TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

16082 ABO GROUP AND RHO TYPING Specimen Container: 86900 Lavender and No additive (red top)

5.0 (2.0) whole blood and 1.0 mL serum Performed: mon - sat turn around: next day

82003 ACETAMINOPHEN (TYLENOL) Therapeutic: 10-20 ug/mL Specimen Container: 82003 No additive (red top)

1.0 (0.2) mL serum Transfer serum to plastic screw cap vial. Performed: referred-A Collect prior to next dose turn around: 3-5 days

12009 ACETONE Negative Specimen Container: 82009 Nitroprusside reaction Gel barrier (gold or tiger top) Clinical Use: The presence of ketone bodies is important in the evaluation 1.0 (0.3) mL serum of carbohydrates metabolism. Allow specimen to completely clot (this can take up to 60 minutes), Centrifuge for 15 minutes. The serum should be physically separated from contact with cells within two hours from Performed: mon - sat the time of collection. turn around: next day

ACETYLCHOLINE RECEPTOR (AChR) BLOCKING 83515 <15% of inhibition Specimen Container: 83519 No additive (red top) Clinical Use: Myasthenia gravis (MG) is a neuromuscular disorder charactarized 1.0 (0.2) mL serum by muscle weakness, most commonly due to autoantibody-mediated Transfer serum to plastic, screw top vial. loss of functional acetylcholine receptors (AChr) in the neuromuscular Serum is the only acceptable sample. junction. This assay is most useful when the acetylcholinesterase receptor modulating are positive. The assay for blocking Transport at room temperature Performed: referred-A antibodies is useful in monitoring response to therapy. turnaround: 3-5 days

84240 ACETYLCHOLINE (AChR) MODULATING ANTIBODY <32% binding inhibition Specimen Container: 83519 Radiobinding assay No additive (red top) Clinical Use: Myasthenia gravis (MG) is a neuromuscular disorder charactarized 1.0 (0.2) mL serum by muscle weakness, most commonly due to autoantibody-mediated Transfer serum to plastic, screw top vial. loss of functional acetylcholine receptors (AChr) in the neuromuscular junction. Modulating Antibody to AChR caues weakness by inhibiting or modulating binding to the receptors. Performed: referred-A turnaround: 3-5 days

84238 ACETYLCHOLINE RECEPTOR BINDING ANTIBODY Negative: ≥.30 nmol/l Specimen Container: 83519 Radioimmunoassay Equivocal 0.31-0.49 nmol/L No additive (red top) Positive: ≥ .50 nmol/L 1.0 (0.2) mL serum Clinical Use: Transfer serum to plastic, screw top vial. Myasthenia gravis (MG) is a neuromuscular disorder charactarized Serum is the only acceptable sample. by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChr) in the neuromuscular Transport at room temperature junction. This assay aids in the differentiating between generalized MG and ocular MG, and in monitoring therapeutic response. If bincing antibodies are negative, assays for blocking and modulating antibodies should be considered.NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: referred-A

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 3-5 days

84065 ACID PHOSPHATASE, PROSTATIC (PAP) < 2.8 ng/mL Specimen Container: 84066 Microparticle Enzyme Immunoassay PAP values from different assay methods cannot be used No additive (red top) interchangeably. This assay was performed using the DPC Chemiluminescence method. 1.0 (0.3) mL FROZEN serum Transfer serum to plastic, screw top vial and freeze. Clinical Use: For diagnosis and monitoring of prostatic carcinoma. Samples should be obtained before rectal exam, biopsy, prostatectomy or prostatic massage, since manipulating the prostate gland my lead to elevated Performed: referred-A PAP levels persisting up to 24-48 hours. turn around: 3-5 days

84240 ACTH - ADRENOCORTICOTROPIC HORMONE Adult Males: 7 - 50 pg/mL Specimen Container: 82024 Immunoassay Adult Females: 5 - 27 pg/mL EDTA (lavender top)

1.5 (0.5) mL FROZEN plasma Clinical Use: Transfer plasma to plastic, screw top vial and freeze. Determination of ACTH is useful in differentiating between primary and secondary adrenocortical hypo-and hyperfunctional disorders: Draw specimens between 7 am and 10 am. If drawn Addison's disease, Cushings syndrome, adrenal carcinoma, ectopic during any other time, the reference ranges do not ACTH syndrome, and nodular hyperplasia. apply. Performed: referred-A turn around: 3-5 days

85307 ACTIVATED PROTEIN C RESISTANCE >2.1 Normal Specimen Container: 85307 RVVT Clotting Assay 1.6-2.1 Borderline 3.2% Sodium Citrate (light blue top) <1.6 Abnormal 2.0 (1.0) mL FROZEN plasma Transfer plasma to a screw cap vial and freeze. The Activated Protein C Resistance (APC-R) test is a clotting based method used to screen for factor V Leiden mutation. A positive reuslt is suggestive of Factor V Leiden mutation. Carriers of this mutation are at a greater risk for venous thrombosis. This test is not a genetic test. Refer to the Factor V (Leiden) Mutation Analysis. Performed: referred-A turn around: 3-5 days

80314 ACYCLOVIR Accompanies report Specimen Container: 80299 High Performance Liquid Chromatography No additive (red top) Clinical Use: Acyclovir is commonly used in the treatment of herpes simplex virus 1.0 (0.5) mL FROZEN serum Transfer serum, to a screw cap vial and freeze. Performed: referred-A turnaround: 7-10 days

82017 ACYLCARNITINE Accompanies report Specimen Container: 82024 Liquid Chromatography/Tandem Mass Spectrometry Sodium heparin (green top tube) Clinical Use: Elevation of one or more acylcarnatines is diagnostic for an 1.0 mL FROZEN plasma organic aciduria or a fatty disorder. A low carnatine level may Transfer plasma to a screw cap vial and freeze. mask a disease state. Performed: referred-a Date of Birth is required. turnaround: 5-7 days

86178 ADENOVIRUS ANTIBODY < 1:8 Antibody Not detected Specimen Container: 86603 Complement Fixation ≥1:8 Antibody Detected No additive (red top)

Single titers of ≥1:64 are indicative of a current infection. Titers 1.0 (0.5) mL serum of 1:8 to 1:32 may be indicative of either past or recent infection. Transfer serum to a plastic, screw cap vial. since CF antibody levels persist for only a few months. A four-fold or greater increase in titer between acute and convalescent Transport at room temperature NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE specimens confirms the diagnosis.

Clinical Use: Adenoviruses can cause acute respiratory and conjunctivitis, as well Performed: referred-A as infantile diarrhea. turn around: 5-7 days

87252 ADENOVIRUS CULTURE Negative Specimen Container: 87252 Rapid Culture VCM Collection Kit A

3 mL conjunctival or throat swab or 3 mL fresh stool (1.0 minimum) or 50 mL first morning urine

Transport at room temperature

Performed: referred-A turn around: 5-7 days

AFB SMEAR AND CULTURE (ACID FAST SMEAR & 87117 CULTURE) See individual assays Specimen Container: 87015 Sterile, leak-proof container 87116 Conventional Culture, Microscopic Exam, Radiometric Assay Clinical Use: 87206 There are more than 70 species of Mycobacteria of which the primary 10 mL sputum or bronchial wash (2.0 mL minimum) pathogen is M. tuberculosis. Tuberculosis is a chronic, granulomatous disease caused by M. tuberculosis. Identification, and, if appropriate, antibiotic sensitivity, is required to initiate therapy.

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: referred-A turn around: preliminary 3 wks/final 8wks

12105 AFP, TUMOR MARKER < 1.3- 8.0 ng/mL Specimen Container: 82105 Siemens Centaur/Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: AFP is a tumor-associated protein. An elevation of serum AFP above 1.0 (0.2) mL serum values typically found in healthy individuals occus in several malignant diseases, most notably nonseminomatous testicular cancer Transport at room temperature and primary hepatocellular carcinoma. AFP is not recommended as a screening procedure to detect cancer in the general population. Performed: mon-sat turnaround: next day

14465 ALANINE AMINOTRANSFERASE (ALT, SGPT) 0-6 days: 0-60 U/L Specimen Container: 84460 Kinetic 6 days-2 years: 0-50 U/L Gel barrier (gold or tiger top) 2-5 years: 0-45 U/L >5 years: 0-35 U/L 1.0 (0.2) mL serum

Clinical Use: Alanine aminotransferase (ALT) measurements are useful in the diagnosis and treatment of heart disease and certain liver diseases. Performed: daily turn around: next day

12040 ALBUMIN 0-6 Days 2–5 mg/dL Specimen Container: 82040 Dye Binding/Bromcresol Green 6 days – 2 years 3-5 mg/dL Gel barrier (gold or tiger top) 2–59 years 3.2-5 mg/dL >60 years 2.8–5 mg/dL 1.0 (0.2) mL serum

Clinical Use: Serum albumin measurements are used in the monitoring and treatment of numerous diseases involving primarily the liver and kidney. Its main value lies in the follow-up therapy, where improvement in the serum albumin level is the best sign of successful medical treatment. There may also be a loss of albumin in the gastrointestinal tract, in the urine by the damaged kidney, or by direct loss of albumin through the skin. More than 50% of patients with gluten-sensitive enteropathy have depressed albumin. The only cause of increased albumin is dehydration; there Performed: daily is no naturally occurring hyperalbuminemia. turn around: next day

82041 ALBUMIN, SYNOVIAL FLUID Acccompanies report Specimen Container: 82085 Nephelometric Sterile, screw cap container Clinical Use: The serous cavities surroundin the abdomen, heart and lungs will 3.0 (2.0) mL Synovial Fluid accumulate fluids, called effusions, when their production or Overnight fasting is preferred. resorption is not in balance. The serum-effusion albumin gradient is Performed: referred-A used to classify whether an effusion is a transudate or an exudate. turn around: 3-5 days

12055 ALCOHOL, (ETHANOL), BLOOD None Detected Specimen Container: 82055 Enzymatic Oxidation Sodium flouride (grey top) or Gel barrier (gold or tiger top)

Test for medical purposes only 5.0 (2.0) mL whole blood or 1.0 (0.3) mL serum DO NOT REMOVE STOPPER. Performed: mon - sat turn around: 1-2 days

12665 ALCOHOL, (ETHANOL), URINE None Detected Specimen Container: 82055 Enzymatic Oxidation Sterile, screw cap container

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 30.0 (5.0) mL random urine Test for medical purposes only

Performed: mon - sat turn around: 1-2 days

82085 ALDOLASE <24 Months 3.4-11.8 U/L Specimen Container: 82085 Enzymatic 2-17 Years 3.4-8.6 U/L No additive (red top) Adults ≤8.1 U/L 2.0 (0.5) mL serum Clinical Use: Transfer serum, to a screw cap vial. Aids in the diagnosis of primary disease of skeletal muscle, Performed: referred-A myocardial infarction and viral hepatitis. Hemolyzed specimens are not acceptable turn around: 3-5 days

82087 ALDOSTERONE Accompanies report Specimen Container: 82088 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Approximately 1-2% of individuals with primary hypertension 2.0 (0.5) mL serum have primary hyperaldosteronism, characterized by Transfer serum, to a screw cap vial. hypokalemia (low potassium) and low direct renin. Because serum aldosterone concentrations vary, due to dietary Gel barrier (gold or tiger top) tubes are not acceptable sodium intake and body position, some physicians prefer Draw "upright" samples at least ½ hour after measurement of 24-hr urine concentrations for aldosterone. patient sits up. Performed: referred-A turn around: 5-7 days

82089 ALDOSTERONE/PLASMA RENIN - ACTIVITY RATIO Accompanies report Specimen Container: 84244 Liquid Chromatography Tandem Mass Spectrometry EDTA (lavender top) Clinical Use: The aldosterone-renin ration is used to screen for primary 2.0 mL FROZEN plasma aldosteronism. Transfer plasma, to a screw cap vial and freeze. Performed: referred-A turn around: 5-7 days

14075 ALKALINE PHOSPHATASE (ALP) 0-2 years 50-270 U/L Specimen Container: 84075 p-Nitrophenol Phosphate at 410/480 nm 2-12 years 60-280 U/L Gel barrier (gold or tiger top) 12-15 years 60-500 U/L

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 15-59 years 29-130 U/L 1.0 (0.2) mL serum Performed: daily > 60 years 33-144 U/L turn around: next day

84078 ALKALINE PHOSPHATASE FRACTIONATION Accompanies report Specimen Container: 84078 Kinetic Gel barrier (gold or tiger top)

2.0 mL serum Performed: referred-A turn around: 3-5 days

84080 ALK. PHOS ISOENZYMES Accompanies report Specimen Container: 84075 Electrophoresis Gel barrier (gold or tiger top) 84080 Clinical Use: Measurement of Alkaline Phosphatase Isoenzymes may be 2.0 (1.0) mL serum useful in determining the source of increased Total Alkaline Phosphatase activity and may assist in the Overnight fasting is preferred diagnosis of hepatobiliary disorders and bone disease Performed: referred-A associated with increased osteoblastic activity. turn around: 2-3 days

86067 ALPHA-1-ANTITRYPSIN 83-199 mg/dL Specimen Container: 82103 Tubidimetric Gel barrier (gold or tiger top) Clinical Use: Congenital deficiency of Alpha-1-Antitrypsin (AAT) is 1.0 (0.5) mL serum associated with early lung disease (emphysema, chronic Overnight fasting is preferred bronchitis, and chronic obstructive lung disease) and neonatal hepatitis and infantile cirrhosis. If a deficiency is present, AAT phenotyping is suggested to Performed: referred-A confirm heterozygous versus homozygous deficiencies. turn around: 3-5 days

83883 ALPHA 1 ACID GLYCOPROTEIN Accompanies report Specimen Container: 82985 Fixed Rate Time Gel barrier (gold or tiger top) Clinical Use: Alpha-1-Acid Glycoprotein is an acute phase reactant 1.0 (0.5) mL serum

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE increased in patients with inflammation. Alpha-1-Acid Overnight fasting is required Glycoprotein is also increased in patients with tumors, possibly acting to protect tissues. In patients with Philadelphia-positive Chronic Myeloid Leukemia, Acid-1-Acid Glycoprotein is associated with a poorer Performed: referred-A prognosis. turn around: 3-5 days

ALPHA-FETOPROTEIN QUAD SCREEN (MATERNAL AFP, 82107 HCG, UE3, INHIBIN A) Accompanies report Specimen Container: 82677 Calculation Gel barrier (gold or tiger top) 84702 Enzyme-Linked Immunosorbent Assay Clinical Use: 82105 Immunochemiluminometric Assay Prenatal risk assessment for neural tube defect, Down Syndrome, 3.0 mL serum 86336 and Trisomy 18. Maternal Date of Birth, Estimated Date of Delivery by US/LMP/PE, weight, race, insulin-dependent diabetes status, repeat sample (Y/N), number of fetuses, and neural tube defect history must be provided for Performed: referred-A interpretation of results. turn around: 3-5 days

ALPHA-FETOPROTEIN TRIPLE SCREEN (MATERNAL AFP, 84914 HCG & UE3) Accompanies report Specimen Container: 82105 Immunoassay Gel barrier (gold or tiger top) 82677 Calculation Clinical Use: 84702 Maternal serum alpha-fetoprotein (MSAFP) is used for 3.0 mL serum prenatal screening of open neural tube defects (ONTD). Maternal serum Triple and Quad Screens are used for Maternal Date of Birth, Estimated Date of Delivery by prenatal screening for Down syndrome (Trisomy 21), US/LMP/PE, weight, race, insulin-dependent diabetes Trisomy 18 (Edwards' syndrome), and open neural tube status, repeat sample (Y/N), number of fetuses, and defects (ONTD). neural tube defect history must be provided for interpretation of results. Performed: referred-A turn around: 3-5 days

83511 ALPHA-SUBUNIT Accompanies report Specimen Container: 83519 Radioimmunoassay Gel barrier (gold or tiger top) Clinical Use: The pituitary glycoprotein hormones-thyroid stimulating hormone 2.0 (0.3) mL serum (TSH), luteinizing hormone (LH), and follicle stimulating hormone (FSH) are comprised of identical alpha subunits that confer biologic specificity. Some pituitary adenomas, unassociated with a clinical

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE syndrome of hormonal over-secretion, produce the alpha subunit, which serves as a useful tumor marker. Measurement of alpha subunit can differentiate TSH-secreting pituitary adenomas (in which the ratio of alpha-to-intact TSH serum concentrations is >1) from thyroid hormone resistance syndromes (in which the ratio is ≥ 1). Gonadotropin-secreting pituitary adenomas, producing excessive alpha subunit, have been reported. Nonpituitary tumors, e.g., choriocarcinoma and carcinoid tumors, secreting the alpha subunit Performed: referred-A have also been described. turn around: 5-7 days

86330 ALPHA-2 MACROGLOBULIN Accompanies report Specimen Container: 83883 Fixed Rate Time Nephelometry Gel barrier (gold or tiger top)

Alpha-2- Macroglobulin is produced in the liver. Increased 2.0 (0.3) mL serum concentrations are associated with patients with some chronic liver Overnight fasting is preferred. diseases, nephrotic syndrome, and diabetes. Decreased concentrations are associated with patients with pancreatitis, Performed: referred-A rheumatoid arthritis, and multiple myeloma. turn around: 5-7 days

82108 ALUMINUM Accompanies report Specimen Container: 82108 Atomic Spectroscopy EDTA Trace Element (royal blue top) or Clinical Use: EDTA (lavender top) Aluminum has been found as a cause of encephalopathy in patients undergoing prolonged hemodialysis for renal failure. Patients in 2.0 (1.0) mL whole blood renal failure lose the ability to filter and excrete aluminum, which consequently accumLates in the blood and eventually in the brain Carefully clean skin before venipuncture. and in bone. Avoid hemolysis. Avoid work-site collection. Avoid fruits, juices, and tea for 24 hours before collection. Performed: referred-A turn around: 5-7 days

