICANCE:  Cancer
27.29 is to be used as an aid in monitoring response to therapy for patients with Stage IV
(metastatic) breast cancer as well as determining early recurrence in Stage II and Stage III breast
cancer patients who were previously treated and free of disease.

Serial testing for patient CA27.29 assay values should be used in conjunction with other clinical
methods used for monitoring response to therapy in patients with Stage IV metastatic breast
cancer and for detecting early recurrence in Stage II and Stage III disease.

Tumors involving glandular organs, such as the breast, can produce high concentration of
CA27.29 in serum, making it useful as a tumor marker.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
0.0-38.0 U/mL
REFERENCES:
  1. 27.29 REV-025202-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Calcium

TEST NAME:  Calcium
TEST NUMBER:  XXXX
CPT CODE:  82310
CLINICAL SIGNIFICANCE:  Monitoring or diagnosis of disorders that include bone, kidney, parathyroid gland or gastrointestinal tract.  Calcium levels can also reflect abnormal Vitamin D or protein levels.

Hypercalcemia develops when the kidney’s capacity to excrete filtered calcium is exceeded.  Hypocalcemia may be due a decrease in the bound fraction, free fraction or both.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  8 hours
Refrigerated:  72 hours
 
REFERENCE RANGES:  8.4-10.2 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT251, Revised February 2018. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

CEA (Carcinoembryonic Antigen)

TEST NAME:  CEA (Carcinoembryonic Antigen)
TEST NUMBER: 
CPT CODE:  82378
USE:  Used as a marker for malignant conditions.
CLINICAL SIGNIFICANCE:  Tumor marker that can be used to manage malignant disease involving breast, lung, prostate, pancreas, ovary along with colorectal cancers.  Can be used to manage disease during treatment, but not recommended as a diagnostic tool.  Elevated CEA levels can be seen in other conditions that do not involve a malignancy.  Additionally, a normal CEA level does not exclude malignancy.

METHODOLOGY: 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Non-smokers: ≤ 7.2
Smokers: ≤14.5
REFERENCES:
 AIA-2000 Assay Specifications sheet, Carcinoembryonic Antigen REV-025254-0513, Tosoh Bioscience, Inc., South San Francisco, CA.

Chloride

TEST NAME:  Chloride
TEST NUMBER:  XXXX
CPT CODE:  82435
USE:  Evaluation of electrolytes, and acid-base balance, and calculation of anion gap.
CLINICAL SIGNIFICANCE: Excluding acid-base balances, chloride levels generally parallel sodium levels.  Chloride may be decreased in prolonged vomiting, congestive heart failure overhydration, chronic respiratory acidosis, Addison disease, metabolic alkalosis, salt losing nephritis, burns, aldosteronism and can be in diuretic therapy.

 Chloride may be increased in dehydration, prolonged diarrhea, acute renal failure, metabolic acidosis and respiratory alkalosis.

METHODOLOGY:   
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
NECESSARY INFORMATION:  Age required
CONTAINER/TUBE:                                         
Preferred: Serum gel
Acceptable: Lithium heparin gel, red top
Specimen Volume:
Min Volume:
Collection Instructions:
1. Serum gel and lithium gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  7 days
Refrigerated:  7 days
Frozen:  XXXXX
CAUSES FOR REJECTION:  Hemolysis or grossly lipemic specimens
REFERENCE RANGES:  98-107 mmol/L
PERFORMING LAB:  Med-Lake Laboratory, LLC
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT 88820, August 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Cholesterol

TEST NAME:  Cholesterol
TEST NUMBER:  XXXX
CPT CODE:  82465
CLINICAL SIGNIFICANCE:  Serum cholesterol levels, when evaluated along with triglyceride and HDL levels is valuable in the diagnosis of various disease states including atherosclerosis, hyperlipoproteinemia, thyroid, and hepatic.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator Tube
Acceptable: Red top
Specimen Volume:
Min Volume:  1mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  8 hours
Refrigerated:  4 days
Frozen:  3 months
REFERENCE RANGES: 
<200 mg/dl                         Desirable
200–239 mg/dL                 Borderline-high
>240 mg/dL                        High
 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT211, Revised November 2016. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, St. Louis, Mo., Elsevier

Creatine Kinase (CK)

TEST NAME:  Creatine Kinase (CK)
TEST NUMBER:  XXXX
CPT CODE:  82550
CLINICAL SIGNIFICANCE:  CK measurement is a useful tool in evaluating patients with muscle weakness, pain, and rhabdomyolysis.  Increased levels  may result from injury, inflammation and/or necrosis in skeletal or heart muscle.  Elevated CK may be the only signal of neuromuscular disorders without clinical symptoms.
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top
Min Volume:  1mL
Collection Instructions:
  1. Serum gel tubes should be centrifuged within 2 hours of collection and stored in the refrigerator
(2-4 C) in the dark
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection and stored in the refrigerator in the dark.
 
STABILITY:
Room temperature:  Refrigerated within 2 hours of collection
Refrigerated:  2 days stored in the dark
 
CAUSES FOR REJECTION:  Moderately or severe hemolysis
REFERENCE RANGES: 
Adults Males      ≤ 200 IU/L
Adult Females   ≤ 170 IU/L
Newborns           2 to 3 times the adult values
 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT207, Revised March 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
  3. Moghadam-Kia, Siamak. (2016, May 18). Approach to Asymptomatic Creatine Kinase Elevation. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC4871266/
Cortisol
TEST NAME:  Cortisol
TEST NUMBER: 
CPT CODE:  82533
CLINICAL SIGNIFICANCE:  Quantitative measurement of cortisol in serum in the am. Cortisol measurement is used to evaluate hypothalamic-pituitary-adrenal function.  Cortisol helps to regulate glucose levels and lipid and protein metabolism.  It is a negative regulator of ACTH. 

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Collect specimen between 8-9 am
2. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
REFERENCE RANGES: 
Collected between 8 – 9am:  10.4 -26.4 µg/dL
REFERENCES:
  1. AIA-2000 Assay Specifications sheet, CORTISOL REV-025287-0513  125, Tosoh Bioscience, Inc., South San Francisco, CA.
C-Peptide II
TEST NAME:  C-Peptide II
TEST NUMBER: 
CPT CODE: 84681
CLINICAL SIGNIFICANCE:  C Peptide II levels can serve as an indirect measurement of insulin secretion.  Additionally, can be used to help interpret glucose tolerance test results.   In cases where anti-insulin antibodies are present, C-peptide levels may be a useful alternative to insulin levels.
C Peptide is a byproduct of the conversion of proinsulin to insulin, and is released in equal amounts into the portal circulation.  Measurement of C-peptide in the bloodstream serves as an index to insulin levels.  Fasting levels of C-peptide are 5 to 10 fold greater than insulin due to longer half-life of C-peptide.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
0.69-2.45 ng/mL
REFERENCES:
  1. AIA 2000 Assay SPECIFICATIONS, REV-025283-0815 ST AIA-PACK CPEP II, Tosoh Bioscience,
Inc., South San Francisco, CA.
  1. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Cystatin-C
TEST NAME:  Cystatin-C
TEST NUMBER:  XXXX
CPT CODE:  82610
CLINICAL SIGNIFICANCE: Marker of renal function.  Cystatin-C is dependent on the GFR and if the GFR decreases the Cystatin-C increases in concentration.

 SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  14 days
Refrigerated:  14 days
 
 
REFERENCE RANGES: 
0.62-1.16 mg/dL
REFERENCES:
  1. Diazyme Laboratories, Inc package insert 71566 Rev B. 12-12-17. Poway, CA

STARTS WITH: D - F

Direct Bilirubin
TEST NAME: Direct Bilirubin
TEST NUMBER:  XXXX
CPT CODE:  82248
CLINICAL SIGNIFICANCE:  Evaluation of liver and biliary disease.  Conjugated and unconjugated bilirubin may help determine disorders of bilirubin metabolism in the absence of other abnormal liver tests.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume:  1mL
Collection Instructions:
1. Serum separator tubes (keep away from light) should be centrifuged and refrigerated within 2 hours of collection.
2. Red-top tubes (keep away from light) should be centrifuged and aliquoted in a plastic transport container and refrigerated within 2 hours of collection.
 
STABILITY:
Room temperature:  Refrigerate within 2 hours of collection kept away from light
Refrigerated:  1 week away from light
 