84014 AMIKACIN PEAK Peak: 20-30 mg/L Specimen Container: 80150 Immunoassay Potentially Toxic Values Peak: ≥ 40.0 mg/L No additive (red top tube)

Clinical Use: 1.0 (0.2) mL serum. Amikacin is an aminoglycoside antibiotic used in the treatment of Transfer serum, to a screw cap vial. gram negative bacillary infections. Amikacin is potentially nephrotoxic and ototoxic and serial monitoring of serum levels provides Peak: Collect peak at the end of 60 minute IV infusion information to maintain safe and therapeutic levels. or 30 minutes after end of 30 minute IV infusion or 60 minutes after IM dose. DO NOT collect in gel barrier (tiger) tubes or Performed: referred-A tubes containing heparin anticoagulant. turn around: 2-3 days

84013 AMIKACIN TROUGH Trough: 4.0-8.0 mg/L Specimen Container: 80150 Immunoassay Potentially Toxic Values Trough: ≥ 15.0 mg/L No additive (red top tube)

Clinical Use: 1.0 (0.2) mL serum. Amikacin is an aminoglycoside antibiotic used in the treatment of Transfer serum, to a screw cap vial. gram negative bacillary infections. Amikacin is potentially nephrotoxic and ototoxic and serial monitoring of serum levels provides Trough: Collect prior to the next scheduled dose information to maintain safe and therapeutic levels. DO NOT collect in gel barrier (tiger) tubes or Performed: referred-A tubes containing heparin anticoagulant. turn around: 2-3 days

82128 AMINO ACID ANALYSIS, PLASMA Accompanies report Specimen Container: 82139 Liquid Chromatography/Mass Spectrometry Sodium heparin (green top) Clinical Use: Amino acids serve many functions including as building blocks for 2.0 mL FROZEN plasma for proteins, neurotransmitters, precursors to hormones, and as Transfer plasma, to a screw cap vial and freeze. enzyme co-factors. More than 70 disorders of amino acid metabolism have been described.NICL The Laboratories/2011 clinical manifestations of Plasma should be separated from cells as soon TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE these disorders are diverse. Some disorders are best indentified as possible after collection. Performed: referred-A with CSF, plasma or urine. turn around: 7-10 days

82130 AMINO ACID PROFILE, URINE Accompanies report Specimen Container: 82139 Liquid Chromatography/Mass Spectrometry Sterile urine container, leak-prof 82570 Clinical Use: Amino acids serve many functions including as building blocks for 2.0 (0.5) mL random urine for proteins, neurotransmitters, precursors to hormones, and as enzyme co-factors. More than 70 disorders of amino acid Do not use preservatives. metabolism have been described. The clinical manifestations of Urine with a pH <2.0 will be rejected. these disorders are diverse. Performed: referred-A turn around: 7-10 days

AMIODARONE (INCLUDES METABOLITE 80026 DESETHYLAMINODARONE) Amiodarone Therapeutic range: 1.5-2.5 mcg/mL Specimen Container: 82492 High Performance Liquid Chromatography Desmethylamiodarone Therapeutic range: 1.5-2.5 mcg/mL No additive (red top tube)

Detection limits 0.3 mcg/mL 1.0 (0.2) mL serum. Transfer serum, to a screw cap vial. Performed: referred-A Toxic effects have been observed at levels as low as 2.0 mcg/mL turn around: 3-5 days

80223 AMITRIPTYLINE+NORTRIPTYLINE Amitriptyline + Nortriptyline Specimen Container: 80299 High Performance Liquid Chromatography 120-250 mcg/L No additive (red top tube)

Detection limit 1.0 (0.2) mL serum. 5 mcg/L Transfer serum, to a screw cap vial.

Clinical Use: Collect as a trough just prior to next scheduled Amytriptyline is a tricyclic antidepressant used in the treatment of dose or at least 12 hours after last dose. depressive disorders. Amitriptyline is metabolized to Nortriptyline, Performed: referred-A whhich is also an active antidepressant. Do not use gel barrier (tiger) tubes turn around: 3-5 days

12140 AMMONIA 16-53 umol/L Specimen Container: 82140 Colorimetric Sodium heparin (green top) Clinical Use: Ammonia is elevated in liver disease, Reye syndrom, urea cycle 2.0 mL FROZEN heparinized plasma, centrifuge enzyme deficiencies, and other medical conditions. The correlation within 30 minutes of collection and transfer to a Performed: mon-sat with hepatic coma is poor. screw cap vial and freeze. turn around: next day

84908 AMOXAPINE, (ASEBDIN) Accompanies report Specimen Container: 82492 High Performance Liquid Chromatography No additive (red top tube) Clinical Use: Test is used for Therapeutic drug monitoring is useful to avoid toxiciity.. 2.0 mL serum. Transfer serum, to a screw cap vial. Performed: referred-A turn around: 7-10 days

12150 AMYLASE, SERUM 18-79 U/L Specimen Container: 82150 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: The most common cause of elevation of serum amylase is 1.0 (0.2) mL serum inflammation of the pancreas (pancreatitis). This elevation may be Performed: daily blunted by Citrates, IV Dextrose, Oxalates, and Saquinavir. turn around: next day

22151 AMYLASE, 2 HOUR URINE 2-34 U/2 HR Specimen Container: 82150 Spectrophotometric Sterile urine container, leak-proof

10.0 (5.0) aliquot urine NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

Performed: mon, weds, fri Record total hours of collection and total volume turn around: 1-3 days of specimen on test requisition.

22154 AMYLASE, 24 HOUR 12-408 U/24 HR Specimen Container: 82150 Spectrophotometric 24 hour urine collection container, no preservative

10.0 (5.0) aliquot of a well-mixed 24-hr urine

Record total hours of collection and total volume

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE of specimen on test requisition. Performed: mon, weds, fri turn around: 1-3 days

12156 AMYLASE, URINE There are no reference ranges established for random urine Specimen Container: 82150 Spectrophotometric specimens Sterile urine container, leak-proof

Clinical Use: 10.0 (5.0) aliquot urine Urinary amylase is useful in the consideration of macroamylasemia and pseudocyst of the pancreas. With macroamylasemia, only the serum level is elevated. With pseudocysts, the urinary concentration Performed: mon, weds, fri remains elevated for weeks after an episode of acute pancreatitis. turn around: 1-3 days

46256 ANA < 1:40 Specimen Container: 86038 Immunofluorescence Microscopy Gel barrier (gold or tiger top) Clinical Use: Antinuclear antibodies are present in Systemic Lupus Erythematosus, 1.0 (0.3) mL serum Sjogren's Syndrome, Mixed Connective Tissue Disease, Scleroderma, liver disease, Drug Induced Lupus, and Rheumatoid Arthritis.

82157 ANDROSTENEDIONE Accompanies report Specimen Container: 82157 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Androstenedione may be useful in evaluating patients with 1.0 (0.3) mL serum. androgen excess and managing patients with congenital adrenal Transfer serum, to a screw cap vial. hyperplasia (CAH) Do not use gel barrier (tiger) tubes. Performed: referred-A turn around: 7-10 days

82164 ANGIOTENSIN-1 CONVERTING ENZYME (ACE) 6 months-17 years: 13-100 U/L Specimen Container: 82172 Kinetic Adults: 9-67 U/L No additive (red top)

Clinical Use: 1.0 (0.2) mL serum. Increased in sarcoidosis, Gaucher's disease, and Transfer serum, to a screw cap vial. lymphoangiomyomatosis.

Performed: Monday-Saturday Morning,

turn around: next day

ANTI-DIURETIC HORMONE (ADH) ARGININE 84588 VASOPRESSIN Accompanies report Specimen Container: 84588 Extraction EDTA (lavender top) Radioimmunoassay Clinical Use: Antidiuretic Hormone (also called ADH 4.0 (1.1) mL FROZEN plasma

Antidiuretic Hormone (also called ADH or Vasopressin) regulates Draw blood in a pre-chilled lavender top tube. water reabsorption in the kidney, reducing diuresis and increasing Transport in an ice bath. Separate plasma and Performed: referred-A blood volume and pressure. freeze immediately. turn around: 8-10 days

86215 ANTI-DNAASE, STREP B <187 U/mL Specimen Container: 86215 Nephelometry No additive (red top) Clinical Use: Documents recent streptococcal infection 1.0 (0.3) mL serum. Performed: referred-A Transfer serum, to a screw cap vial. turn around: 3-5 days

86225 ANTI-DNAds ANTIBODIES ≤ 4 IU/mL Negative Specimen Container: 86225 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Immunoassay 5-9 IU/mL Indeterminate Gel barrier (gold or tiger top) ≥10 IU/mL Positive 1.0 (0.3) mL serum Clinical Use: High levels to antibody to double stranded DNA are found in active Overnight fasting is preferred. systemic lupus erythematosus, but are uncommom in other Performed: referred-A autoimmune diseases. turn around: 3-5 days

86255 ANTI-MITOCHONDRIAL ANTIBODY <1:20 Specimen Container: 86255 Immunoassay No additive (red top) Clinical Use: A high anti-Mitochondrial (AMA) titer supports the diagnosis of 1.0 (0.3) mL serum. primary bilary cirrhosis (PBC). Low titers of AMA may be detected Transfer serum, to a screw cap vial. in other liver disorders, which include chronic active hepatitis and crytogenic cirrhosis. Mitochondrial M2 Antibody has an Performed: referred-A even higher specificity for PBC. turn around: 3-5 days

83517 ANTI-MULLERIAN HORMONE Accompanies report Specimen Container: 83520 Immunoassay No additive (red top tube) Clinical Use: AMH/MIS may be used in the investigation of ovarian reserve and 1.0 (0.5) mL FROZEN serum. the premenopausal transition in women; the detection and onset of Transfer serum, to a screw cap vial and freeze. puberty in the young; the differential diagnosis of intersex disorders; the diagnosis of cryptochidism and anorchidism; and the evaluation Performed: referred-A of male gonadal function in all ages. turn around: 5-7 days

86238 ANTI-SMITH Ab, SM & SM/RNP Smith Antibody Specimen Container: 86235 x2 Enzyme Immunoassay < 1.0 AI: Negative Gel barrier (gold or tiger top) Smith/Ribonucleoprotein Antibody < 1.0 AI: Negative 1.0 (0.5) mL serum.

Clinical Use: Requires a fasting specimen Antibodies to Sm are highly specific for systemic lupus erythematosus (SLE) and, when present, are considered a marker antibody. However, these antibodies are found in only 20% of patients with SLE. RNP antibodies (also known as anti-u1 or ribonucleoprotein antibodies) are found in 45% of SLE patients, but are also observed in numerous other disease states such as Sjogren's syndrome, scleroderma, and polymyositis. Elevated levels of anitbodies to RNP are seen in mixed connective tissue disease. In SLE, RNP antibodies have been associated with a relatively benign disease course with lower incidence of renal and central nervous system involvement. Patients may be considered positive for RNP antibodies when the RNP antibody result is significantly higher Performed: referred-A than the Sm antibody result. turn around: 3-5 days

86252 ANTI-SMOOTH MUSCLE (ACTIN) ANTIBODY < 20 Units: Negative Specimen Container: 83516 Enzyme Linked Immunosorbent Immunoassay 20-30 Units: Weak positive No additive (red top) > 30 Units: High positive 1.0 (0.3) mL serum. Clinical Use: Transfer serum, to a screw cap vial. This ELISA assay is based on purified F-Actin IgG antibodies. IgG antibodies to F-Actin are present in approximately 75% of patients with autoimmune hepatitis type 1, 65% with autoimmune hepatitis type 1, 65% with autoimmune cholangitis, 30% with primary Performed: referred-A biliary cirrhosis, and 2% of the healthy population. turn around: next day

46060 ANTI-STREPTOLYSIN O (ASO) Adult: Specimen Container: 86060 Latex ≤ 200 IU/mL Gel barrier (gold or tiger top) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Pediatric ≤17 yrs: < 150 IU/mL 1.0 (0.5) mL serum.

Performed: mon - sat Fasting specimen is preferred turn around: next day

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 85300 ANTITHROMBIN III ACTIVITY Accompanies report Specimen Container: 85300 Immunoturbidimetric 3.2 Sodium Citrate (light blue top)

1.0 (0.5) mL FROZEN plasma

Collection Instructions for Platelet Poor Plasma: Centrifuge light blue-top tube 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid the wbc/platelet buffy layer, and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of platelets (< 10,000/mcl). Freeze immediately Performed: referred-A turn around: 3-5 days

85301 ANTITHROMBIN III PROFILE Accompanies report Specimen Container: 85300 Immunoturbidimetric 3.2 Sodium Citrate (light blue top) Test Components: Antithrombin III Activity 1.0 (0.5) mL FROZEN plasma Antithrombin III Antigen Collection Instructions for Platelet Poor Plasma: Centrifuge light blue-top tube 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid the wbc/platelet buffy layer, and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of Performed: referred-A platelets (< 10,000/mcl). Freeze immediately turn around: 3-5 days

82172 APOLIPRPROTEIN A1 Male: 94-176 mg/dL Specimen Container: 82172 Fixed Rate Time Nephelometry Female: 101-198 mg/dL Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum. Apolipoprotein A1 is the primary protein associated with HDL Performed: referred-A cholesterol. Like HDL cholesterol, increased concentrations are Fasting for at least 12 hours is required. turn around: 3-5 days

82173 APOLIPRPROTEIN B-100 Female: 49-103 mg/dL Specimen Container: 82172 Nephelometric Male: 52-109 mg/dL Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum. Apolipoprotein B (APO B) has been reported to be a powerful indicator of CAD. In some patients with CAD, APOB is elevated Fasting for at least 12 hours is required. Performed: referred-A even in the presence of normal LDL cholesterol turn around: 3-5 days

82174 APOLIPOPROTEIN EVALUATION Accompanies Report Specimen Container: 82172 X2 Nephelometric Gel barrier (gold or tiger top) Test Components: Apolipoprotein A 1 1.0 (0.5) mL serum. Apolipoprotein B Performed: referred-A Fasting for at least 12 hours is required. turn around: 3-5 days

82176 ARSENIC, URINE 50 mcg/g Creatinine or less Specimen Container: 82175 Includes Creatinine 2nd voided a.m. urine for nonexposed adult Acid washed, metal free urine container 82570

Inductively Coupled Plasma-Mass Spectrometry 50 mcg/g Creatinine or less 7.0 (3.5) mL random or 2nd voided a.m. urine Biological Exposure Index (end-of-shift-work-week) Instructions: Patient should refrain from eating Detection limit seafood and taking herbal supplements for at Performed: referred-A 10 mcg/L least 3 days before specimen collection. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 5-7 days

82175 ARSENIC, BLOOD < 23 mcg/L Specimen Container: 82175 Inductively Coupled Plasma-Mass Spectrometry Detection limit: 3 mcg/L EDTA Trace Element (royal blue top)

7.0 (2.0) whole blood

Instructions: Patient should refrain from eating seafood and taking herbal supplements for at Performed: referred-A least 3 days before specimen collection. turn around: 5-7 days

83886 ASHKENAZI JEWISH PANEL Accompanies report Specimen Container: 83900 Polymerase Chain Reaction EDTA (lavender top) 83891 (x3) Allele-Specific Hybridization Clinical Use: 83909 (x4) Allele specific primer extension This panel detects Jewish mutations in the following 4.0 mL in each of 3 EDTA (lavender-top) tubes, 83892 (x7) Fluorescent detection/color coded microspheres diseases: Bloom, Canavan, Cystic Fibrosis, Fanconi Anemia whole blood. 83912 (x11) (C), Familial Dysautonomia, Gaucher, Glycogen Storage 83901 (x33) Disease I, Maple Syrup Urine Disease, Mucolipidosis IV, Transport at ambient temperature. 83914 (x67) Performed: referred-A Niemann-Pick, and Tay-Sachs. turn around: 10-14 days

14455 ASPARTATE AMINOTRANSFERASE (AST, SGOT) 10 - 43 mU/mL Specimen Container: 84450

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Kinetic Gel barrier (gold or tiger top) Clinical Use: Aspartate Aminotransferase is widely distributed throughout the 1.0 (0.2) mL serum tissues, with significant amounts in the heart and liver, although smaller amounts can be found in skeletal muscles, kidneys, pancreas, spleen, lungs, and brains. Increase in AST can be seen in myocardial infactions, hepatitis, liver necrosis, cirrhosis Performed: daily and liver metastasis. turn around: next day

86606 ASPERGILLUS ANTIBODY Accompanies report Specimen Container: 86606 (x3) Gel barrier (gold or tiger top) Clinical Use: Aspergillus is a group of molds. Aspergillosis ranges in severity 1.0 (0.2) mL serum and includes allergy-type illness, allergic bronchopulmonary aspergillosis, aspergillois sinusitis, aspergilloma, and invasive aspergillosis. Infection is more common in patients who are immunocompromised. Early diagnosis contributes to effective Performed: referred-A medical treatment. turn around: 5-7 days

87304 ASPERGILLUS ANTIGEN Aspergillus Ag: Index < 0.5 Specimen Container: 87305 Immunoassay Serum: Gel barrier (gold or tiger top) Result Interpretation Bronchial lavage/wash: Sterile, leak-proof container An index < 0.5 is considered to be negative. An index ≥0.5 is considered to be positive. A positive result for patients being 2.0 (1.0) mL FROZEN serum, transfer to a treated with piperacillin-tazobactam and other beta-lactam screw cap vial and freeze. antibiotics such as amoxicillin-clavulanate may be a false positive due to cross-reactivity and should be viewed in conjunction with 2.0 (1.0) mL bronchial lavage/wash all clinical findings. Positive results with this assay have also been reported in patients infected with Penicillium marneffei and Transport Frozen Cryptococcus. Do not store or transport at room temperature

Clinical Use: The Platelia(R) Aspergillus EIA is used for the detection of Aspergillus galactomannan antigen in serum or bronchial alveolar lavage (BAL) by enzyme immunoassay. The Platelia(R) Aspergillus EIA is an aid in the early diagnosis of invasive aspergillosis. This asssay is to be used and test results interpreted in conjunction with other conventional diagnostic procedures, such as microbiological culture, histological examination of biopsy Performed: referred-A samples, and other signs and symptoms of Aspergillus infection turn around: 3-5 days

83551 ATROPINE, BLOOD Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry EDTA (lavender top) or No additive (red top)

3.0 (1.2) mL plasma or serum, transfer to a plastic, screw cap vial.