REFERENCE RANGES:  Adults 0.0-0.2 mg/dL
REFERENCES:
  1.  Carolina Liquid Chemistries package insert, DT229, Revised March 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
E2 (Estradiol)
TEST NAME:  E2 (Estradiol)
TEST NUMBER: 
CPT CODE:  82670
Clinical Significance:  Estradiol levels in conjunction with FSH and LH levels can help assess ovary function.  Can be used in males to evaluate syndromes such as gynecomastia.
E2 (Estradiol) is a steroid hormone produced mainly by ovaries in females and a small amount is produced by the testes in males.  It can be used in to evaluate ovary function and cyclic levels.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Male                                       <25 – 75 pg/mL
Ovulating Female:
Follicular phase                <25 – 84 pg/mL
Mid-cycle                            198 – 693 pg/mL
Luteal phase                      190 – 270 pg/mL
Postmenopausal Female  32 – 73 pg/mL
REFERENCES:
  1.   AIA-2000 Assay Specifications sheet ESTRADIOL REV-025274-0513, Tosoh Bioscience, Inc., South San Francisco, CA.
Ferritin
TEST NAME:  Ferritin
TEST NUMBER: 
CPT CODE:  82728
CLINICAL SIGNIFICANCE:  Ferritin is the major protein for iron storage, from which iron can be mobilized for the purpose of making hemoglobin, myoglobin or other iron containing molecules.  Ferritin levels are a highly sensitive indicator of iron deficiency due to decline in iron stores before bloodstream levels or hemoglobin levels decline.  Levels are usually proportional to the stored iron content.  Additionally, ferritin is an acute phase reactant and may be increased in tissue injury or acute inflammatory response.  Ferritin in elevated in various chronic diseases.  The ferritin in this state is stored but is sequestered which leads to anemia of chronic disease.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Age                        Male                                     Female
18-45                     22-340 ng/mL                    6-115 ng/mL
>45                         22-415 ng/mL                    15-200 ng/mL
REFERENCES:
  1. Gulhar R, Jialal I. Physiology, Acute Phase Reactants. [Updated 2019 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519570/
  2. AIA-2000 Assay Specifications sheet CA 125 REV-025288-0513, Tosoh Bioscience, Inc., South San Francisco, CA.
  3. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
  4. Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: Past, present and future. Biochim Biophys Acta. 2010;1800(8):760-9.
2.2.  2.
Folate (Folic Acid, Serum Folate)
TEST NAME:  Folate (Folic Acid, Serum Folate)
TEST NUMBER: 
CPT CODE:  82728
CLINICAL SIGNIFICANCE:  Folate levels may be used to determined to evaluate nutritional status, megaloblastic anemia and neuropathy.
Because of its dependence on Vitamin B12 for certain biochemical pathways, it is beneficial to determine Folate along with vitamin B12 level to help evaluate cause of any deficiency.    They may be caused by low dietary intake, pregnancy, liver disease, malabsorption, alcoholism, and celiac disease.   In addition, intake of certain drugs, or gut sterilization may cause deficiencies.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Fasting specimen recommended
2. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
3 –16 ng/mL
REFERENCES:
  1.  AIA-2000 Assay Specifications sheet, 020593-0513 AIA-6000II Assay Specifications, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Burtis, C., Bruns, D., 2015, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics., (7th Ed.), St. Louis, Mo., Elsevier
Follicle-Stimulating Hormone (FSH)
TEST NAME:  Follicle-Stimulating Hormone (FSH)
TEST NUMBER: 
CPT CODE:  83001
CLINICAL SIGNIFICANCE:  FSH stimulates ovarian follicle growth and estrogen production in women, and testicular spermatogenesis in men.
Determination of FSH concentrations is essential in assessment and monitoring of patients with
suspected infertility. Other physiological disorders associated with abnormal FSH secretion have
been reported.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Male                       1.0 – 42.5 mIU/mL
Ovulating Female:
Follicular phase  2.7 – 15.4 mIU/mL
Peak                        3.9 – 22.0 mIU/mL
Luteal phase         1.0 – 14.4 mIU/mL
Postmenopausal Female  25.0 – 160.0 mIU/mL
 
REFERENCES:
  1. Follicle Stimulating Hormone REV-025265-013 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

Free Triiodothyronine (FT3)

TEST NAME:  Free Triiodothyronine (FT3)
TEST NUMBER: 
CPT CODE:  84481
CLINICAL SIGNIFICANCE:  Since protein bound T3 is not available for cellular uptake and does not appear to exert any metabolic effect, the measurement of FT3 may therefore represent a more valid clinical
assessment of patient thyroid status.
Direct measurement of free T3 enables thyroid function examination even in the presence of
abnormal liver function, hormone fluctuation during pregnancy,11 and variations in levels of serum
binding proteins.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
2.0 – 4.9 pg/mL
REFERENCES:
  1.  FREE TRIIODOTHYRONINE REV-025286-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Free Thyroxine (FT4)

TEST NAME:  Free Thyroxine (FT4)
TEST NUMBER: 
CPT CODE:  84439
CLINICAL SIGNIFICANCE:  Historically, measurement of total serum T4 (bound + free) has been used to assess the clinical status of the thyroid gland.4,5 However, this analysis is not diagnostically accurate when significant changes occur in the serum binding proteins.6,7 Alterations in TBG concentration,
pregnancy, oral contraceptives, estrogen therapy or drugs which alter the binding of thyroxine to
the carrier proteins may cause corresponding changes in the total T4 when unbound free
thyroxine levels remain relatively unchanged.8,9 Therefore, measurement of the free T4 (FT4)
typically correlates more closely to the patient’s actual thyroid status than the total.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.

STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days

REFERENCE RANGES: 
0.75 – 1.54 ng/dL
REFERENCES:

  1. FREE THYROXINE REV-025268-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

STARTS WITH: G - I

GAMMA-GLUTAMYLTRANSFERASE (GGT)
TEST NAME: GAMMA-GLUTAMYLTRANSFERASE (GGT)
TEST NUMBER:  XXXX
CPT CODE:  82977
CLINICAL SIGNIFICANCE:  GGT along with Alkaline phosphatase is elevated in intrahepatic or posthepatic biliary obstruction, liver neoplasm, infectious hepatitis, alcoholic hepatitis, pancreatitis, and some pancreatic malignancies.  GGT can also be useful in differentiating bone or liver as the source of increased alkaline phosphatase.
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume:  1mL
Collection Instructions:
1. Serum separator tubes (keep away from light) should be centrifuged and refrigerated within 2 hours of collection.
2. Red top tubes (keep away from light) should be centrifuged and aliquoted in a plastic transport container and refrigerated within 2 hours of collection.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  7 days
Frozen:  2 months
REFERENCE RANGES: 
Adults:                                  Female 9 -36 U/L
Male 12-64 U/L 
 Children / Adolescents:
1 day – 6 months              Female 15 – 132 U/L   
Male 12 – 122 U/L 
6 months – 1 year            Female 1 – 39 U/L   
Male 1 – 39 U/L 
1 year – 12 years              Female 4 – 22 U/L   
Male 3 – 22 U/L 
13 years – 18 years          Female 4 – 24 U/L   
Male 2 – 42 U/L 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT209, Revised December 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Glucose