Performed: referred-A turn around: 5-7 days

80601 AUTOIMMUNE DISEASE PANEL Accompanies report Specimen Container: 84155 Components: No additive (red top) 84165 ANA IFA Screen w/Reflex to Titer and Pattern, IFA Clinical Use: 86038 C3, ComLement See individual test components 6.0 (4.0) mL serum, transfer to 4 separate, plastic 86225 Complement Component C4 screw cap vials. 86431 DNA (DS) Antibody 86160 (x2) Protein Electrophoresis Protein, Total Rheumatoid Factor

Performed: referred-A NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 3-5 days

87797 B. PERTUSSIS/PARA DNA, QL B. pertussis DNA: Not detected Specimen Container: 87798 (x2) Real-Time PCR B. parapertussis DNA: Not detected Culture transport swab (pink cap) Sterile, leak-proof container

1.0 (0.3) mL Nasopharyngeal wash,aspirate in a sterile, leak-proof container or Nasopharyngeal swab collected in Amies culture tube Clinical Use: (pink cap) Bordetella pertussis is the cause of whooping cough that may occur in unimmunized individuals. B. parapertussis is a related Use Amies' collection tube with liquid Amies and wire organism that causes a similar, but milder, disease. Laboratory collection swab. Do not use calcium alginate swabs, diagnosis may require both culture and serological confirmation, as they may contain substances that inhibit PCR.

Performed: referred-A Transport Refrigerated turn around: 3-5 days

86753 BABESIA MICROTI IgG, IgM < 1:16: Babesia microti IgG Specimen Container: 86753 (x2) Assay < 1:20: Babesia microti IgM No additive (red top)

Clinical Use: 1.0 (0.1) mL serum. Babesia serological testing is used to diagnose infection by the Transfer serum, to a screw cap vial. Performed: referred-A Babesia tick-borne protozoan. Infection may cause hemolytic anemia. turn around: 3-5 days

82483 BACLOFEN / LIORESAL Accompanies report Specimen Container: 82489 Liquid Chromatography/Tandem Mass Spectrometry Clinical Use: No additive (red top) or Baclofen is primarily used to treat spasiticity and is under EDTA (Lavender top) investigation for the treatment of acoholism. 3.0 (1.2) mL serum or plasma, transfer to a plastic, screw cap vial.

Performed: referred-A Do not use gel barrier tube. turn around: 5-7 days

BARTONELLA SPECIES ANTIBODY- IgG and IgM with Reflex 86613 to Titers Negative: B. henselae IgG Screen Specimen Container: 86611 Indirect Immunofluorescence Assay < 1:64: B. henselae IgG Titer Gel barrier (gold or tiger top) Negative: B. henselae IgM Screen < 1:20: B. henselae IgM Titer 1.0 (0.2) mL serum Negative: B. quintana IgG Screen < 1:64: B. quintana IgG Titer Negative: B. henselae IgM Screen < 1:20: B. quintana IgM Titer

Clinical Use: Bartonella henselae infections have been associated with many clinical presentation, including cat scratch disease, bacillary Performed: referred-A angiomatosis, peliosis hepatis, and bacteremia. turn around: 3-5 days

20163 BASIC METABOLIC PANEL See Individual Tests Specimen Container: 80048 Components: Gel barrier (gold or tiger top) Sodium, Potassium, Chloride, Carbon Dioxide, Glucose, Urea Nitrogen (BUN), Creatinine, Calcium 1.0 (0.2) mL serum Performed: daily turn around: next day

83905 BCR/ABL GENE REARRANGEMENT, QUAN. PCR, Cell-based Accompanies report Specimen Container: 83891 Real-Time PCR EDTA (lavender top) 83900 Reverse Transcriptase-Polymerase Chain Reaction 83912 NICL Laboratories/2011 6.0 (4.0) mL whole blood 83902 (x2) TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 83896 (x3) Ship immediately, due to short sample stability Performed: referred-A of 72 hours. turn around: 5-7 days

84185 BENCE JONES PROTEIN, 24 Hr URINE Accompanies report Specimen Container: 84156 Colorimetric 24 hour urine collection container 84166 Electrophoresis 86335 Nephelometric 50.0 (30.0) mL aliquot of a well mixed 24 hour 83883 (x2) urine collected with no preservitive

Performed: referred-A turn around: 3-5 days

84186 BENCE JONES PROTEIN RANDOM UR Accompanies report Specimen Container: 84156 Colorimetric Sterile urine container, leak-prof 84166 Electrophoresis 86335 Nephelometric 50.0 (30.0) mL aliquot of a well mixed random 83883 (x2) urine collected with no preservitive

Performed: referred-A turn around: 3-5 days

80288 BENZTROPINE (COGENTIN ) Accompanies report Specimen Container: 80299 Gas Chromatography No additive (red top) or Clinical Use: EDTA (lavender top) Therapeutic drug monitoring is useful to avoid toxiciity. 5.0 (2.2) mL serum or plasma Transfer serum or plasma, to a screw cap vial.

Do not use Gel barrier (gold or tiger top) tube

The optimum time to collect the sample is Performed: referred-A 10-14 hours after oral dose. turn around: 5-7 days

82232 BETA-2-MICROGLOBULIN Adults: ≤ 2.51 mg/L Specimen Container: 82232 Nephelometric Pediatric (< 18 years of age): Reference Range not established Gel barrier (gold or tiger top)

Beta-2 Microglobulin normally passes through the glomerulus 1.0 (0.5) mL serum into the proximal tubule where much of it is reabsorbed. Serum levels are therefore an index of glomerular function. When impaired, Fasting is preferred. serum levels rise in inverse ratio to glomerular filtration rate. Hemolyzed and/or lipemic specimens are Increased amounts of Beta-2 Microglobulin are excreted in several unacceptable. renal disorders, e.g., balkan nephropathy, heavy metal poisoning and renal tubular diseae, due to therapeutic agents. Serial levels of Beta-2-Microglobulin in serum and urine are used to evaluate transplant viability and anticipate rejection. Following a successful graft, serum levels decline toward normal. Increasing serum levels provide an early sign of rejection. Elevated levels are also noted in lymphproliferative disorders, neoplasms (malignant and benign), inflammatory disease, and autoimmune diseases, such as systemic Performed: referred-A lupus erythematosus (SLE), and Sjogrens disease. turn around: 3-5 days

83537 BETA INTERFERON AUTOANTIBODIES-IgG Accompanies report Specimen Container 83520 Multi-Analyte Immunodetection If the Interferon-beta IgG is ≥4.0, this test will reflex to No additive (red top) Interferon-beta (IFNB) Antibody Neutralization Assay, performed at an additional charge. 1.5 ( 0.5) mL serum Transfer serum to plastic, screw cap vial. Clinical Use: Some multiple sclerosis patients receiving recombinant interferon- Collect sample at least 8 hours after beta (IFNb) develop IFNb-specific antibodies that may block the Interferon injection. therapeutic effect of the treatment. This assay screens for IgG Verify Medication: Avonex, Rebif, NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE antibodies capable of binding to IFNb; all samples with detectable Betaseron, Extavia. If the patient has been on IFnB binding antibodies are then tested for IFNb neutralizing therapy, please provide the medication and natibodies, using a bioassay. Approximately two weeks are duration. If patient is not on therapy, physician required to perform the neutralization bioassay; those results must supply reason for ordering test. The specific will be reported separately when available. interferon drug being used to treat the patient must be provided with the patient's requisition. Testing of specimens without this information Performed: referred-A will be delayed until information is provided. turn around: 5-7 days

47084 BETA STREP GROUP B SCREEN No Streptococcus Group B isolated Specimen Container 87081 Culture Culture transport swab (pink cap)

Transport at Room Temperature Performed: mon-sat turn around: 4 Days

82010 BETA-HYDROXYBURTYRATE Accompanies report Specimen Container 82010 Enzymatic Gel barrier (gold or tiger top) Clinical Use: In diabetics, the measurement of B-hydroxybutyrate, as well as 1.0 (0.3) mL serum blood glucose, is needed for the assessment of the severity of diabetic coma and is essential for the exclusion of hyperosmolar nonketotic diabetic coma. A specific enzymatic assay for Beta- Performed: referred-A hydroxybutyrate is extremely important in the assessment of ketosis. turn around: 5-7 days

83792 BILE ACIDS, FRACTIONATED & TOTAL (PREGNANCY) Accompanies report Specimen Container 83789 Liquid Chromatography/Tandem Mass Spectrometry Gel barrier (gold or tiger top) Clinical Use: Intrahepatic cholestasis of pregnancy (ICP) occurs in the second 1.0 (0.5) mL serum and third trimester of pregnancy. While its clinical manifestation in the mother is benign and is limited to pruritus, it may have Transport at room temperature. negative impact on the fetus, including fetal prematurity and demise. This is predicted by the level of bile acids and TAT is critical Performed: referred-A to institute therapy or early delivery to prevent fetal complications. turn around: 5-7 days

12250 BILIRUBIN, DIRECT 6 days- 60 years: 0 – 0.9 mg/dL Specimen Container 82248 Colorimetric Gel barrier (gold or tiger top) Clinical Use: Measurement of the levels of bilirubin is used in the diagnosis and 1.0 (0.5) mL serum treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gall bladder obstruction. The assessment Protect from light. of direct bilirubin is helpful in the differentiation of hepatic disorders. The increase in total bilirubin, associated with obstructive jaundice, is primarily due to the direct (conjugated) fraction. Both direct and Performed: daily indirect bilirubin are increased in the serum with hepatitis turn around: next day

12249 BILIRUBIN, TOTAL 0 – 1 day: 2.0 - 6.0 mg/dL Specimen Container 82247 Colorimetric 1 – 7 days: 6.0 - 10.0 mg/dL Gel barrier (gold or tiger top) 7 days – 59 years: 0.2 - 1.3 mg/dL > 60 years: 0.2 - 1.0 mg/dL 1.0 (0.5) mL serum

Clinical Use: Protect from light. Measurement of levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gall bladder obstructive disease Performed: daily bladder obstructive disease. turn around: next day

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 22251 BILIRUBIN, TOTAL & DIRECT See individual tests Specimen Container 82247 Colorimetric Gel barrier (gold or tiger top) 82248

1.0 (0.5) mL serum

Performed: daily Protect from light. turn around: next day

84592 BIOTIN (VITAMIN B7) Accompanies report Specimen Container 84591 Bioassay No additive (red top)

2.0 (1.0) mL serum.

Allow sample to clot for 30 minutes, centrifuge for 10 minutes and transfer serum to plastic, amber vial. If amber vial is not available, Performed: referred-A wrap tube in aluminum foil to protect from light. turn around: 3 weeks

87802 BK VIRUS DNA, QUANTITATIVE PCR less than 500 copies/mL Specimen Container 87799 Real Time Polymerase Chain Reaction Gel barrier (gold or tiger top) Clinical Use: This test is used to determine the presence of BK Virus DNA in 1.0 (0.5) mL FROZEN serum patient's specimens. Detection of the virus in these specimens may be indicative of an active infection, as PCR detects the Allow blood to clot at room temperature and presence of the virus, and not the host's reaction to the virus. separate serum from cells within 1 hour of Polyamavirus BK DNA detection in urine or plasma is associated collection. Transfer serum to sterile, plastic, with an increased risk of graft rejection in renal recipients. screw-cap tube and freeze. Performed: referred-A Quantitative testing may indicate change in risk over time. turn around: 3-5 days

87791 BK VIRUS DNA, QUANT PCR, URINE less than 500 copies/mL Specimen Container 87799 Real Time Polymerase Chain Reaction Sterile Sterile urine container, leak-prof Clinical Use: This test is used to determine the presence of BK Virus DNA in 0.7 (0.3) mL random urine patient's specimens. Detection of the virus in these specimens may be indicative of an active infection, as PCR detects the Transport frozen. presence of the virus, and not the host's reaction to the virus. Polyamavirus BK DNA detection in urine or plasma is associated with an increased risk of graft rejection in renal recipients. Quantitative testing may indicate change in risk over time.

Performed: referred-A turn around: 3-5 days

86612 BLASTOMYCES ANTIBODY, ID Negative Specimen Container 86612 Immunodiffusion Gel barrier (gold or tiger top) Interpretive Criteria Negative: Antibody not detected 1.0 (0.1) mL serum Positive: Antibody detected

A positive result is diagnostic of active or recent blastomycosis and is found in approximately 80% of proven cases of blastomycosis.

Clinical Use: Blastomycosis, caused by the fungus Blastomyces dermatitidis, occurs most commonly in men ages 20-69 years. Infection may Performed: referred-A be transient or lead to chronic, progressive pulmonary disease. turn around: 5-7 days

87452 BLASTOMYCES ANTIGEN Accompanies report Specimen Container: 87449 Enzyme Immunoassay Sterile Sterile urine container, leak-prof NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: No Additive (Red top tube) A change of 2 ng/mL or more compared to the prior specimen is significant, and should be considered in conjunction with clinical and other laboratory findings in deciding if the patient is 2.0 mL Body Fluid, Bronchoscopy Specimen, or Urine responding to or failing treatment. in sterile leakproof container

2.0 mL serum, transport in a Red top tube (no gel).

Performed: referred-A Transport at Room Temperature turn around: 5-7 days

13880 B-NATRIURETIC PEPTIDE (BNP ) 0 – 100 pg/mL Specimen Container: 83880 Chemiluminescence EDTA (Lavender top) Clinical Use: BNP is increased in congestive heart failure, left ventricular 1.0 (0.5) mL FROZEN plasma, transfer to plastic, hypertrophy, acute myocardial infarction, coronary angioplasty, screw cap vial and freeze. and hypertension. Elevations are also observed in pulmonary hypertension (indicating right ventricular dysfunction), acute lung injury, hypervolemic states, chronic renal failure and cirrhosis. cirrhosis. Decreasing levels indicate therapeutic response to Performed: daily anti-hypertensive therapy. turn around: next day

86622 BRUCELLA ANTIBODY, IgG & IgM Accompanies report Specimen Container: 86622 (x2) Enzyme-Linked Immunosorbent Assay Gel barrier (gold or tiger top) Clinical Use: Brucellosis is caused by transmission from animal to human. 1.0 (0.2) mL serum Brucella abortus is transmitted from cows. A high titer of IgM suggests recent exposure. A high titer of IgG suggests active infection. A lower titer of IgG may indicate past exposure or Performed- referred-A treated infection. turn around: 5-7 days

14520 BUN (BLOOD UREA NITROGEN) 0 – 6 days: 4 – 15 mg/dL Specimen Container: 84250 Colorimetric 6 days – 2 years: 5 – 18 mg/dL Gel barrier (gold or tiger top) 2 yrs – 59 years: 5 – 20 mg/dL > 60 years : 8 – 28 mg/dL 1.0 (0.2) mL serum

Clinical Use: BUN is most commonly measured in the diagnosis and treatment of certain renal and metabolic diseases. Increased BUN concentration may result from increased production of urea, due to (1) diet or excessive destruction of cellular proteins as occurs in massive infection and fevers; (2) reduced renal perfusion resulting from dehydration or heart failure; (3) nearly all types of kidney disease, and (4) mechanical obstruction to urine excretion such as is caused by stones, tumors, infection, or stricture. Decreased urea levels are less frequent and occurs Performed: daily primarily in advanced liver disease and in overhydration. turn around: next day

82475 BUPROPION (WELLBUTRIN ) Accompanies report Specimen Container: 83789 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Bupropion is an antidepressant for treating mental depression. 1.0 (0.2) mL FROZEN serum Monitoring its level is important to optimize therapy, to avoid Transfer serum to plastic, screw cap vial and freeze. toxicity, and to assure compliance. Performed: referred-A compliance. Do not use Gel barrier tubes (tiger top) turn around: 5-7 days

83500 C1 INHIBITOR, FUNCTIONAL Normal : ≥68 % Specimen Container: 86161 Immunoassay Equivocal: 41-67 % No additive (red top) Abnormal: ≤40 % Less than 40% of the reference functional activity indicates a 1.0 (0.2) mL FROZEN serum NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE likely diagnosis of hereditary angioedema or acquired C1 Transfer serum to plastic, screw cap vial and freeze inhibitor deficiency. within one hour of collection.