TEST NAME: Glucose
TEST NUMBER:  XXXX
CPT CODE:  82947
CLINICAL SIGNIFICANCE:  Glucose level aids in the diagnosis and monitoring of type 1 or type 2 diabetes, gestational diabetes, hypoglycemia and other diseases of the adrenal, pituitary and thyroid systems.
Monitoring glucose levels aids not only in diagnosing various diseases of impaired glucose metabolism, but also in early prediction in some cases.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes (keep away from light) should be centrifuged within 2 hours of collection.
2. Red-top tubes (keep away from light) should be centrifuged and aliquoted in a plastic transport container within 2 hours of collection.
 
STABILITY:
Room temperature:  8 hours
Refrigerated:  3 days
 
REFERENCE RANGES:  74-106 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT208, Revised November 2016. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

HDL Cholesterol

TEST NAME: HDL Cholesterol
TEST NUMBER:  XXXX
CPT CODE:  83718
CLINICAL SIGNIFICANCE:  HDL Cholesterol is considered the “good” cholesterol.  HDL is known to carry other “bad” cholesterol to the liver and then broken down and flushed from the body.
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 3 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 3 hours of collection.
 
STABILITY:
Room temperature:  3 hours
Refrigerated:  1 week
 
REFERENCE RANGES: 
Low:      <40 mg/dL
High:      ≥60 mg/dL
 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT616, Revised July 2018. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, St. Louis, Mo., Elsevier

HS C-REACTIVE PROTEIN (hsCRP)

TEST NAME: HS C-REACTIVE PROTEIN (hsCRP)
TEST NUMBER:  XXXX
CPT CODE:  86141
CLINICAL SIGNIFICANCE:  HS-CRP is a sensitive, yet nonspecific acute phase reactant that activates the classical complement pathway, is involved in the initiation of phagocytosis, and detoxification of damaged tissues.  CRP may be up to 1000 fold elevated after myocardial infarction.  Mild increased in CRP levels, which can be detected by the HS-CRP method, may be utilized to used to determine cardiovascular risk.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  1 week
Frozen:  1 year
REFERENCE RANGES:  <3.0 mg/L
REFERENCES:
1.Carolina Liquid Chemistries package insert, published by Kamiya Biomedical Company, , Revised Feb 1 2017.
2.Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

Intact Parathyroid hormone (iPTH)

TEST NAME: Intact Parathyroid hormone (iPTH)
TEST NUMBER: 
CPT CODE:  83970
CLINICAL SIGNIFICANCE: Daltons). PTH raises blood ionized calcium levels by promoting bone dissolution and releasing calcium phosphate from the bone to the extra cellular fluid through direct action on bone. PTH also promotes reabsorption of ionized calcium and depresses the renal reabsorption of phosphate through action on the renal tubular. Hence, PTH is an important hormone to optimize calcium ion concentrations in the blood.

PTH is rapidly metabolized in the liver and kidney primarily to biologically active N-terminal
and biologically inactive C-terminal fragments with much longer half-lives. C-terminal fragments,
excreted from the kidney, are grossly elevated in subjects with renal insufficiency. Intact PTH
assays accurately reflects PTH-secretion kinetics due to less influence by declining renal
function.  
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 8.2 – 83.5 pg/mL  
REFERENCES:
  1. Intact PTH REV-025213-0813 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Iron

TEST NAME: Iron
TEST NUMBER:  XXXX
CPT CODE:  83540
CLINICAL SIGNIFICANCE:  Iron disorders can be present under many different circumstances.  Decreased iron levels can be present in many situations including chronic blood loss, decreased iron intake or absorption, increased demand (e.g. pregnancy), and anemia of chronic disease.  Increases in Iron levels can be seen after multiple transfusions, increased iron intake, increased iron storage release, and because of increased red  cell destruction.
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hrs
Refrigerated:  7 days
 
REFERENCE RANGES:  60-150 µg/dL
 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT618, Revised July 2018. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

STARTS WITH: L - M

Lactate Dehydrogenase (LDH)
TEST NAME:  Lactate Dehydrogenase (LDH)
TEST NUMBER:  XXXX
CPT CODE:  83615
USE: 
CLINICAL SIGNIFICANCE: In spite of being present in a variety of clinical conditions, LDH levels are most useful in hematology and oncology diagnosis and monitoring.   LDH levels 50 times the upper reference range have been reported in megaloblastic anemias, and quickly return to within reference range after treatment.  Patients with malignancies may show increased LDH levels.  LDH is a relevant predictor of disease activity in leukemias and certain lymphomas.  LDH levels are increased after myocardial infarction and reach their peak approximately 48 hours after incident and persist for approximately 10 days.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  3 days
Frozen:  Do not freeze
REFERENCE RANGES: 
Male:    50-166 U/L
Female: 60-132 U/L
 
REFERENCES:
 
  1.   Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
  2.  Carolina Liquid Chemistries package insert, DT205pi, November 2016. Brea, CA
LDLD Cholesterol (Direct Cholesterol)
TEST NAME:  LDLD Cholesterol (Direct Cholesterol)
TEST NUMBER:  XXXX
CPT CODE:  83271
CLINICAL SIGNIFICANCE:  Studies have shown that LDL-C is a key factor in the pathogenesis of atherosclerosis and coronary artery disease.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
NECESSARY INFORMATION:  Gender required
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  5 days
REFERENCE RANGES: 
<130 mg/dL                        Desirable
130-159 mg/dL                 Borderline high risk
≥160 mg/dL                        High risk
 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT661, Revised July 2018. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Luteinizing Hormone
TEST NAME: Luteinizing Hormone
TEST NUMBER: 
CPT CODE: 83002
CLINICAL SIGNIFICANCE: LH induces ovulation and thereafter maintains the corpus
luteum and progesterone production in women.  In men, LH stimulates testosterone production.
Hypothalamic control of both LH and FSH secretion by the anterior pituitary appears to be by a
common releasing hormone, gonadotropin-releasing hormone (GnRH) or luteinizing hormone-
releasing hormone (LHRH), with negative feedback at the hypothalamic level by estrogen in the
female and testosterone in the male.

Raised levels of LH and LH:FSH ratio are frequently found in polycystic ovary syndrome (PCOS), a common cause of infertility in women and other physiological disorders associated with abnormal LH secretion.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
REFERENCES:
  1. LUTEINIZING HORMONE REV-025296-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Lipase
TEST NAME:  Lipase
TEST NUMBER:  XXXX
CPT CODE:  83690
CLINICAL SIGNIFICANCE:  The most commonly used biomarker for the diagnosis and treatment of pancreatic disease, including acute pancreatitis and blockages of the pancreatic duct’
 Lipase levels increase after acute pancreatitis within 4 to 8 hours, peak at approximately 24 hours and decrease within 7 to 14 days.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
NECESSARY INFORMATION:  Gender required
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 30 minutes of collection.
2. Red-top tubes should be centrifuged and aliquoted within 30 minutes of collection.
 
STABILITY:
Room temperature:  1 week
Refrigerated:  3 weeks
Frozen:  3 months
REFERENCE RANGES:  6-32 U/L
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT621, Revised July 2018. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Lipoprotein (a)
TEST NAME:  Lipoprotein (a)
TEST NUMBER:  XXXX
CPT CODE:  83695
CLINICAL SIGNIFICANCE:  Increased  Lipoprotein (a) levels have been linked to  a high risk for coronary heart disease and increased risk of myocardial infarction and stroke and restenosis after angioplasty and coronary bypass.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 3 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 3 hours of collection.
 
 
STABILITY:
Room temperature:  24 hours
REFERENCE RANGES:  10-30 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, AU204, Revised September 2018. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Lp-PLA2 Activity
TEST NAME:  Lp-PLA2 Activity
TEST NUMBER:  XXXX
CPT CODE:  83698
CLINICAL SIGNIFICANCE: Lp-PLA2 Activity is used in conjunction with clinical evaluation and patient risk assessment as an aid in predicting coronary heart disease in patients with no history of cardiovascular events.

Lp-PLA2 is not elevated in systemic inflammatory conditions so it can be a more specific marker of vascular inflammation.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Plasma
CONTAINER/TUBE:                                         
Preferred: K2 EDTA -Lavender top
Min Volume: 1 mL
Collection Instructions:
1. EDTA tubes should be centrifuged within 4 hours of collection and aliquoted, then refrigerated
2. Hemolyzed specimens will not be accepted
 
STABILITY:
Room temperature:  4 hours
Refrigerated:  2 weeks
 
 
REFERENCE RANGES: 
Reduced risk:     <225 nmol/min/mL
Increased risk:   ≥225 nmol/min/mL
REFERENCES:
  1. Diazyme Laboratories, Inc package insert 30050F-01 Rev A. Poway, CA

STARTS WITH: P - S

Phosphorus (Inorganic)
TEST NAME:  Phosphorus (Inorganic)
TEST NUMBER:  XXXX
CPT CODE:  84100
CLINICAL SIGNIFICANCE:  Hypophosphatemia is a common occurrence in hospital patients.  It may be caused by alcoholism, carbohydrate induced insulin secretion, vomiting, diarrhea, inadequate absorption (due to intake of aluminum or magnesium containing antacids), vitamin D deficiency, and hyperparathyroidism. Hyperphosphatemia is most commonly caused by the kidneys’ inability to excrete phosphate.  Moderate increases can be seen in patients with low parathyroid hormone levels, parathyroid hormone resistance, acromegaly, and hypervitaminosis (vitamin D).