Clinical Use: C1 Esterase is decreased in angioedema. The inherited form is Do not use Gel barrier tubes (tiger top) usually diagnosed in the first two decades of life. The acquired form affects primarily adults with autoimmune or lymphoproliferative disorders. Approximately 15% of patients with hereditary angioedema have a normal concentration of the protein but it is dysfunctional. This test should be the first test performed to rule Performed: referred-A out herditary angioedema. turn around: 5-7 days

86158 C1 INHIBITOR, PROTEIN 11-26 mg/dL Specimen Container: 86160 Nephelometric Gel barrier (gold or tiger top) Clinical Use: C1 Esterase is decreased in angioedema. The inherited form is 1.0 (0.5) mL serum usually diagnosed in the first two decades of life. The acquired form affects primarily adults with autoimmune or lymphoproliferative Collect on ice. Chill in ice bath during clotting. disorders. Approximately 15% of patients with hereditary Separate from clot with minimum centrifugation. angioedema have a normal concentration of the protein but it is Refrigerate serum immediately. Avoid hemoysis. Performed: referred-A dysfunctional. turn around: 3-5 days

86163 C3 COMPLEMENT 90-180 mg/dL Specimen Container: 86160 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: C3 is the most abundant complement protein and is critical to 1 .0 ( 0.5) mL serum activation of both the classical and alternative pathways. C3 is an acute phase reactant. Decreased concentrations are observed in Overnight fasting is preferred. patients with systemic lupus erythematosus (SLE), endocarditis, and disseminated intravascular coagulation (DIC), Congenital deficiency of C3 places such patients at high risk for recurrent Performed: referred-A bacteremia. turn around: 3-5 days

86164 C4 COMPLEMENT 16-47 mg/dL Specimen Container: 86160 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: Decreased C4 leve is associated with acute systemic lupus 1 .0 ( 0.5) mL serum erythematosus, glomerulonephritis, immune complex disease, cryoglobulinemia, congenital C4 deficiency and generalized Overnight fasting is preferred. Performed: referred-A autoimmune disease. turn around: 3-5 days

86165 C5 COMPLEMENT 6.0-20.0 mg/dL Specimen Container: 86160 No additive (red top) Clinical Use: The complement system is critical to inflammatory responses. 1.0 (0.1) mL serum C5-C9 are components of the common pathway. Patients with congenital deficiency of any of of these components are at Centrifuge within 2 hours after collection and increased risk of meningococcal meningitis. transfer serum to a clean, plastic, screw-cap vial.

Performed: referred-A turn around: 3-5 days

86999 CA 15-3, CANCER ANTIGEN < 32 U/mL Specimen Container: 86300 Immunoassay Gel barrier (gold or tiger top) This test was performed using the Siemens (Bayer) chemiluminescent method. Values obtained from different 1.0 (0.5) mL serum assay methods cannot be used interchangeably. CA 15-3 levels, regardless of value, shouldNICL not Laboratories/2011 be interpreted as TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE absolute evidence of the presence or absence of disease.

Clinical Use: CA 15-3 may be useful for monitoring patients with metastatic breast cancer and certain ovarian cancers. The CA 15-3 values from sequential samples have a high correlation with the clinical course in most patients with with metastatic breast cancer. Performed: referred-A turn around: 3-5 days

86998 CA 19-9, CANCER ANTIGEN <37 U/mL Specimen Container: 86301 Immunoassay Gel barrier (gold or tiger top) CA 19-9 is absent in individuals with blood group Lewis Le(a-b-), as observed in approximately 5% of Caucasian and 20-25% of 1.0 (0.5) mL serum African American patients.

Clinical Use: A large percentage of patients with gastrointestinal tumors (such as pancreatic, liver, gastric, colorectal tumors) and some other malignancies have been shown to have elevated serum CA 19-9 levels. Serum CA 19-9 levels may be useful for monitoring disease activity or predicting relapse following treatment. CA 19-9 should Performed: referred-A not be used as a screening test. turn around: 3-5 days

86313 CA 27.29 <38 U/mL Specimen Container: 86300 Immunoassay This test was performed using the Siemens (Bayer) Gel barrier (gold or tiger top) Chemiluminescent Method. Values obtained from different assay methods cannot be used interchangeably. CA27.29 1.0 (0.5) mL serum levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. Allow appropriate time for the specimen to clot (30 minutes). Avoid hemolysis. Centrifuge for 15 Clinical Use: minutes. Transfer serum to plastic, screw top CA27.29 may be useful for monitoring patients for vial. metastatic breast cancer. Performed: referred-A turn around: 3 -5 days

86148 CA 125 ≤ 20 U/mL Specimen Container: 86304 Immunoassay This test was performed using the Siemens (DPC) Gel barrier (gold or tiger top) chemiluminescent method. Values obtained from different assay methods cannot be used interchangeably. CA 125 1.0 (0.5) mL serum levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease Centrifuge within 1 hour of collection and transfer serum specimens to plastic, screw top Clinical Use: vial. The CA 125 level can provide prognostic information in the follow-up management of patients with ovarian carcinoma. The assay should be used as an adjunctive test in the management of ovarian cancer patients. CA 125 is not recommended as a cancer screening procedure to detect Performed: referred-A cancer in the general poputation. turn around: 3-5 days

82300 CADMIUM, BLOOD Adults, Nonsmokers Specimen Container: 82300 Inductively Coupled Plasma-Mass Spectrometry 1.7 mcg/L or less EDTA (lavender top) Adults, Smokers 5.0 mcg/L or less 4.0 (2.0) mL whole blood OSHA Reference Range 5.0 mcg/L or less Toxic Concentration Early signs of toxicity have been observed at 30 ug/L

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Cadmium is a naturally occurring element that is mined and used in industrial production because of its durability. Excessive cadmium exposure can damage lungs, kidneys, and the Performed: referred-A and the digestive tract. turn around: 3-5 days

82308 CALCITONIN (THYROCALCITONIN) Adult Males Specimen Container 82308 Immunoassay 10 pg/mL or less No Additive (red top) Adult Females 5 pg/mL or less 1.0 (0.5) mL FROZEN serum Pediatric (Males and Females) Transfer serum to plastic, screw top vial and freeze. *< 6 mos 41 pg/mL or less *6 mos-3 yrs 14 pg/mL or less Overnight fasting is preferred. 3-17 yrs 6 pg/mL or less *Infant/toddler ranges obtained with the Nichols Institute Diagnostics Calcitonin- ICMA (Clinical Chemistry 2004; 50:1828-9).

Clinical Use: Calcitonin concentration is increased in patients with medullary thyroid carcinoma. Calcitonin concentrations may be used to Performed: referred-A monitor disease. turn around: 3-5 days

12310 CALCIUM 0 - 6 days : 7.2 – 12 mg/dL Specimen Container: 82310 Colorimetric 6 days - 2 years: 9.0 – 11 mg/dL Gel barrier (gold or tiger top) > 60 years: 8.2 – 10.2 mg/dL 1.0 (0.5) mL serum Clinical Use: Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low Performed: daily level of calcium may result in tetany. turn around: next day

82330 CALCIUM, IONIZED < 8 months No Ref Range established Specimen Container: 82330 Ion-Specific Electrode 8 months-10 years 4.9-5.4 Gel barrier (gold or tiger top) 11-17 years 4.8-5.3 Adult 4.8-5.6 1.0 (0.5) mL serum

Clinical Use: Let tube clot and spin immediately with cap on. Ionized calcium represents the true bioavailable calcium in the Do not open tube. Ship the unopened gel barrier circulation. In situations where the total calcium is normal, but tube at room temperature. Do not freeze does not fit the clinical picture, a determination of the ionized calcium will, many times, show an elevation in the bioavailable Performed: daily calcium. turn around: next day

22340 CALCIUM, URINE 24 HR Calcium 24 hour: Specimen Container: 82340 Colorimetric 42 - 353 mg/24 hr 24 hour urine collection container - 25 mL 6N HCL 82570

Creatinine 24 hour: 10.0 (5.0) mL aliquot of 24-hour urine Male: 0.6 - 2.5 g/24 hr preserved with 25 mL 6N HCL. Female: 0.6 - 1.5 g/24 hr Specify total 24-hour volume on request form. Clinical Use: Urinary calcium reflects dietary intake, rate of calcium absorption by the intestine and bone resorption. Abnormal levels are found in Paget's disease, hyperthyroidism and hyperparathyroidism. Performed: mon, wed, fri NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 1-3 days

12335 CALCIUM, UR RANDOM No reference ranges have been established Specimen Container: 82310

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Colorimetric Sterile urine container, leak-prof Clinical Use: In the presence of elevated calcium, the body attempts to excrete 10.0 (5.0) mL random urine the excess. It is acceptable to add preservative after collection if urine is refrigerated during collection. Record total volume and collection Performed: mon, wed, fri time on specimen container and requisition. turn around: 1-3 days

86628 CANDIDA ALBICANS Ab (IgG, IgA, IgM) Accompanies report Specimen Container: 86628 (x3) Immunoassay No additive (red top) Clinical Use: Candidiasis is a fungal infection that may cause localized 1.0 (0.2) mL serum. Transfer serum to a plastic, or systemic disease. The severity of infection is broad extending screw cap vial. to life threatening. Acute and convalescent titers should be Performed: referred-A compared. turn around: 5-7 days

12372 CARBAMAZEPINE (TEGRETOL ) 4 - 12 ug/mL Specimen Container: 80156 No additive (red top) Clinical Use: Performed: mon - sat Therapeutic drug monitoring is useful to avoid toxiciity. 1.0 (0.2) mL serum. turn around: next day

80318 CARBAMAZEPINE-10. 11-EPOXIDE 0.2 - 2.0 mcg/mL Specimen Container: 80156 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top)

Clinical Use: 2.0 (1.0) mL serum, transfer to a plastic,screw top Carbamazepine and its metabolite (10,11-Carbamazepine epoxide) vial. are widely used for control of generalized tonic-clonic, partial- onset, complex and mixed seizure disorders. The metabolism of Do not use Gel barrier (gold or tiger top) tubes. carbamazepine carbamazepine in epileptic patients has several different pathways that can be altered when the patient is comedicated with other anticonvulsants and, therefore, its therapeuticlevel should be monitored along with its metabolite in their free and protein-bound states.

Performed: referred-A turn around: 3-5 days

12218 CARBON DIOXIDE (BICARBONATE) 14 days – 59 years: 20 - 30 mg/dL Specimen Container: 82374 Enzymatic > 60 years: 20 - 32 mg/dL Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.2) mL serum Carbon dioxide is used to assess acid-base balance. Increased concentrations are most often due to respiratory acidosis or After blood collection, keep tube closed. Performed: daily metabolic alkalosis. turn around: next day

82374 CARBOXYHEMOGLOBIN (CARBON MONOXIDE) Nonsmoker: < 2% of total hgb Specimen Container: 82375 Spectrophotometric Average Smoker: 4-5% of total hgb EDTA (lavender top) Heavy Smoker: 8-12% of total hgb Potentially Toxic: > 15% of total hgb Full tube whole blood. Limit of Detection: 2% of total hgb After blood collection, keep tube closed. Clinical Use: Carbon monoxide is the most common of the gaseous poisons Malfunctioning or poorly ventilated heating appliances and internal combustion engines are frequent causes of carbon monoxide poisoning. Carbon monoxidedNICL Laboratories/2011 combines reversibly TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE with hemoglobin in a manner almost identical to oxygen, resulting in a decrease in the amount of oxygen carried by hemoglobin. Accidental poisoning can occur even at low levels (greater than 0.01%) of CO in the atmosphere with prolonged Performed: referred-A exposure. turn around: 3-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

86916 CARDIOLIPIN ANTIBODY, IgG Cardiolipin IgG (GPL U/mL) Specimen Container: 86147 Immunoassay < 10 Negative Gel barrier (gold or tiger top) 10-15 Equivocal 16-40 Positive - Uncertain risk factor; may be reactive 1.0 (0.5) mL serum > 40 Positive - Risk factor for thrombosis and and pregnancy loss.

Clinical Use: Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid Performed: referred-A and psoriatic arthritis, and primary Sjogren's syndrome. turn around: 3-5 days

86147 CARDIOLPIN ANTIBODY, IgM Cardiolipin IgM (GPL U/mL) Specimen Container: 86147 < 10 Negative Gel barrier (gold or tiger top) 10-15 Equivocal 16-40 Positive - Uncertain risk factor; may be reactive 1.0 (0.5) mL serum > 40 Positive - Risk factor for thrombosis and and pregnancy loss.

Clinical Use: Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid Performed: referred-A and psoriatic arthritis, and primary Sjogren's syndrome. turn around: 3-5 days

82127 CARNITINE, FREE & TOTAL Accompanies report Specimen Container: 82379 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: Carnitine is useful in diagnosing and monitoring patients with 3.0 (1.0) mL serum primary or secondary carnitine deficiency. Serum should be removed from cells immediately after collection. Transfer serum to a plastic screw Performed: referred-A cap vial. turn around: 3-5 days

82380 CAROTENE Carotene: Adult Reference Ranges Specimen Container: 82380 High Performance Liquid Chromatography 4-51 ug/dL Males >17 years Gel barrier (gold or tiger top) 6-77 ug/dL Females >17 years Carotene: Pediatric Reference Ranges 2.0 (0.7) mL serum 5- 80 ug/dL 9 months-6 years 9-190 ug/dL 7 years- 17 years Centrifuge and transfer serum specimen to a clean, plastic, amber, screw-cap vial, or foil Clinical Use: wrap to protect from light. Beta Carotene, a fat soluble nutrient, is a perrcursor to vitamin A. Deficiencies may lead to vitamin A deficiency. Excessive vitamin A intake may lead to headaches, loss of appetite, nausea and Performed: referred-A ldiarrhea, skin changes, and potential birth defects. turn around: 5-7 days

82383 CATECHOLAMINES, FRACTIONATED - RANDOM URINE Accompanies report Specimen Container: 82384 High Performance Liquid Chromatography Sterile urine container, leak-prof Clinical Use: The three catecholamines (norepinephrine, epinephrine, and 10.0 (5.0) mL random urine and dopamine) are the principal secretoryNICL Laboratories/2011 products of neural TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE tissue. Clinically, the measurement of circulating catecholamines Patient should avoid alcohol, coffee, tea, tobacco, is valuable in the diagnosis of catecholamine secreting tumors and strenuous exercise before collection. associated chiefly with hypertension (pheochromocytomas, neuroblastomas, and gangliomas) and with the evaluation of Performed: referred-A orthostatic hypotension. turn around: 3-5 days

82386 CATECHOLAMINES, FRACTIONATED & VMA, 24 HR URINE Accompanies report Specimen Container: 82384 High Performance Liquid Chromatography 24 hour urine container - 25 mL 6N HCL 84585 82570 20.0 (10.0) mL aliquot of a well mixed 24 hour urine

Record 24-hour urine volume on test request form and urine container.

Urine without preservative is acceptable if pH is Performed: referred-A below 6 and the sample is shipped frozen. turn around: 3-5 days

82384 CATECHOLAMINES, FRACTIONATED & TOTAL, PLASMA Accompanies report Specimen Container: 82384 High Performance Liquid Chromatography Sodium heparin (green top), pre-chilled Clinical Use: The evaluation of plasma catecholamines is utilized 4.0 (2.5) mL FROZEN heparinized plasma in the differential diagnosis of pheochromocytoma. Centrifuge within 30 minutes of collection and In addition, monitoring norepinephrine levels in transfer plasma to a plastic, screw cap vial and association with clonidine suppression has been freeze. recommended as a means of distinguishing patients with pheochromocytoma from patients with essential Overnight fasting is required. hypertension. Measurement of plasma norepinephrine levels may aid in the differential diagnosis of Patients should be relaxed in either a supine or orthostatic and postural hypotension. upright position before blood is drawn. States of anxiety and stress can cause fluctuations in Performed: referred-A Catecholamine levels. turn around: 3-5 days

84006 CATECHOLAMINES, FRACTIONATED, 24HR URINE Accompanies report Specimen Container: 82384 24 hour urine container - 25 mL 6N HCL 82570 Clinical Use: The three catecholamines (norepinephrine, epinephrine, and 10.0 (5.0) mL aliquot of a well mixed 24 hour urine and dopamine) are the principal secretory products of neural tissue. Clinically, the measurement of circulating catecholamines Patient should avoid alcohol, coffee, tea, tobacco, is valuable in the diagnosis of catecholamine secreting tumors and strenuous exercise before collection. associated chiefly with hypertension (pheochromocytomas, neuroblastomas, and gangliomas) and with the evaluation of Record 24-hour urine volume on test request Performed: referred-A orthostatic hypotension. form and urine container. turn around: 3-5 days

25029 CBC FOR CLOZARIL W/DIFF Accompanies report Specimen Container: 85025 Combined Impedence and Flow Cytometry EDTA (lavender top) Clinical Use: The FDA requires blood testing for patients taking clozapine. 5.0 (1.0) mL whole blood Performed: daily WBC and ANC values must be monitored per established protocol. turn around: next day

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

25022 CBC WITH DIFFERENTIAL AND PLATELETS Accompanies report Specimen Container: 85025 Combined Impedence and Flow Cytometry EDTA (lavender top) Clinical Use: Test is used for enumeration of the components in the 5.0 (1.0) mL whole blood Performed: daily blood to provide a general hematologic assessment. turn around: next day

25026 CBC WITH MANUAL DIFFERENTIAL Accompanies report Specimen Container: 85007 Automated and Manual Combined Impedence and Flow Cytometry EDTA (lavender top) Clinical Use: Test is used for enumeration of the components in the 5.0 (1.0) mL whole blood Performed: daily blood to provide a general hematologic assessment. turn around: next day

25021 CBC W/ PLATELETS (HEMOGRAM) NO DIFFERENTIAL Accompanies report Specimen Container: 85027 Automated Combined Impedence and Flow Cytometry EDTA (lavender top) Clinical Use: Test is used for enumeration of the components in the 5.0 (1.0) mL whole blood Performed: daily blood to provide a general hematologic assessment. turn around: next day

25021 CBC W/O DIFFERENTIAL Accompanies report Specimen Container: 85027 Combined Impedence and Flow Cytometry EDTA (lavender top) Clinical Use: Test is used for enumeration of the components in the 5.0 (1.0) mL whole blood Performed: daily blood to provide a general hematologic assessment. turn around: next day

86355 CD4 HELPER, T-LYMPHOCYTE Accompanies report Specimen Container: 86361 Flow Cyometry EDTA (lavender top) Clinical Use: Assists in evaluating helper cell immune status in 5.0 (1.0) mL whole blood immunodeficiency diseases such as AIDS. Maintain the specimen at ambient temperature Performed: referred-A Do not refrigerate. turn around: 3-5 days

86357 CD4/CD8 T-LYMPHOCYTES Accompanies report Specimen Container: 86355 EDTA (lavender top) 86359 86360 Clinical Use: 5.0 (1.0) mL whole blood T and B lymphocyte count and helper/suppressor cell immune status assist in evaluating cellular immunocompetency. Maintain the specimen at ambient temperature Performed: referred-A Do not refrigerate. turn around: 3-5 days

16151 CARCINOEMBRYONIC ANTIGEN (CEA) 0 – 2.5 ng/mL Specimen container: 82378 Siemens Centaur/Chemiluminescence Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.2) mL serum Increased serum CEA levels have been detected in persons with primary colorectal cancer and in patients with other For monitoring for recurrence of disease, all malignancies involving the gastrointestinal tract, breast, lung subsequent samples must be of the same ovarian, prostatic, liver, and pancreatic cancers. Elevated specimen type. serum CEA levels have also been detected in patients with nonmalignant disease, especially patients who are older or who are smokers. CEA levels are not useful in screening the general population for undetected cancers. However, CEA levels provide important information about patient prognosis, recurrence of tumors after surgical removal, and effectiveness of therapy.