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum gel
Acceptable: Red top
Min Volume: 1mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted into a plastic tube within 2 hours of collection. 
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  1 week
 
REFERENCE RANGES: 
Adults:                  2.5-4.8 mg/dL
Children:              4.0-7.0 mg/dL
 
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT218, April 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

Potassium

TEST NAME:  Potassium
TEST NUMBER:  XXXX
CPT CODE:  84132
CLINICAL SIGNIFICANCE:  Abnormal potassium levels have serious consequences.  Symptoms of hypokalemia are muscle weakness, irritability, paralysis and at extremely low levels can lead to cardiac defects and lead to arrest.  Hyperkalemia commonly occurs when renal tubular function is impaired and potassium is not adequately secreted.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  6 weeks
Refrigerated:  6 weeks
 
REFERENCE RANGES:  3.5-5.1 mmol/L
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT 88811, August 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Prolactin (PCL)
TEST NAME:  Prolactin (PCL)
TEST NUMBER: 
CPT CODE:  84146
CLINICAL SIGNIFICANCE:  Measurement of serum prolactin concentrations is essential in evaluating patients with infertility or suspected hypothalamic-pituitary dysfunction. Increased serum prolactin concentrations are observed in pregnancy and during lactation. Other conditions associated with abnormal prolactin concentrations have been reported.

Since physical or emotional stress may elevate blood levels of prolactin, patients should be under
resting basal conditions prior to sampling. Also, prolactin levels rise rapidly with sleep, so
samples ideally should not be taken until 1 – 2 hours after awakening.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 2 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Male  3.3 – 20.8 ng/mL
Premenopausal Female  2.1 – 47.6 ng/mL
Postmenopausal Female  0.0 – 41.4 ng/mL
REFERENCES:
  1. Prolactin REV-0252-0513 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Progesterone
TEST NAME: Progesterone
TEST NUMBER: 
CPT CODE:  84144
CLINICAL SIGNIFICANCE:  Progesterone is secreted in small amounts by the ovaries during the
follicular phase of the menstrual cycle and increases sharply following ovulation and
corpus luteum development .  Unless pregnancy occurs, a steep decline to follicular
levels occurs prior to the next menstrual cycle. This pattern provides the rationale for
the use of serum progesterone measurement as a reliable method for ovulation
detection.

 Daily progesterone levels are considered the most accurate means for documenting
luteal phase defect. Measurement of progesterone in blood can also be used to
detect and evaluate patients at risk for abortion during the early weeks of gestation.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  7 days
Frozen:  60 Days
 
REFERENCE RANGES: 
 
Male                                       </= 0.88ng/mL
Female
Follicular phase                 0.11 — 0.95ng/mL
Luteal phase                       1.65 – 22.04 ng/mL
Postmenopausal females  </= 0.90 ng/mL
Pregnant females:
First trimester                   3.24 – 60.54 ng/mL
Second trimester             21.52 – 104.58 ng/mL
Third trimester                 66.52 – 367.64 ng/mL
 
REFERENCES:
  1. PROG III REV-025240-0118 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

Prostate Specific Antigen (PSA)

TEST NAME: Prostate Specific Antigen (PSA)
TEST NUMBER: 
CPT CODE:  84153
CLINICAL SIGNIFICANCE:  The presence of PSA has been demonstrated in normal, benign hyperplastic, and malignant prostatic tissue, in metastatic prostatic carcinoma, and also in prostatic fluid as well as seminal plasma.

PSA is not present, however, in any other tissue from men, nor is it produced by cancers of the lung, colon, rectum, stomach, pancreas or thyroid.
 
Elevated serum PSA levels have been reported in patients with prostate cancer, benign prostatic hypertrophy, or inflammatory conditions of other adjacent genitourinary tissues. Prostate cancer cannot be diagnosed until biopsy results confirm the presence of cancer cells. Studies indicate that PSA is
an important tool in assessing the effect of therapy. Especially in patients being treated with
hormone therapy, concurrent serial determinations of PSA and PAP may provide added clinical
value in monitoring patients with prostatic cancer.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
0 – 4.0 ng/mL
REFERENCES:
  1. Prostate Specific Antigen REV-025263-0813 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Rheumatoid Factor
TEST NAME:  Rheumatoid Factor
TEST NUMBER:  XXXX
CPT CODE:  86431
USE:  
CLINICAL SIGNIFICANCE: Rheumatoid Factor has been found to be present in 50 – 79% of adults with rheumatoid arthritis.  Quantitative RF testing is useful for diagnostic and prognostic purposes.

Early diagnosis and treatment of rheumatoid arthritis has been found to prevent or retard joint erosion.  In some cases it may promote a state of remission. 

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
NECESSARY INFORMATION:  Gender required
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  1 week
Frozen:  2 months
REFERENCE RANGES:  <11 IU/mL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, AU629, Revised June 2017. Brea, CA
  2. Heidari B. (2011). Rheumatoid Arthritis: Early diagnosis and treatment outcomes. Caspian journal of internal medicine2(1), 161-70. www.ncbi.nlm.nih.gov/pmc/articles/PMC3766928/

Sodium

TEST NAME:  Sodium
TEST NUMBER:  XXXX
CPT CODE:  84295
CLINICAL SIGNIFICANCE:  Imbalances may occur because of excessive retention, loss or gain of sodium.  Hypernatremia is consistently due to hyperosmolality.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  2 weeks
Refrigerated:  2 weeks
 
REFERENCE RANGES:  136-145 mmol/L
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT 88820 , Revised August 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
 

STARTS WITH: T - V

Triiodothyronine (T3)
TEST NAME: Triiodothyronine (T3)
TEST NUMBER: 
CPT CODE:  84480
CLINICAL SIGNIFICANCE:  Serum T3 measurements can be a valuable component of a thyroid-function screening panel in diagnosing certain disorders of thyroid function in addition to conditions caused by iodide deficiency. Assays for T3 are valuable in early detection of hyperthyroidism and for monitoring
the efficacy of treatment for thyroid disorders. A normal T3 value in the presence of an elevated
T4 and/or Free T4 (FT4) level may also help to rule out hyperthyroidism.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
70 – 170 ng/dL
REFERENCES:
  1. TRIIODOTHYRONINE REV-025282-0813 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Thyroxine (T4)
TEST NAME: Thyroxine (T4)
TEST NUMBER: 
CPT CODE:  84436
CLINICAL SIGNIFICANCE:  The primary function of the thyroid gland is the secretion
of thyroxine (T4) or triiodothyronine (T3).  Abnormal secretion of T4 and/or T3 may lead either to
hyper- or hypo-thyroidism.

T4 is largely converted to T3 in peripheral tissues by monodeiodination. Total T4 rises and falls
with the TBG level in euthyroid individuals. An erroneous interpretation of thyroid function may be
obtained if a condition exists which changes the TBG concentrations. Certain drugs compete
with T4 for binding to TBG, which results in decreased levels of total T4 through the negative
feed-back of thyroid hormone concentration on TSH secretion.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
4.0 – 11.0 μg/dL
REFERENCES:
  1. Thyroxine REV-025258-0813 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Testosterone
TEST NAME: Testosterone
TEST NUMBER: 
CPT CODE:  84403
CLINICAL SIGNIFICANCE:  Testosterone is one of the major male sex hormones produced by the interstitial cells of Leydig in the testes. The measurement of the total testosterone in serum can provide information to evaluate adrenal and testicular functions. It is useful for the diagnosis of the hypergonadism 1 and hyperpituitarism 2 in men, and hirsutism 3, menstrual disorders, and polycystic ovarian syndrome in women. It is also useful for the characterization and follow up of some cancers such as testicular, breast, ovarian, and adrenal tumors.
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES: 
Male:                    199-1586 ng/dL
Female:               10-73.23 ng/dL
REFERENCES:
  1. Testosterone REV-025204-0813 AIA-360 ASSAY SPECIFICATIONS, Tosoh Bioscience, Inc., South San Francisco, CA.
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Anti-Thyroglobulin antibodies (TgAb)
TEST NAME:  Anti-Thyroglobulin antibodies (TgAb)
TEST NUMBER: 
CPT CODE:  86800
CLINICAL USE:  Increased levels of thyroid autoantibodies are found in a variety of thyroid disorders including Hashimoto’s disease, Graves Disease, myxedema, asymptomatic arthritis, and certain malignancies. 

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red top tubes should be centrifuged and aliquoted within 2 hours of collection, then store refrigerated.
 
STABILITY:
Room temperature:  2 hours
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES:  <28.7 IU/mL
 
REFERENCES:
  1.   Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
  2. AIA-2000 Assay Specifications Sheet, Tg(AB) SDS, REV-020291-0513, Tosoh Bioscience, Inc.,
South San Francisco, CA.

TIBC

TEST NAME:  TIBC
TEST NUMBER:  XXXX
CPT CODE:  83550
CLINICAL SIGNIFICANCE:  Measurement of TIBC along with total iron is useful in diagnosing and treating iron deficiency anemia, anemia of chronic disease and other disruptions in the homeostatic iron cycle.  Total iron-binding capacity (TIBC) is the measure of the ability of serum proteins, principally transferrin, to bind iron.  TIBC is elevated in iron deficiency and decreased in anemia of chronic disease.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
NECESSARY INFORMATION: 
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  2 weeks
Refrigerated:  1 month
Frozen:  1 month
REFERENCE RANGES:  250-450 µg/dL
REFERENCES:
  1. Pointe Scientific package insert, P802-17517-01, Revised May 2016. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Total Bilirubin
TEST NAME:  Total Bilirubin
TEST NUMBER:  XXXX
CPT CODE:  82247
CLINICAL SIGNIFICANCE:  Bilirubin is the byproduct that results from the breakdown process of senescent RBCs.  It is extracted and metabolized primarily in the liver and excreted in bile and urine.  Measurement of Tbil can be useful for diagnosing and monitoring disorders of liver, gallbladder blockages and hemolytic processes. 