Values obtained from different NICLassay Laboratories/2011 methods cannot be TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE used interchangeably. CEA levels, regardless of value, should not be interpreted as absolute evidence of the Performed: mon, wed, fri presence or absence of disease. turn around: 1-3 days

86010 CELIAC DISEASE Ab PANEL Gliadin IgG and IgA Ab Specimen Container: 86255 Enzyme Immunoassay < 11 U/mL: Negative Gel barrier (gold or tiger top) 83516 (x3)

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Indirect Immunofluorescence Assay Tissue Transglutaminase IgA Ab < 5 U/mL: Negative 2.0 (1.2) mL serum Reticulin IgA Ab < 1:10: Negative Overnight fasting is preferred

Clinical Use: Celiac Disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and assist identification of patients who may Performed: referred-A require biopsy. turn around: 3-5 days

83522 CELIAC DISEASE EVALUAT-R Transgutaminase IgA Autoantibodies: Specimen Container: 83516 (x3) Indirect Immunofluorescence Assay <4.0 U/mL Gel barrier (gold or tiger top) 86225 (x2) Enzyme Immunoassay Reticulin IgA Autoantibodies: <1:10 titer 4.0 (2.0) mL serum Endomysial IgA Autoantibodies: <1:10 titer Gliadin IgG Antibodies <10.0 U/mL Gliadin IgA Antibodies <5.0 U/mL

Clinical Use: A comprehensive evaluation for the antibodies associated with Performed: referred-S gluten sensitivity, characteristic of Celiac Disease turn around: 5-7 days

89053 CELL COUNT/DIFF, CSF Accompanies report Specimen Container: 89051 Microscopic Examination Sterile container, leak-proof

2.0 (0.5) mL CSF, transport at room temperature.

Specimens are usually collected in three sterile tubes labeled 1, 2, and 3 in the order in which they are withdrawn. Tube 1 is used for chemical and serological tests; tube 2 is used for Microbiology; tube 3 is used for the cell count, because it is the least likely to contain cells introduced by the spinal tap Performed: referred-A procedure. turn around: 3-5 days

89052 CELL COUNT/DIFF, BODY FLUID Accompanies report Specimen Container: 89051 Microscopic Examination Plastic, leakproof container EDTA (lavender top)

3.0 (1.0) mL unpreserved body fluid, submitted in a plastic leakproof container, refrigerated. and 3.0 (1.01) mL body fluid, submitted in a EDTA (lavender top) tube, refrigerated.

Please specify type of body fluid on the request form. Performed: referred-A Transport both samples in the same shipping container. turn around: 3-5 days

83858 CELONTIN (METHSUXIMIDE) Accompanies report Specimen Container: 83858 High Performance Liquid Chromatography No additive (red top) Clinical Use: Therapeutic drug monitoring is useful to avoid toxiciity. 2.0 (1.0) mL FROZEN serum Transfer serum to plastic, screw cap vial and freeze. Performed: referred-S turn around: 5-7 days NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

86257 CENTROMERE B ANTIBODY < 1.0 AI: Negative Specimen Container: 86038 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Centromere B Antibody is diagnostic for the form of scleroderma 1.0 (0.5) mL serum known as CREST (calcinosis, Raynauds phenomenon, Performed: referred-A esophageal dysmotility, sclerodactyly, and telangiectasia). turn around: 3-5 days

82390 CERULOPLASMIN Accompanies Report Specimen Container: 82390 Nephelometric Gel barrier (gold or tiger top) Clinical Use: Decreased levels of ceruloplasmin are found in Wilson's disease, 1.0 (0.5) mL serum fulminent liver failure, intestinal malabsorption, renal failure resulting in proteinuria, chronic active hepatitis, and malnutrition. Elevated levels are found in primary biliary cirrhosis, pregnancy (first trimester), oral contraceptive use, and in acute inflammatory Performed: referred-A condiditons since ceruloplasmin is an acute phase reactant. turn around: 3-5 days

86631 CHLAMYDIA ANTIBODY, SERUM IgG <1:8 Specimen Container: 86631 Indirect Immunofluorescence Assay IgM <1:20 Gel barrier (gold or tiger top) 86632

1.0 (0.3) mL serum, refrigerate Clinical Use: This test uses Chlamydial Initial Body Inclusions from the L2 serotype of C. trachomatis in cultured cell monolayers. The inclusions are broadly reactive to both Chlamydial genus and species-specific antibody. Thus, this test is offered as a screen to detect anitbody produced against all Chlamydial species. Since exposure in humans to Chlamydia is common, this test is of limited value for the differential diagnosis of infections caused Performed: referred-A by different Chlamydia species. turn around: 5-7 days

87179 CHLAMYDIA BY DNA PROBE None detected Specimen Container: 87490 DNA Hybridization with Chemiluminescent Detection Gen-Probe PACE 2™ Clinical Use: C. trachomatis is associated with infections of the mucous Cervical/endocervical swab, Male Urethral swab or membranes of the urogenital system, the upper respiratory Conjunctival swab in Gen-Pprobe PACE 2™ tract, and the eye. In industrialized contries, C. trachomatis usually causes sexually transmitted disease in developing Do not use swabs other than those in collection kit. countries. It is the major cause of preventable blindness Do not place cleaning swab in transporter along with (trachoma). The organism may cause urethritis, cervicitis, sample swab. Culture is the recommended procedure salpingitis, epididymitis, or proctitis. Infections are often for diagnosis of chlamydial infection in cases of asymptomatic. suspected child abuse. Note: grossly bloody specimens will be resulted with a qualifying comment. This method has been validated using endocervical, male urethral, and conjunctival swab specimens. Performance Performed: referred-A with other specimens has not been assessed. turn around: 3-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 87110 CHLAMYDIA TRACHOMATIS CULTURE No Chlamydia isolated Specimen Container: 87110 Culture M4RT transport kit 87140 Indirect Immunofluorescence Assay Clinical Use: C. trachomatis is associated with infections of the mucous 3.0 mL Body Fluid Transport frozen in M4RT membranes of the urogenital system, the upper respiratory tract or and the eye. It may be sexually transmitted; resulting diseases Swab Transport frozen in M4RT include urethritis, cervicitis, salpingitis, epididymitis, proctitis or and lymphogranuloma venereum. Coinfection with C. trachomatis Tissue Transport frozen in M4RT and N. gonorrhoeae can occur. Infections of the upper respiratory tract and eye usually occur in newborns exposed at parturition. SPECIMEN COLLECTION: In adults, eye infection may be transmitted by hand after contact Proper specimen collection from the patient is extremely with secretions. Isolation by tissue culture is recommended when critical for successful isolation and identification of testing individuals under the age of 13 years. infectious organisms. For specific guidance regarding specimen collection procedures, follow industry standards for collecting infectious organisms. Specimens should be collected as soon as possible after clinical onset of disease. Highest Chlamydia titers are present during the acute illness.

FOR M4 TRANSPORT MEDIA VIAL: 1. Aseptically remove cap from vial. 2. Aseptically place sample into the vial with medium. 3. Replace cap on vial and close tightly. 4. Label with appropriate patient information. Performed: referred-A 5. Send to the laboratory for immediate analysis. turn around: 5-7 days

17491 CHLAMYDIA TRACHOMATIS, DNA PROBE Negative Specimen Container: 87491 Roche Amplicor/Amplified DNA probe M4RT transport kit Clinical Use: C. trachomatis is associated with infections of the mucous Cervical/endocervical swab, Male Urethral swab or membranes of the urogenital system, the upper respiratory tract Conjunctival swab in M4RT. and the eye. It may be sexually transmitted; resulting diseases include urethritis, cervicitis, salpingitis, epididymitis, proctitis Maintain at room temperature. and lymphogranuloma venereum. Coinfection with C. trachomatis and N. gonorrhoeae can occur. Infections of the upper respiratory Do not use collection kit if media is yellow.. tract and eye usually occur in newborns exposed at parturition. In adults, eye infection may be transmitted by hand after contact with secretions. Isolation by tissue culture is recommended when Performed: tues, thur testing individuals under the age of 13 years. turn around: 2-5 days

CHLAMYDIA TRACHOMATIS/NEISSERIA GONORRHOEAE, 27491 DNA PROBE Negative Specimen Container: 87491 Roche Amplicor/Amplified DNA probe M4RT transport kit 87591 Clinical Use: C. trachomatis, the number one cause of sexually Cervical/endocervical swab, Male Urethral swab or transmitted disease in the United States, is responsible Conjunctival swab in M4RT. for an estimated 3-4 million new cases annually. Infants born to women with chlamydial infection of the cervix are Maintain at room temperature. at risk of acquiring an infection during vaginal birth. Gonococcal and chlamydial urethritis may coexist. Do not use collection kit if media is yellow.. Demonstrating the presence of N. gonorrhoeae is important in initiating appropriate therapy to prevent the spread of infection. Performed: tues, thur turn around: 2-5 days

87491 CHLAMYDIA/GC, DNA PAP VIAL (THIN PREP) Not Detected Specimen Container: 87491 Strand Displacement Amplification Liquid Cytology (PreservCyt® Preservative (Thin Prep®) 87591 Clinical Use: Chlamydia trachomatis infections are recognized as the leading Endocervical cause of sexually transmitted diseases (STD) in the United States. C. trachomatis is known to cause cervicitis, pelvic Thinprep® Vial-0.5 mL prealiquot* of Preservcyt® inflamatory disease (PID), urethritis,NICL epididymitis Laboratories/2011 and proctisis. material TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Neisseria gonorrhoeae (gonococci) is the causative agent of *Aliquot before performance of liquid based cytology gonorrhoeae. In women, the disease is most often found in the testing. Performed: referred-A cervix, but the vagina and uterus may also be infected. turn around: 3-5 days

87491 CHLORDIAZEPOXIDE Accompanies report Specimen Container: 80154 Liquid Chromatography/Tandem Mass Spectrometry No Additive (red top) Clinical Use: or Therapeutic drug monitoring is useful to avoid toxiciity. EDTA (lavender top)

1.0 (0.4) mL serum or plasma, transfer to a plastic Performed: referred-A screw-cap vial. turn around: 7-10 days

12435 CHLORIDE 3 days – 12 years: 91 - 108 mq/dl Specimen Container: 82435 ISE > 12 years: 93 - 110 mq/dl Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.2) mL serum Chloride is the primary plasma anion. Chloride, along with other electrolytes, is useful in evaluating patients with acid-base Performed: daily and water disturbances or imbalances. turn around: next day

12438 CHLORIDE, URINE RANDOM No Reference Ranges have been established Specimen Container: 82436 ISE Sterile urine container, leak-prof Clinical Use: An increase in urine chloride may result from water deficient 10 (2.0) mL random urine, no preservative dehydration, diabetic acidosis, Addison's disease and salt-losing renal disease. Decreased urine levels are seen in congestive heart failure, severe diaphoresis and in hypochloremic metabolic alkalosis due to prolonged vomiting.

Performed: daily turn around: next day

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

84022 CHLORPROMAZINE (THORAZINE) Accompanies report Specimen Container: 82491 Gas Chromatography EDTA (lavender top) Clinical Use: or Chlorpromazine is a phenothiazine for treating psychosis No Additive (red top) and Tourettes syndrome. Monitoring its level is important to optimize therapy, to avoid toxicity, and to assure compliance. 3.0 (1.2) mL plasma or serum, transfer to plastic, Performed: referred-A screw-cap vial. turn around: 10-14 days

12465 CHOLESTEROL 19-29 years: 90 – 170 mg/dL Specimen Container: 82465 Spectrophotometric 29-64 years: 110 – 200 mg/dL Gel barrier (gold or tiger top) > 64 years: 120 – 200 mg/dL 1.0 (0.2) mL serum Clinical Use: Total LDL and HDL cholesterol, in conjuction with a triglyceride determination, provide valuable information for the risk of coronary artery disease. Total serum cholesterol analysis is useful in the diagnosis of hyperlipoproteinemia, atherosclerosis, Performed: daily hepatic and thyroid diseases. turn around: next day

20156 CHOLESTEROL & HDL Accompanies Report Specimen Container: 80061 Spectrophotometric Gel barrier (gold or tiger top) 82465 Liquid Selective Detergent/Direct 1.0 (0.3) mL serum Performed: daily turn around: next day

20002 CHOLESTEROL/TRIGLYCERIDE Accompanies Report Specimen Container: 82465 Spectrophotometric Gel barrier (gold or tiger top) 82778 Enzymatic 1.0 (0.3) mL serum

82482 CHOLINESTERASE, PLASMA (PSEUDOCHOLINESTERASE) Females: 2504-6297 IU/L Specimen Container: 82480 Kinetic Males: 3334-7031 IU/L EDTA (lavender top) Spectrophotometric or Clinical Use: Sodium heparin (green top) Approximately 1 in every 2500 individuals has inherited defective or deficiency of the enzyme (pseudocholinesterase) that 1.0 (0.5) mL plasma metabolizes succinylcholine (an anesthetic agent). With normal Centrifuge within 1 hour of collection and transfer dosage, these individuals have prolonged apnea. Such plasma to a plastic, screw-cap vial. individuals are responsive at much smaller concentrations of this anesthetic agent than the general population. Low Transport refrigerated. concentrations of pseudocholinesterase are observed in individuals exposed to organophosphorous insecticides Performed: referred-A and patients with hepatic dysfunction. turn around: 3-5 days

82480 CHOLINESTERASE, RBC 9572-15031 IU/L Specimen Container: 82482 Kinetic 2 EDTA (lavender top) Spectrophotometric Approximately 1 in every 2500 individuals has inherited defective or deficiency of the enzyme (pseudocholinesterase) that 1.0 (0.5) mL plasma metabolizes succinylcholine (an anesthetic agent). With normal Centrifuge within 1 hour of collection and transfer dosage, these individuals have prolonged apnea. Such plasma to a plastic, screw-cap vial. individuals are responsive at much smaller concentrations of and this anesthetic agent than the general population. Low 5.0 (1.0) mL whole blood concentrations of pseudocholinesterase are observed in individuals exposed to organophosphorous insecticides Ship both whole blood and plasma samples , and patients with hepatic dysfunction. refrigerated in the same shipping container.

NICL Laboratories/2011 Do not send packed cells. Do not send one tube TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: referred-A of whole blood. turn around: 3-5 days

82400 CHROMIUM, SERUM ≤ 1.4 mcg/L Specimen Container: 82495 Atomic Spectroscopy No additive trace metal (royal blue top) Clinical Use: Occupational exposure and exposure to environmental 2.0 (0.5) mL serum. contamination of Chromium may lead to toxicity. The need for Allow blood to clot in an upright position for 1 hour. Chromium supplements is unproven. Supplements taken in Centrifuge. Pour (do not pipette) the serum into an in excess may also lead to Chromium toxicity. acid-washed, metal-free, plastic, leakproof vial.

Patient should refrain from taking vitamins, or mineral or herbal supplements for at least 7 days Performed: referred: before specimen collection. turn around: 5-7 days

86324 CHROMOGRANIN A Accompanies report Specimen Container: 88230 Electrochemiluminescent Immunoassay Gel barrier (gold or tiger top) Clinical Use: Chromogranin A has been identified in a number of normal and 0.8 (0.3) mL serum Performed: referred-A neoplastic endocrine tissues. turn around: 5-7 days

88262 CHROMOSOME ANALYSIS, BLOOD Accompanies report Specimen Container: 88230 Chromosome Analysis Sodium heparin (green top) Tissue Culture Clinical Use: This test may assist with the detection of chromosome 3.0 - 5.0 mL whole blood, transport at room temperature abnormalities. Clinical history and reason for referral are required Performed: referred-A with test order. turn around: 2-3 weeks

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 84009 CITALOPRAM Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No Additive (red top) Clinical Use: or Therapeutic drug monitoring is useful to avoid toxiciity. EDTA (lavender top)

1.0 (0.4) mL serum or plasma, transfer to a plastic, Performed: referred-A screw-cap vial turn around: 7-10 days

82507 CITRIC ACID, 24 HR URINE 100-1300 mg/24 h Specimen Container: 82507 Enzymatic 24 hour urine collection container, no additive Spectrophotometric Clinical Use: Citrate binds to calcium and inhibits kidney stone formation. 10.0 (1.0) mL well mixed aliquoit of a 24 hour urine Thus, low concentrations of citrate may lead to kidney stone collected with no preservative. formation. This is the most importanat risk factor for kidney stone formation in children. The treatment of calcium stones Refrigerate during and after collection. involves increasing urinary citrate excretion. Please specify on the request form and on the urine Performed: referred-A container the total 24-hour urine volume. turn around: 3-5 days

82552 CK ISOENZYMES MM, MB, BB Refer to Total CK for its reference ranges. Specimen Container: 82550 Electrophoresis For the CK Isoenzymes, there are no Gel barrier (gold or tiger top) 82552 reference ranges. An interpretive comment accompanies each report. 2.0 (1.0) mL FROZEN serum. Transfer serum to a plastic, screw-cap vial and freeze. Clinical Use: Creatine Kinase Isoenzymes is useful in the evaluation of myocardial disease. Isoenzyme MM is found in skeletal muscle whereas isoenzyme MB is increased in recent myocardial (heart) Performed: referred-A damage. turn around: 3-5 days

12553 CK MB <0.18 - 5.0 Specimen Container: 82553 Siemens Centaur/Chemiluminesence Gel barrier (gold or tiger top) Clinical Use: Detection of CK-MB in significant amounts is used to confirm or 1.0 (0.2) mL serum, refrigerated refute a diagnosis of myocardial infarction. Performed: daily turn around: next day

88186 CLL LYMPHOMA DIAGNOSTIC PANEL Not applicable Specimen Container: 88184 Flow Cytometry Sodium Heparin (green top) 88189 Clinical Use: or 88185 (x17) Test is used to aid in the diagnosis of EDTA (lavender top) chronic lymphocytic leukemia/lymphoma. or ACD-A (yellow top)

5.0 (3.0) mL whole blood, submit at room temperature

A clinical summary or differential diagnosis is required with each specimen. If possible, submit CBC results with differential or an EDTA tube of Performed: referred-A perfipheral blood. turn around: 3-5 days

80308 CLOMIPRAMINE (ANAFRANIL ) Clomipramine + Desmethyl-Clomipramine: 160-450 ng/mL Specimen Container: 80299 High Performance Liquid Chromatography 160-450 ng/mL No additve (red top) Detection limit: 5 ng/mL 2.0 (1.5) mL serum, transfer serum to plastic, screw- cap vial. Clinical Use: Performed: referred-A Therapeutic drug monitoring is useful to avoid toxiciity. turn around: 5-7 days NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

80154 CLONAZEPAM (KLONOPIN ) 30-60 ng/mL Specimen Container: 80154 High Performance Liquid Chromatography Toxic: > 70 ng/mL No additve (red top)

Detection limit: 2.0 (1.5) mL serum, transfer serum to plastic, screw- 5 ng/mL cap vial.

Clinical Use: Clonazepam is a benzodiazepine used as a tranquilizer. Clonazepam is used in treating patients with seizures and in reducing tardive dyskinesia. Therapeutic drug monitoring is Performed: referred-A useful to avoid toxicity. turn around: 5-7 days

80313 CLONIDINE, SERUM/PLASMA Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additve (red top) Clinical Use: Therapeutic drug monitoring is useful to avoid toxiciity. 2.0 (1.5) mL serum, transfer to plastic, screw-cap vial Performed: referred-A turn around: 5-7 days

80286 CLORAZEPATE (TRANZENE) 0.1-2.0 mcg/mL Specimen Container: 80154 High Performance Liquid Chromatography No additive trace metal (royal blue top) Detection limit: 0.1 mcg/mL 0.1 mcg/mL 2.0 (1.0) mL serum, transfer to plastic, screw-top vial

Clinical Use: Clorazepate is a benzodiazepine used to treat anxiety. It has CNS depressant effects. The primary metabolite, nordiazepam Performed: referred-A is measured by this assay. turn around: 7-10 days

47449 CLOSTRIDIUM DIFFICLE TOXIN A&B Negative Specimen container: 87324 Enzyme immunoassay Sterile, leakproof container Clinical Use: Clostridium difficile is a spore-forming bacterium that is part of 5.0 (1.0) grams stool specimen without medium, the normal intestinal flora. With intestinal overgrowth. C. difficile preservative or barium. is the major cause of antibiotic-associated diarrhea and colitis secondary to antimicrobial therapy. C. difficile is the primary Specmen may be refrigerated up to 72 hours, for cause of pseudomembranous colitis. The organism produces longer stabiity, freeze. Performed: daily cytotoxins that lead to frequent, foul-smelling, watery stools. turn around: next day

80290 CLOZARIL (CLOZAPINE) Norclozapine Specimen container: 82492 High Performance Liquid Chromatography Trough, steady-state: 25-400 ng/mL EDTA (lavender top)

Detection limit: 2.0 (1.0) mL FROZEN plasma. Transfer plasma to a 25 ng.mL plastic, screw-cap vial and freeze.

Clinical Use: Do not use Gel barrier (gold or tiger top) tubes. Clozapine is used selectively in the treatment of patients with schizophrenia. The major active metabolite is norclozapine. Hematologic factors may be affected. Therapeutic drug Performed: 3-5 days monitoring is useful to optimize dose and to avoid toxicity. turn around: next day

86329 COCCIDIODES ANTIBODIES C. immitis Ab Specimen Container: 86635 Complement Fixation Negative Gel barrier (gold or tiger top) Interpretive Criteria Negative: Antibody not detected 1.0 ( 0.2) mL serum. Positive: Antibody detected

All serum titers ≥1::2 should be considered evidence indicative of coccidioidomycosis, although titers of 1:2 and 1:4 should be NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE confirmed by Immunodiffusion testing. Titers exceeding 1:6 usually reflect disseminated disease. In general, higher titers are correlated with disease severity, and changes in serial titers are of prognostic value. A negative CF test does not, however, rule out diagnosis

Clinical Use: Infection by Coccidioides immitis can produce a spectrum of disease, with most patients being asymptomatic and some developing disseminated disease, including pneumonia Performed: referred-A and meningitis. turn around: 3-5 days

86007 COLD None detected Specimen Container: 86157 Hemagglutination No additive (red top) Clinical Use: This test can be useful for the detection of cold agglutinins in 3.0 (0.5) mL serum association with cold agglutinin syndrome.

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clot at 37° C. Centrifuge and immediately separate serum, and transfer to a plastic, screw-top Performed: referred-A vial. Transport at room temperature. turn around: 3-5 days

88347 COLLAGEN TYPE II ANTIBODY Accompanies report Specimen Container: 86038 Enzyme-Linked Immunosorbent Assay No additive (red top) Clinical Use: Collagen II antibodies occur in 22% of patients with sensory neural 3.0 (2.0) mL FROZEN serum hearing loss, 30% in patients with sudden hearing loss, and 67% Transfer serum to a plastic, screw-cap vial and freeze of patients with Meniere's disease. Collagen antibodies also occur in patients with relapsing polychondritis and in patient with Performed: referred-A rheumatoid arthritis. turn around: 7-10 days

86157 COMPLEMENT COMPONENT C1q Accompanies report 1 (Min 0.1) mL Serum. Transport in a 86160 Radial Immunodiffusion refrigerated Red-top tube (no gel). The complement system is critical to the inflammatory response. C1q concentrations Alternate Specimen(s) may be decreased in patients with acquired 1 (Min 0.1) mL Plasma. Transport in a angioedema, immune complexed induced refrigerated Lavender Top EDTA Tube. vasculitis, and concurrent low concentrations of C1 inhibitor, carcinoma, or lymphoma.

Performed: referred-A turn around: 3-5 days

86162 COMPLEMENT PROFILE 1 Accompanies report Specimen container: 86160 (x3) Enzymatic No additive (red top) tubes 86162 Nephelometric Test Components. Turbidimetric C1 Inhibitor, Protein For Specimen requirements see individual Tests listed C3, Complement under Test Components. Complement Component C4 Complement, Total (CH50) Patient should be fasting.

Centrifuge within 30 minutes of collection. Transfer serum to clean, plastic, screw-capped Performed: referred-A vial(s), freeze and ship frozen. turn around: 3-5 days

86166 COMPLEMENT, TOTAL (CH50) 31-60 U/mL Specimen container: 86162 Colorimetric No additive (red top) Clinical Use: Total Complement (CH50) concentration is an overall measure 1.0 (0.2) mL FROZEN serum of the complement system.Decreased concentrations are observed in patients patients with complement factor Centrifuge specimen within 1 hour of deficiencies and disease activity, e.g., systemic lupus collection. Immediately pipette serum into Performed: referred-A erythematosus (SLE) and immune complex disease. sterile, plastic, screw-cap vial and freeze. turn around: 3-5 days

20164 COMPREHENSIVE METABOLIC Accompanies report Specimen container: 80053 Components: Gel barrier (gold or tiger top) Alkaline Phosphatase Clinical Use: ALT See individual tests for Clinical Use:. 2.0 (1.0) mL serum AST Bilirubin, Total Calcium Carbon Dioxide Chloride Creatinine Glucose Potassium Protein, Total Sodium NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Urea Nitrogen (BUN) Performed: daily turn around: next day

86031 COOMBS, DIRECT Negative Specimen container: 86880 Hemagglutination EDTA (lavender top) Clinical Use: The DAT (Direct Coombs' Test) is positive if red cells have been 5.0 (3.0) mL whole blood coated, in vivo, with immunoglobulin, complement, or both. A positive result can occur in immunemediated red cell destruction, Transport refrigerated. autoimmune hemolytic anemia, a transfusion reaction, or in Performed: referred-A patients receiving certain drugs. turn around: 3-5 days

16016 COOMBS, INDIRECT (ANTIBODY SCREEN) Negative Specimen container: 86850 Agglutination EDTA (lavender top) Clinical Use: The Indirect Coombs (Antibody Screen) is useful to identify red 5.0 (3.0) mL whole blood blood cell IgG antibodies that may cross the placenta and cause hemolytic disease of the newborn. Transport refrigerated. Performed: mon-sat turn around: 1-2 days

82525 COPPER Accompanies report Specimen container 82525 Flame Atomic Absorption Spectroscopy Trace Element EDTA tube (royal blue top) Clinical Use: Copper is an essential trace element. It is required for hemoglobin 2.0 (0.7) mL whole blood hemoglobin synthesis and is a constituent of the cytochrome oxidase system. The most important abnormality in copper metabolism is Wilson's disease. Subnormal concentrations are found in patients with hypoproteinemia, e.g., protein malnutrition, protein malabsorption syndrome, nephrosis and Merkes' syndrome. Above normal concentrations are found in a number of acute and chronic diseases, such as malignant diseases (including leukemia), hemochromatosis, biliary cirrhosis, thyrotoxicosis, and various infections. Serum copper levels are also high in patients taking Performed: referred-A contraceptives or estrogen. turn around: 5-7 days

82527 COPPER, 24-HOUR URINE 15-60 mcg/24 h Specimen container: 82525 Atomic Spectroscopy 24 hour urine container, acid washed, no preservative. Clinical Use: Urinary copper concentrations are useful to monitor patients who 7.0 (3.0) aliquot of a well mixed 24-hour specimen.

are on chelation therapy. Copper is an essential element that Transport in an acid washed metal free, leak-proof is a cofactor of many enzymes. Copper metabolism is disturbed container. in Wilsons disease, Menke's disease, primary biliary cirrhosis, and Indian childhood cirrhosis. Copper concentrations are also Record total volume on specimen container and useful to monitor patients, especially preterm newborns on on test requisition. nutritional supplementation. Results of copper are often Performed: referred-A interpreted together with ceruloplasmin. Random urine is not acceptable. turn around: 3-5 days

84007 CORTICOSTERONE Accompanies report Specimen Container: 82528 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Measurement of corticosterone may help confirm the diagnosis 1.0 (0.25) mL serum of the very rare aldosterone deficiency disorder, corticosterone Transfer serum to a plastic, screw-cap vial. methyloxidase (18-hydroxylase) enzyme deficiency, where the ratio of corticosterone to 18-hydroxycosticosterone may be An early morning specimen is preferred. Performed: referred-A increased. turn around: 7-10 days

83543 CORTICOTROPIN RELEASING HORMONE Accompanies report Specimen Container: 83519 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Radioimmunoassay Sodium heparin (green top) Clinical Use: CRH concentrations are increased in the last two trimesters of 3,0 (1.1) mL plasma. pregnancy, due to placental production and in patients with Transfer plasma to a plastic screw-cap vial. Cushing's syndrome, due to ectopic production of CRH. Performed: referred-A syndrome, due to ectopic production of CRH. turn around: 5-7 days

84449 CORTISOL BINDING GLOBULIN Accompanies report Specimen Container: 84449 Radioimmunoassay Gel barrier (gold or tiger top) Clinical Use: Cortisol binding globulin (CBG), also known as transcortin, binds 1.0 (0.2) mL serum approximately 92% of circulating cortisol with high affinity. The CBG assay is helpful, along with other tests such as total and free cortisol measurements and ACTH, in assessing unexpected values of blood cortisol. For example, the differential diagnosis of highly elevated total serum cortisol cortisol levels includes Cushing syndrome, resistance to glucocorticoids (CBG levels are Performed: referred-A normal), and elevated CBG levels. turn around: 5-7 days

12532 CORTISOL, AM 4.3 - 22.4 ug/dL Specimen container: 82533 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Total cortisol concentrations are decreased in Addison's disease, 1.0 (0.5) mL serum and increased in Cushing's disease and in other conditions of glucocorticoid excess. Collect specimen between 7:00-9:00 a.m. Indicate collection time on specimen container Performed: daily and test requisition. turn around: next day

82530 CORTISOL, FREE 24 HR URINE Accompanies report Collection container: 82530 Liquid Chromatography/Tandem Mass Spectrometry 24 hour urine container, no preservative Clinical Use: Urinary Free Cortisol is useful in the detection of patients with Cushing's syndrome for whom Free Cortisol concentrations 2.0 ( 0.8) mL well mixed aliquot of a 24-hour urine, are elevated. collected with no preservative

Record 24-hour urine volume on test request form and specimen container.

24-hour urine specimens, collected with the following preservatives, are acceptable: 25 mL 6N HCl; 10 mL conc. Glacial Acetic Acid; Performed: referred-A 10 g Boric Acid. turn around:7-10 days

82531 CORTISOL, PM 3.1 - 16.7 ug/dL Specimen container: 82533 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Total cortisol concentrations are decreased in Addison's disease, 1.0 (0.5) mL serum and increased in Cushing's disease and in other conditions of glucocorticoid excess. Collect specimen between 3:00-5:00 p.m. Indicate collection time on specimen container Performed: daily and test requisition. turn around: next day

82537 CORTISOL, SALIVA Accompanies report Specimen container: 82533 Liquid Chromatography/Tandem Mass Spectrometry Salivette Tube® (Sarstedt)

0.5 (0.2) mL saliva

Collect using Salivette® Collection Tube NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE (Sarstedt) 10 minutes after rinsing mouth with water.

Patient should refrain from eating food and smoking Performed: referred-A cigarettes for 1 hour before sample collection. turn around:7-10 days

12531 CORTISOL, SERUM 3.0 – 22.4 ug/dL Specimen container: 82533 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Total cortisol concentrations are decreased in Addison's disease, 1.0 (0.5) mL serum and increased in Cushing's disease and in other conditions of Performed: daily glucocorticoid excess. turn around: next day

84910 CORTISONE Accompanies report Specimen container: 83789 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Measurements of Free Cortisol and Cortisone are useful in 1.0 (0.3) mL serum, transfer to a plastic screw-cap vial. diagnosing patients with low-Renin hypertension, caused by apparent mineralocorticoid excess. This may be due to either an inherited defect in 11HSDB2 enzyme or an acquired inhibitor of the enzyme by such compounds as Performed: referred-A glycyrrhizic acid, a component of natural licorice. turn around:5-7days

83887 COTININE (NICOTINE) URINE Accompanies report Specimen container: 80101 Enzyme Immunoassay Sterile urine container, leak-prof Gas Chromatography Clinical Use: Cotinine, a nicotine metabolite, is measurable in body fluids, 2.0 mL random urine, refrigerated. including urine, and can be utilized as an objective measure of Performed: referred-A smoking exposure. turn around:5-7days

80287 COUMADIN Therapeutic Range: 1.0-10.0 mcg/mL Specimen container: 80299 High Performance Liquid Chromatography Toxic: > 10.0 mcg/mL EDTA Trace Element (royal blue top)

3.0 (1.2) mL plasma. Transfer plasma to a plastic, screw-cap vial and Performed: referred-A turn around: 3-5 days

84681 C-PEPTIDE 0.8-3.1 ng/mL Specimen container: 84681 Immunoassay No additive (red top) Clinical Use: C-Peptide is useful in the evaluation of pancreatic beta cell 1.0 (0.4) mL FROZEN serum. function and for determining the source of insulin in patients Transfer serum to a plastic, screw-cap vial and freeze. with hyperinsulinemic hypoglycemia. Performed: referred-A Fasting specimen required. turn around: 3-5 days

12550 CPK (CREATINE KINASE) Male: 26 – 140 U/L Specimen container: 82550 Spectophotometric Female: 38 – 174 U/L Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum Test for myocardial infarction and skeletal muscle damage. Elevated results may be due to: myocarditis, myocardial infarction Sample must be free from hemolysis. (heart attack), muscular dystrophy, muscle trauma or excessive Performed: daily exercise. turn around: next day

16140 C-REACTIVE PROTEIN, CRP 0 - 1.0 mg/L Specimen Container: 86140 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Increased CRP levels are found in inflammatory conditions, 1.0 (0.5) mL serum including: bacterial infection, rheumatic fever, active arthritis, mycardial infarction, malignancies and in the post-operative state. Performed: daily turn around: next day

16141 C-REACTIVE PROTEIN, CARDIAC Cardiac CRP level CHD Risk Level Specimen Container: Immunoturbidimetric Less than 1.0 mg/L Low Gel barrier (gold or tiger top) 1.0 - 3.0 mg/L Average 86140 Greater than 3.0, up to 10 High* 1.0 (0.5) mL serum

*If the CRP value exceeds 10.0 mg/L after repeat testing, the patient should be evaluated for non-cardiovascular etiologies. Due to the lack of specificity of cardiac CRP, the test should be Performed: daily performed twice, optimally 2 weeks apart, and the results averaged. turn around: next day

12565 CREATININE 0 – 6 days: 0.3 – 1.0 mg/dL Specimen Container: 82565 Spectrophotometric 6 days - 2 years: 0.2 – 0.6 mg/dL Gel barrier (gold or tiger top) 2 - 12 years: 0.3 – 1.0 mg/dL > 12 years 0.4 – 1.6 mg/dL 1.0 (0.5) mL serum