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  2 weeks
Refrigerated:  2 weeks
 
REFERENCE RANGES:  .20-1.0 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT28, Revised April 2017. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier
Transferrin
TEST NAME: Transferrin
TEST NUMBER:  XXXX
CPT CODE:  84466
CLINICAL SIGNIFICANCE:  Transferrin transports iron from the intestine, reticuloendothelial system, and liver parenchymal cells to all cells. Transferrin levels decrease in anemia of chronic disease are elevated in iron deficiency.  Transferrin is increased in iron overload.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  1 week
Frozen:  2 months
REFERENCE RANGES:  250-400 mg/dL
 
REFERENCES:
  1. Kamya Biomedical package insert, K-Assay Transferrin, Revised February 2017. Brea, CA
 
  1. Kotze, M. J., van Velden, D. P., van Rensburg, S. J., & Erasmus, R. (2009). Pathogenic Mechanisms Underlying Iron Deficiency and Iron Overload: New Insights for Clinical Application. EJIFCC20(2), 108-23. www.ncbi.nlm.nih.gov/pmc/articles/PMC4975278/

Triglyceride

TEST NAME:  Triglyceride
TEST NUMBER:  XXXX
CPT CODE:  84478
CLINICAL SIGNIFICANCE:  Fasting triglyceride levels are useful as indicators of risk of atherosclerosis or coronary artery disease. Lipidemias may develop primarily from an inherited metabolic disorder, or secondarily from acquired diseases such as diabetes mellitus, pancreatitis, nephrotic syndrome and alcoholic liver disease.

SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
NECESSARY INFORMATION:  Patient fasting 12 hours
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  1 week

REFERENCE RANGES: 
Normal                 <150 mg/dL
High                       150-199 mg/dL
Hypertriglyceridemia      200-199 mg/dL
Very high             >499 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT213, December 2016. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, St. Louis, Mo., Elsevier

Uric Acid

TEST NAME:  Uric Acid
TEST NUMBER:  XXXX
CPT CODE:  84550
USE:  Uric acid levels can be useful in the assessment of gout, but it is important to consider that levels are often normal during an acute attack. 
CLINICAL SIGNIFICANCE:  Uric acid levels can be useful in the assessment of gout, but it is important to consider that levels are often normal during an acute attack.  Uric acid levels are also useful in the diagnosis and treatment starvation, psoriasis, renal failure, leukemia, patients receiving chemotherapy or radiation. 
 
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Serum separator tube
Acceptable: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Serum separator tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
 
STABILITY:
Room temperature:  24 hours
Refrigerated:  3 days
Frozen:  6 months
REFERENCE RANGES: 
Child:                     2.0-5.5 mg/dL
Adult male:         3.5-7.2 mg/dL
Adult Female:    2.6-6.0 mg/dL
REFERENCES:
  1. Carolina Liquid Chemistries package insert, DT212, December 2016. Brea, CA
  2. Rifai, N., Horvath, A., Wittwer, C., 2019, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. (8TH Ed.), St. Louis, Mo., Elsevier

Vitamin B12 (cyanocobalamin)

TEST NAME:  Vitamin B12 (cyanocobalamin)
TEST NUMBER: 
CPT CODE:  82607
CLINICAL SIGNIFICANCE:   Vitamin B12 deficiency can be caused by several factors, including inadequate nutrition, malabsorption, gastric disorder, intake of proton pump inhibitors, or damage to terminal ileum.  Vitamin B12 deficiency is associated with megaloblastic anemia, neuropathy, and significant, sometimes irreversible neurological disorders.  Increased levels are usually the result of intake of supplements. 

 SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  24 hours
Frozen:  60 Days
 
REFERENCE RANGES:
 230 – 1050 pg/mL
REFERENCES:
  1.  Burtis, C., Bruns, D., 2015, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics., (7th Ed.), St. Louis, Mo., Elsevier.
 
  1. AIA-2000 Assay Specifications sheet, 020593-0513 AIA-PACK B12 SDS, Tosoh Bioscience, Inc., South San Francisco, CA.

Vitamin D (25-OH vitamin D or 25-hydroxyvitamin D)

TEST NAME:  Vitamin D (25-OH vitamin D or 25-hydroxyvitamin D)
TEST NUMBER: 
CPT CODE:  82306
CLINICAL SIGNIFICANCE:  Vitamin D deficiency is associated with osteoporosis, cancers, cardiovascular disease, hypocalcemia, and other disorders of mineral metabolism
SPECIMEN REQUIREMENTS
SPECIMEN TYPE:  Serum
CONTAINER/TUBE:                                         
Preferred: Red top tube
Min Volume: 1 mL
Collection Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 1 hour of collection, then store refrigerated.
 
STABILITY:
Room temperature:  1 hour
Refrigerated:  48 hours
Frozen:  60 Days
 
 
REFERENCE RANGES: 
10.8 – 54.75 ng/mL
Vitamin D deficiency – <20 ng/mL
Vitamin D insufficiency – <30 ng/mL
Vitamin D toxicity – >100 ng/mL
Vitamin D sufficient – 30 to 100 ng/mL
REFERENCES: 
  1. AIA-2000 Assay Specifications sheet AIA-Pack 25-OH Vitamin D, REV-025234-0813 25-OH VITAMIN D, Tosoh Bioscience, Inc., South San Francisco, CA. 
  2. Burtis, C., Bruns, D., 2015, Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics., (7th Ed.), St. Louis, Mo., Elsevier