Performed: daily turn around: next day

22575 CREATININE CLEARANCE, 24 HOUR Male: 86 - 125 mL/min Specimen Container: 82575 Spectrophotometric Female: 75 - 115 mL/min 24 hour urine container, no preservative and Clinical Use: Gel barrier (gold or tiger top) Creatinine Clearance reflects the gomurular filtration rate, the ability of kidneys to filter waste products. Moderate decreases in 10.0 (1.0) mL aliquot of a well mixed 24 hour urine renal function are detected by the Creatinine Clearance. and 1.0 (0.5) mL serum. Progression of kidney disease can be monitored with the Creatinine Clearance. Record patient's height, weight and total urine Performed: mon, wed, fri volume on test requisition. turn around: next day

22576 CREATININE CLEARANCE 4 HR Male: 86 - 125 mL/min Specimen Container: 82575 Spectrophotometric Female: 75 - 115 mL/min Urine collection container, no preservative and Clinical Use: Gel barrier (gold or tiger top) Creatinine Clearance reflects the gomurular filtration rate, the ability of kidneys to filter waste products. Moderate decreases in 10.0 (1.0) mL aliquot of a well mixed 24 hour urine renal function are detected by the Creatinine Clearance. and 1.0 (0.5) mL serum. Progression of kidney disease can be monitored with the Creatinine Clearance. Record patient's height, weight and total 24 hour Performed: mon, wed, fri volume on test requisition. turn around: next day

22570 CREATININE, URINE 24 HR Male: 0.6 – 2.5 gm/24 hr Specimen Container: 82570 colorimetric Female: 0.6 – 1.5 gm/24 hr 24 hour urine collection container, no preservative

Clinical Use: 10.0 (1.0) mL aliquot of a well mixed 24 hour urine Creatinine is the endproduct of creatinine metabolism. Creatinine is present primarily in muscle and the amount of creatinine Record 24-hour urine volume on test request produced is related to total skeletal muscle mass. Daily creatinine form and specimen container. production is fairly constant except when there is a massive injury to muscle. The kidneys excrete creatinine very efficiently and blood levels and daily urinary excretion of creatinine fluctuate very little in healthy normal people. Since blood and daily urine excretion of creatinine show minimal fluctuation, creatinine excretion is useful in determining whether 24-Hour urine specimens for other analysis (e.g., Protein) have been completely and Performed: mon, wed, fri accurately collected. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 1-3 days

12571 CREATININE, RANDOM URINE No reference range has been established Specimen Container: 82570 colorimetric Sterile urine container, leak-prof

Performed: mon, wed, fri 10.0 (0.5) mL random urine turn around: 1-3 days

82595 CRYOGLOBULIN None detected Specimen Container: 82595 Cold Precipitation No additive (red top) Clinical Use: Cryoglobulins are a group of proteins which precipitate from 5.0 (2.5) mL serum serum, plasma, or urine upon exposure to cold. After collection, allow specimen to clot at 37 degrees C for 30-60 minutes. Place in a 37 degrees C incubator or a waterbath. If not available, adjust tap water in a container to 37 degrees C. Place collection tube into container. Monitor temperature throughout clotting process. Centrifuge clotted tube in a prewarmed centrifuge. (Run centrifuge for 10 minutes before centrifuging the specimen.) Pour serum into a plastic screw-cap vial and submit at room temperature. DO NOT REFRIGERATE.

Performed: referred-A Do not use gel barrier tube. turn around: 5-7 days

86641 CRYPTOCOCCAL ANTIBODY <1:2 Specimen Container: 86641 Tube Agglutination Method No additive (red top) Clinical Use: Cryptococcus neoformans is a yeast-like organism found 1.0 (0.5) mL serum, transfer to plastic screw-top vial commonly in pigeon bird droppings. Crpytococcosis is associated with subacute and chronic meningitis, pulmonary, skin, bone and Performed: referred-A other lesions, especially in patients who are immunocompromised. turn around: 3-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

87450 CRYPTOCOCCAL ANTIGEN LATEX Not detected Specimen Container: 86403 Latex Agglutination Gel barrier (gold or tiger top) Clinical Use: If Cryptococcal antigen screen is detected, equivocal, or indeterminate, The encapsulated soil yeast Cryptococcus neoformans causes 2.0 (0.5) mL serum then a reflex to titer will be performed at an additional charge (CPT: 86406). cryptococcosis. Pulmonary infection is acquired by inhalation of the organism and is usually subclinical in the immunocompetent host. Dissemination may occur in an immunocompromised patient, Performed: referred-A often to the meninges. turn around: 3-5 days

87210 CRYPTOSPORIDIUM SMEAR No Cryptosporidium, Isospora, or Cyclospora detected. Specimen Container: 87210 Stain Respiratory: 10% formalin container Stool: 10% formalin, Ecofix or SAF container

5.0 (2.0) mL respiratory specimen

Stool must be collected without contamination by urine or water. Add a sufficient amount of stool to bring the liquid level to the Fill to Here line on the Formalin. Mix contents throughly until homogenous. Performed: referred-A turn around: 3-5 days

89060 CRYSTALS, SYNOVIAL FLUID None seen Specimen container: 89060 Polarizing Microscopy No additive (red top) Clinical Use: Microscopic examination of synovial fluid for the presence and 3.0 (1.0) mL synovial fluid classification of crystals is useful for the diagnosis of gout and pseudogout. Performed: referred-A pseudogout. Transport at room temperature turn around: 3-5 days

47075 CULTURE, ANAEROBIC No Anaerobes Isolated Specimen container: 87075 Culture Anaerobic transport swab

Appropriate specimens include abscess, deep wounds and aspirates.

Label with name, date of collection and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 3-7 days

47040 CULTURE, BLOOD No growth at 5 days Specimen container: 87040 Culture 2 Sodium Polyanetholesulfonate (SPS) yellow top tubes or If positive, an identification and sensitivity Bactec Blood Culture Bottle (aerobic & anaerobic) will be performed for an additional charge. 16.0 (3.0) mL whole blood Performed: daily turn around: 7 days * Low volume will result in decreased recovery of pathogens.

Refer To Micorbiology Culture Procedures

47039 CULTURE, BODY FLUIDS No growth Specimen container: 87070 Culture Sterile, leakproof container 87015

Body Fluid (peritoneal, pericardial, synovial) in sterile container. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE If positive, an identification and sensitivity will be performed for an additional charge. Label specimen container with name and source.

Refer To Micorbiology Culture Procedures

Performed: daily turn around: 2-3 days

47063 CULTURE, CATH URINE No growth Specimen container: 87086 Culture Sterile, leakproof container Gray-top transport tube from urine collection kit If positive, an identification and sensitivity will be performed for an additional charge. 4.0 (0.5) mL urine, collected from a straight catheter, refrigerate.

Do not use urine collection kit for specimens less than 4.0 mL.

Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47041 CULTURE, CSF No growth Specimen container: 87070 Culture Sterile, leakproof container 87205

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

If positive, an identification and sensitivity 2.0 (0.3) mL CSF will be performed for an additional charge. Submit CSF specimen immediately at room temperature. Do not refrigerate.

Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47069 CULTURE, DECUBITUS No growth Specimen container: 87075 Culture Culture transport swab (pink cap)

If positive, an identification and sensitivity Label specimen container with name and source. will be performed for an additional charge. Refer To Micorbiology Culture Procedures Performed: daily turn around: 2-3 days

47105 CULTURE, ENVIRONMENTAL No growth Specimen container: 87070 Culture Culture transport swab (pink cap)

Label specimen with facility name and site.

Refer To Micorbiology Culture Procedures Performed: daily turn around: 2-3 days

47044 CULTURE, EYE No growth Specimen container: 87070 Culture Culture transport swab (pink cap)

If positive, an identification and sensitivity Conjunctival or corneal scraping will be performed for an additional charge. Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47064 CULTURE, FOLEY CATH URINE No growth Specimen container: 87086 Sterile, leakproof container Gray-top transport tube from urine collection kit

4.0 (0.5) mL urine, collected from a foley catheter, refrigerate.

Do not collect specimen from a catheter bag

Do not use urine collection kit for specimens less than If positive, an identification and sensitivity 4.0 mL. will be performed for an additional charge. Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47060 CULTURE, NASOPHARYNGEAL Normal Respiratory Flora Specimen container: 87070 Culture Culture transport swab (pink cap)

Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 2-3 days

47070 CULTURE, OTHER No growth Specimen container: 87070 Culture Culture transport swab (pink cap)

If positive, an identification and sensitivity Label specimen container with name and source. will be performed for an additional charge. Refer To Micorbiology Culture Procedures Performed: daily turn around: 2-3 days

47042 CULTURE, SPUTUM Normal Respiratory Flora Specimen container: 87070 Culture Sterile, leak-proof container

If positive, an identification and sensitivity Respiratory specimen (sputum or tracheal aspirate) will be performed for an additional charge. Do not send in formalin, Refrigerate specimen.

Label specimen container with name and source.

Refer To Micorbiology Culture Procedures Performed: daily turn around: 2-3 days

47045 CULTURE, STOOL No Salmonella, Shigella or Campylobacter Isolated Specimen container: 87045 Culture Stool transport swab (red cap) If an etiologic agent is not isolated with the first culture Para-Pak C&S transport vial (orange cap) two additional specimens should be submitted to the laboratory over the next few days. Organisms may be 3.0 (1.0) gram stool shed intermittently; collection of specimens at different times over several days may enhance recovery. Do not submit stool sample that contains barium

Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47081 CULTURE, THROAT Normal Respiratory Flora Specimen container: 87070 Culture Culture transport swab (pink cap)

Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47113 CULTURE, URINE, CLEAN CATCH MID STREAM No growth Specimen Container 87086 Culture Sterile, leakproof container Gray-top transport tube from urine collection kit If positive, an identification and sensitivity

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE will be performed for an additional charge. 4.0 (0.5) mL urine, collected using aseptic techniques, refrigerate.

Do not use urine collection kit for specimens less than 4.0 mL.

Label specimen container with name and source.

Performed:daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47074 CULTURE, VAGINAL Normal Vaginal Flora Specimen container: 87075 Culture Culture transport swab (pink cap)

Appropriate sources include cervical or vaginal

Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

47043 CULTURE, WOUND No growth Specimen container: 87075 Culture Culture transport swab (pink cap)

If positive, an identification and sensitivity Appropriate sources include lesion, abcess, or scraping will be performed for an additional charge. Label specimen container with name and source.

Performed: daily Refer To Micorbiology Culture Procedures turn around: 2-3 days

83536 CYCLIC CITRULLINE PEPTIDE (CCP) < 20 Units: Negative Specimen container: 86200 Immunoassay 20-39 Units: Weak positive Gel barrier (gold or tiger top) 40-59 Units: Moderate positive > 59 Units: Strong positive 1.0 (0.5) mL serum

Clinical Use: Anti-CCP is useful in diagnosing Rheumatoid Arthritis in entities that may potentially be confused with Rheumatoid Arthritis that are Rheumatoid-Factor positive, such as SLE, Anti-CCP is usually Performed: referred-A negative. turn around: 3-5 days

80037 CYCLOSPORINE A Trough Specimen container: 80158 Liquid Chromatography/Tandem Mass Spectrometry 100-300 ng/mL EDTA (lavender top) Toxic >300 ng/mL 5.0 (2.0) mL whole blood Detection limit 25 ng/mL Optimum time to collect sample is 1 hour before next dose. Clinical Use: Cyclosporine is a commonly used immunosuppresive drug in patients receiving transplants. Therapeutic drug monitoring is Performed: referred-A useful to optimize dose and avoid toxicity. turn around: 3-5 days

83901 CYSTIC FIBROSIS GENOTYPR-CARRIER STUDY Accompanies report Specimen container: 83891 Polymerase chain reaction (PCR), primer extension and tag sorting. EDTA (lavender top) 83892 (2) Clinical Use: 83900 In 2001 the American College of Medical Genetics (ACMG) and 5.0 (3.0) mL whole blood 83901 (x19) the American College of Obstetricians and Gynecologists (ACOG) Transport at room temperature within 24 hours of 83909 finalized a description of a mutation panel that is now collection. 83912 recommended for general population screening - not just those 83914 (x70) with a personal or family history of carrying the CF gene. Requires pre-analytic clinical information in order Additional mutations now included in the Specialty Cystic Fibrosis interpret the test results. The patient's ethnic NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 70 GenotypR™ have been shown to improve carrier detection background and family history of CF should be rates particularly in Hispanics (from 57% to 72%) and Blacks detailed on the Molecular Genetics Requisition Form. (from 69% to 81%).

Specialty’s Cystic Fibrosis 70 GenotypR™ detects 70 clinically relevant mutations, including the mutations recommended by ACMG and ACOG for carrier screening and additional mutations that occur in at least one U.S. ethnic group. A negative result reduces, but does not eliminate,carrier risk. Performed: referred-S turn around: 14-21 days

82133 CYSTINE, 24-HOUR URINE Accompanies report Specimen container: 82131 Liquid Chromatography/Mass Spectrometry 24 hour urine collection container, no preservative Clinical Use: Cystinuria is an autosomal recessive disease in which dibasic 1.8 (0.5) mL FROZEN urine, from a 24-hr urine amino acids, including cystine, are excreted in excess. Cystine collection. kidney stones account for approximately 1-3% of all kidney stones. Age of onset is often younger than with other types of kidney Transport frozen stones and the recurrence is approximately one-third.

Performed: referred-A turn around: 7-10 days

83879 CYTOCHROME P450 2D6 GENOTYPE Accompanies report Specimen container: 83891 Polymerase Chain Reaction EDTA (lavender top) 83900 Single Nucleotide Primer Extension Reaction Clinical Use: 83909 The CYP2D6 gene product is responsible for the metabolism 5.0 (3.0) mL whole blood 83912 of many major drug groups including many antidepressants, 83892 (x3) neuroleptics, and cardiovascular drugs. Cytochrome 450 83914 (x8) 2D6 Genotype detects eight alleles associated with the poor metabolizer phenotype (PM). Patients with duplication of the CYP2D6 gene are ultraextensive metabolizers (UEM). Approximately 5-10% of Caucasian individuals express PM Performed: referred-A phenotype and the same percentage the UEM phenotype. turn around: 10-14 days

68104 CYTOLOGY, OTHER SOURCE Accompanies report Specimen container: 88104 Microscopic Sterile Urine Container, leak-proof Clinical Use: Urine cytology is useful in diagnosing diseases that involve 100.0 (25.0) mL clean catch random urine, refrigerated Performed: mon-fri the mucosal surface. turn around: 5-7 days

86644 CYTOMEGALOVIRUS IGG ANTIBODY Index Value Interpretation Specimen container: 86644 Enzyme-Linked Immunosorbent Assay ≤ 0.90 Negative - no CMV IgG Ab detected Gel barrier (gold or tiger top) 0.91-1.09 Equivocal ≥ 1.10 Positive - CMV IgG Ab detected 1.0 (0.1) mL serum

A positive result indicates that the patient has antibody to CMV. It does not differentiate between an active or past infection. The clinical diagnosis must be interpreted in conjunction with the clinical signs and symptoms of the patient.

Clinical Use: CMV infections are common and usually asymptomatic. In patients who are immunocompromised, CMV may cause disseminated, severe disease. CMV may cause birth defects in a minority of infected newborns. Antibody IgG may represent prior exposure or recent infection if there is a significant change in titer between acute and convalescent specimens. An elevated titer of Antibody Performed: referred-A IgM represents a recent CMV infection. turn around: 3-5 days

86645 CYTOMEGALOVIRUS IGM ANTIBODY Index Value Interpretation Specimen container: 86645 Enzyme Immunoassay ≤ 0.90 Negative - no CMV IgM Ab detected Gel barrier (gold or tiger top) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 0.91-1.09 Equivocal ≥ 1.10 Positive - CMV IgM Ab detected 1.0 (0.1) mL serum

Results from any one IgM assay should not be used as a sole determinant of a current or recent infection. Because an IgM test can yield false positive results and low levels of IgM antibody may persist for more than 12 months post infection, reliance on a single test result could be misleading. If an acute infection is suspected, consider obtaining a new specimen and submit for both IgG and IgM testing in two or more weeks.

Clinical Use: CMV infections are common and usually asymptomatic. In patients who are immunocompromised, CMV may cause disseminated, severe disease. CMV may cause birth defects in a minority of infected newborns. Antibody IgG may represent prior exposure or recent infection if there is a significant change in titer between acute and convalescent specimens. An elevated titer of Antibody Performed: referred-A IgM represents a recent CMV infection. turn around: 3-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 87497 CYTOMEGALOVIRUS DNA, QUANT PCR Not detected Specimen container: 87496 EDTA (lavender top) Real-Time PCR Clinical Use: CMV infections are common and usually asymptomatic. In patients 3.0 (0.3) mL whole blood, refrigerate who are immunocompromised, CMV may cause disseminated, severe disease. CMV may cause birth defects in a minority of infected newborns. DNA methods provide the highest sensitivity Performed: referred-A and specificity of any method. turn around: 3-5 days

15379 D-DIMER 0 - 0.5 ncg/mL FEU Specimen container: 85379 Turbidimetric Sodium citrate (light blue top) Clinical Use: D-Dimer is one of the measurable by-products of activation of 1.0 (0.5) mL FROZEN plasma the fibrinolytic system. Quantitation of D-Dimer assesses Transfer plasma to a plastic, screw-cap vial and freeze. fibrinolytic activation and intravascular thrombosis. D-Dimer is of particular value in excluding the diagnosis of venous Transport frozen Performed: daily venous thromboembolism among patients of high risk. turn around: next day

83523 DESIPRAMINE (NORPRAMIN ) 125-300 mcg/L Specimen container: 80160 High Performance Liquid Chromatography No additive (red top) Clinical Use: Serum level of Desipramine is used to assess patient compliance 1.0 (0.6) mL serum and to make dosage adjustments to achieve therapeutic levels, Transfer serum to a plastic, screw-cap vial. while avoiding toxicity. Desipramine is a tricyclic antidepressant Performed: referred-A most frequently used in the treatment of depression. turn around: 3-5 days

80317 DEXAMETHASONE Baseline: Specimen container: 80299 Liquid Chromatography/Tandem Mass Spectrometry Less than 20 ng/dL No additive (red top)

1 mg dexamethasone overnight: 1.0 (0.5) mL serum 180-550 ng/dL (8:00-10:00 a.m.) Transfer serum to a plastic, screw-cap vial.

Clinical Use: Measurement of Dexamethasone is useful in assuring compliance Collect specimen between 8:00 and 10:00 a.m. with Dexamethasone treatment and documenting adequate dosing during such procedures as the Dexamethasone Suppression Test Gel barrier tubes (tiger top) are unacceptable Performed: referred-A used in the differential diagnosis of Cushing's syndrome. turn around: 3-5 days

82626 DHEA (DEHYROEPIANDROSTERONE) Accompanies report Specimen container: 82626 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: DHEA is a weakly androgenic steroid that is useful when 0.5 (0.3) mL serum congenital adrenal hyperplasia is suspected. . It is also useful in Transfer serum to a plastic, screw-cap vial. determining the source of androgens in hyperandrogenic conditions, such as polycystic ovarian syndrome and adrenal Gel barrier tubes (tiger top) are unacceptable Performed: referred-A tumors. turn around: 7-10 days

82627 DHEA-SULFATE Accompanies report Specimen container: 82627 Immunoassay Gel barrier (gold or tiger top) Clinical Use: DHEA-S is the sulfated form of DHEA and is the major adrogen 1.0 (0.5) mL serum produced by the adrenal glands. This test is used in the differential diagnosis of hirsute or virilized female patients and for the diagnosis of isolated premature adrenarche and adrenal tumors. About 10% of hirsute women with polycystic ovarian syndrome (PCOS) have elevated DHEA-S, but normal levels of Performed: referred-A other androgens. turn around: 3-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 22636 DIAZEPAM (VALIUM ) Therapeutic Specimen container: 80154 High Performance Liquid Chromatography Diazepam: 0.1 - 2 ug/mL No additive (red top) Nordiazepam: 0.1 - 2 ug/mL 0.5 (0.3) mL serum Clinical Use: Transfer serum to a plastic, screw-cap vial. Therapeutic drug monitoring of anxiolytic drug. Nordiazepam is the active metabolite of parent drug. Gel barrier tubes (tiger top) are unacceptable

Performed: referred-A Collect as trough specimen, prior to next dose. turn around: 7-10 days

82640 DIGITOXIN Therapeutic range: 10 - 30 ng/mL Specimen container: 80299 Immunoassay Reporting limit: 5 ng/mL No additive (red top)

Clinical Use: 1.0 (0.3) mL serum Digitoxin is a cardiovascular drug. It is used for therapeutic Transfer serum to a plastic, screw-cap vial. monitoring. Performed: Tuesday, Thursday Afternoon Gel barrier tubes (tiger top) are unacceptable turn around: 4 Days

12643 DIGOXIN (LANOXIN ) 0.8 - 2.0 ng/mL Specimen container: 80162 Competitive Immunoassay-Chemilluminesence Gel barrier (gold or tiger top)

1.0 (0.5) mL serum

Performed: daily Collect 8-24 hours after last dose. turn around: next day

82651 DIHYDROTESTOSTERONE Accompanies report Specimen container: 82651 Extraction No additive (red top) Radioimmunoassay Clinical Use: Chromatography DHT is a potent androgen derived from testosterone via 4.0 (1.1) mL serum 5-alpha-reductase activity. 5-alpha-reductase deficiency results Transfer serum to a plastic, screw-cap vial. in incompletely virilized males (phenotypic females). This diagnosis is supported by an elevated ratio of testosterone to Performed: referred-A DHT. turn around: 5-7 days

14045 DILANTIN (PHENYTOIN) 10-20 mcg/mL Specimen container: 80185 Chemilluminesce Gel barrier (gold or tiger top) Clinical Use: Phenytoin is an anticonvulsant used in the treatment of tonic-clonic 1.0 (0.5) mL serum (Grand Mal) and focal seizures. Therapeutic drug monitoring is Performed: daily useful in optimizing dose and avoiding toxicity. turn around: next day

86226 ssDNA, IgG ANTIBODY __< 69 U/mL: Negative 1 (Min 0.5) mL Serum. Transport in a refrigerated 86226 Enzyme Immunoassay 69-229 U/mL: Moderate Positive Serum Separator Tube. _> 229 U/mL: Positive Alternate Specimen(s) Autoantibodies to ssDNA recognize the purine and 1 (Min 0.5) mL Serum. Transport in a refrigerated pyrimidine bases of DNA. These antibodies are Red-top tube (no gel). found in SLE and may be present in patients with ANA-negative SLE. However, high titers are not risk of lupus nephritis and may be found in drug induced specific for SLE or for lupus, rheumatoid arthritis, and chronic active hepatitis.

Performed: Monday-Friday Morning turn around: next day

82504 DOPAMINE, PLASMA Accompanies report Specimen Container: 82491 High Performance Liquid Chromatography Sodium heparin (green top), pre-chilled Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Dopamine is a catecholamine. Measurement is useful in patients 4.0 (2.5) mL FROZEN heparinized plasma with suspected pheochromocytoma, neuroblastoma, or Centrifuge within 30 minutes of collection and paraganglioma. transfer plasma to a plastic, screw cap vial and freeze.

Performed: referred-A Overnight fasting is required. turn around: 5-7 days

82656 DOXEPIN AND NORDOXEPIN (SINEQUAN) Doxepin + Nordoxepin (Desmethyldoxepin) Specimen container: 80166 High Performance Liquid Chromatography 150-250 mcg/L No additive (red top)

Toxic 3.0 (1.5) mL serum 500 or more Transfer serum to a plastic, screw-cap vial.

Clinical Use: Doxepin in a tricyclic Antidepressant. Its metabolite, Nordoxepin Performed: referred-A (Desmethyl Doxepin) is also pharmacologically active. turn around: 3-5 days

80104 DRUG ABUSE SCREEN 7, SERUM Accompanies report Specimen container: 80101 (x7) Gas Chromatography Mass Spectrometry No additive (red top) Immunoassay Clinical Use:

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Chromatography The serum or plasma concentration of a drug is measured as a 10.0 (5.0) mL serum guide to individualization of therapy. Additionally, the problem of Transfer serum to a plastic, screw-cap vial. Test Components: noncompliance with prescribed medications during continuing AMPHETAMINES therapy, particularly in the pain management field, is an elusive BARBITURATES cause of therapeutic failure. BENZODIAZEPINES COCAINE METABOLITE MARIJUANA OPIATES PCP (Phencyclidine)

Performed: referred-A turn around: 5-7 days

80100 DRUG OVERDOSE PANEL, SERUM None detected Specimen container: 80101 (x5) Enzyme-Linked Immunosorbent Assay No additive (red top) Please read this important message: This Drug Screen is Test Components: for medical use only. The results are presumptive, based 5.0 (1.0) mL serum AMPHETAMINES on screening methods, and they have not been confirmed by Transfer serum to a plastic, screw-cap vial. COCAINE METABOLITE a second independent chemical method. MARIJUANA OPIATES PCP (Phencyclidine)

Performed: referred-A turn around: 5-7 days

22659 DRUG SCREEN, 5 PANEL UR None detected Specimen Container: 80101 (X5) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES BARBITURATES BENZODIAZEPINES COCAINE METABOLITE OPIATES

Performed: mon-sat turn around: 1-2 days

22660 DRUGE SCREEN, 7 PANEL UR None detected Specimen Container: 80101 (x7) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES

BARBITURATES BENZODIAZEPINES COCAINE METABOLITE CANNABINOIDS (Marijuana) OPIATES PCP (Phencyclidine)

Performed: mon-sat turn around: 1-2 days

80106 DRUG SCREEN, COMPREHENSIVE (URINE) No drugs detected Specimen Container: 80100 Colorimetric Sterile urine container, leak-prof 80101 (x8) Immunoassay These results are for medical treatment only. Analysis was Chromatography performed as Non-Forensic testing. 60.0 (25.0) mL random urine

Urine was tested for the following : Analgesics Antiarrythmics Anticonvulsants Antidepressants NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Antihistamines Antipsychotics Barbiturates Benzodiazepine Metabs. Cannabinoids Cocaine Metabolite Opiates/Narcotics Muscle Relaxants Phencyclidine Sedatives/Hypnotics Stimulants Performed- referred-A Volatiles turn around: 5-7 days

22664 DRUG SCREEN, M51X URINE None detected Specimen Container: 80101 (X8) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES BARBITURATES BENZODIAZEPINES COCAINE METABOLITE CANNABINOIDS (Marijuana) METHAQUALONE OPIATES PCP (Phencyclidine)

Performed: mon-sat turn around: 1-2 days

22665 DRUG SCREEN, M55X URINE None detected Specimen Container: 80101 (x6) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES BARBITURATES BENZODIAZEPINES COCAINE METABOLITE CANNABINOIDS (Marijuana) OPIATES

Performed: mon-sat turn around: 1-2 days

22669 DRUG SCREEN, M55X-EMP UR None detected Specimen Container: 80101 (X6) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES BARBITURATES BENZODIAZEPINES COCAINE METABOLITE CANNABINOIDS (Marijuana) OPIATES

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: mon-sat turn around: 1-2 days

22661 DRUG SCREEN, NSP URINE None detected Specimen Container: 80100 (x7) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES BARBITURATES BENZODIAZEPINES COCAINE METABOLITE CANNABINOIDS (Marijuana) OPIATES PROPOXYPHENE

Performed: mon-sat turn around: 1-2 days

82540 DRUG SCREEN, SERUM COMP None detected Specimen Container: 80100 Gas Chromatography Mass Spectrometry 2 EDTA (lavender top) 80101 (x4) Enzyme-Multiplied immunoassay Technique Clinical Use: Thin Layer Chromatography This screen is designed primarily for unknown drug identifications 8.0 (5.0) mL whole blood, transport refrigerated and organic chemicals detectable by gas chromatography mass spectrometry (GCMS). Computer searches of our drug library (over 300 drugs and metabolites) and a library of over 20,000 organic compounds are performed to attempt identification of Performed: referred-A all unknowns. turn around: 5-7 days

22667 DRUG SCREEN, UR (P1) None detected Specimen Container: 80101 (x5) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. Test Components: 50.0 (25.0) mL random urine AMPHETAMINES COCAINE METABOLITE CANNABINOIDS (Marijuana)

OPIATES PCP (Phencyclidine)

Performed: mon-sat turn around: 1-2 days

22663 DRUG SCREEN, UR-10 PANEL None detected Specimen Container: 80101 (X10) EMIT/Enzyme IMM/EIA Sterile urine container, leak-prof These results are for medical treatment only. AMPHETAMINES 50.0 (25.0) mL random urine BARBITURATES BENZODIAZEPINES COCAINE METABOLITE CANNABINOIDS (Marijuana) METHADONE METHAQUALONE OPIATES PROPOXYPHENE PCP (Phencyclidine)

Performed: mon-sat turn around: 1-2 days

83787 DULOXETINE / CYMBALTA Accompanies report Specimen Container 83789 High Performance Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Therapeutic drug monitoring is useful in optimizing dose and 2.0 (1.0) mL serum. avoiding toxicity. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Transfer serum to plastic, amber vial. If amber vial is not available, wrap in foil to protect from light. Performed: referred-A turn around: 5-7 days

87427 E.COLI SHIGELLA TOXINS, EIA, STOOL Not detected Specimen container: 87427 Broth-enhanced Toxin Assay by EIA Stool Culture transport swab (red top) or Clinical Use: Para-Pak C&S transport vial (orange cap) If Shigella Toxin is detected, then a reflex to culure for This test detects Shiga toxins produced by enterohemorrhagic E. coli O157 will be performed at an additional charge E. coli and other enteric organisms which have been isolated 3.0 (1.0) gram stool in Cary Blair transport from patients who have hemorrhagic colitis with or without Performed: referred-A hemolytic-uremic syndrome (HUS). Label specimen container with name and source. turn around: 7-10 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

87081 E.COLI 0157, STOOL CULTURE None isolated Specimen container: 87046 Culture Stool Culture transport swab (red top) or If an etiologic agent is not isolated with the first Para-Pak C&S transport vial (orange cap) culture, two additional specimens should be submitted to the laboratory over the next few days. Organisms may be 3.0 (1.0) gram stool in Cary Blair transport shed intermittently; collection of specimens at different times over several days may enhance recovery. Rectal swabs are less reliable for detecting enteric pathogens. Submit liquid or bloody stool in bacterial culture transport medium.

Performed: referred-A Label specimen container with name and source. turn around: 7-10 days

86666 EBV CAPSID AG, AB (IgG) Index Interpretation Specimen Container: 86665 Immunoassay ≤ 0.90 Negative Gel barrier (gold or tiger top) 0.91-1.09: Equivocal ≥ 1.10 Positive 1.0 (0.2) mL serum

A positive result indicates that the patient has antibody to EBV VCA. It does not differentiate between an active or past infection The clinical diagnosis must be interpreted in conjunction with the clinical signs and symptoms of the patient.

Clinical Use: Primary infection by EBV causes infectious monocucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders, including tumors. VCA-IgG appears approximately 10 weeks after initial infection and persists for life. Absence of VCA-IgG Performed: referred-A typically indicates the patient is susceptible to infection. turn around: 3-5 days

86665 EBV CAPSID AG, AB (IgM) Index Interpretation Specimen Container: 86665 Immunoassay ≤ 0.90 Negative Gel barrier (gold or tiger top) 0.91-1.09: Equivocal ≥ 1.10 Positive 1.0 (0.2) mL serum

A positive result is indicative of IgM antibody to EBV VCA. The clinical diagnosis must be interpreted in conjunction with the clinical signs and symptoms of the patient.

Clinical Use: Primary infection by EBV causes infectious monocucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders, including tumors. VCA-IgM typically appears approximately 4-6 weeks after initial infection and declines to undetectable in approximately 4-6 weeks after initial infection and declines to undetectable in 1 month in Performed: referred-A young children and up to 3 months in others. turn around: 3-5 days

86667 EBV EARLY ANTIGENS, Ab Index Interpretation Specimen Container: 86663 Immunoassay ≤ 0.90 Negative Gel barrier (gold or tiger top) 0.91-1.09: Equivocal ≥ 1.10 Positive 1.0 (0.2) mL serum

A positive result indicates that the patient has IgG antibody to Epstein-Barr Virus Early Antigen (EBV-EA). It does not differentiate between an active or past infection. The clinical diagnosis must be interpreted in conjunction with the clinical signs and symptoms of the patient.

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Primary infection by EBV causes infectious monocucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders, including tumors. Early Antigen D Antibody appears approximately 1 month after infection and typically is transient lasting 1-2 months. Persistently elevated levels suggest reactivation Performed: referred-A or persistence of EBV infection. turn around: 3-5 days 86668 EHRLICHIA Ab IgG, IgM 86666 (x2) Indirect Immunofluorescence Assay IgG: < 1:64 Specimen Container: IgM: < 1:20 Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.2) mL serum Human monocytic ehrlichiosis (HME) is a tick-borne infection caused by Ehrlichia chaffeensis. Infections range in severity Performed: referred-A severity from asymptomatic to life-threatening, especially in turn around: 3-5 days

20004 ELECTROLYTES (CHEM 4) Accompanies report Specimen Container: 80051 Gel barrier (gold or tiger top) Components: Sodium, Potassium, Chloride, Carbon Dioxide Clinical Use: The electrolyte panel is useful in assessing acid-base balance in 1.0 (0.5) mL serum Performed: daily a wide variety of medical conditions. turn around: next day

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

86273 ENDOMYSIAL ANTIBODY SCREEN (IgA), REFLEX TO TITER Negative Specimen Container: 86255 Immunofluorescence Assay Gel barrier (gold or tiger top) Clinical Use: Antiendomysial antibodies of the IgA class seem to be the most 1.0 (0.3) mL serum sensitive and specific markers for celiac disease and dermatitis Performed: referred-A herpetiformis, compared with antireticulin and antigliadin turn around: 3-5 days

87255 ENTEROVIRUS CULTURE Negative Specimen container: 87254 Indirect Immunofluorescence Assay VCM collection Kit A Rapid Culture Clinical Use: Enteroviruses are among the most common viruses infecting 3.0 (1.0) mL Conjunctiva, CSF, Stool, Throat, Vesticle. humans and are associated with diverse clinical syndromes fluid/scraping, Nasal/nasophyngeal, lower respiratory ranging from minor febrile illness to severe, potentially tract specimens, transport in a refrigerated VCM. fatal conditions e.g., aseptic meningitis, encephalitis, paralysis, myocarditis, and neonatal enteroviral sepsis) and could be Do not use VCM if media is yellow. linked with the development of some chronic diseases (e.g., type 1 diabetes and dilated cardiomyopathy). Each year, an estimated 10 to 15 million symptomatic Enterovirus infections Performed: referred-A occur in the United States. turn around: 10-14 days

15012 EOSINOPHIL COUNT, TOTAL Accompanies report Specimen container: 85048 Automated Cell Count EDTA (lavender top) Clinical Use: Elevated blood Eosinophils (eosinophilia) are found in patients 5.0 (2.0) mL whole blood with parasitic infections, asthma, some drug reactions, pulmonary eosinophilic syndrome, and eosinophilic leukemia. Slight elevations amy be found in patients with allergic rhinitis, hay fever, Performed: daily and asthma. turn around: next day

11015 EOSINOPHIL SMEAR, URINE No reference ranges have been established Specimen container: 81085 Microscopic Examination Urine collection container, leak-proof

10.0 (5.0) mL random urine, refrigerated

86247 EPIDERMAL ANTIBODIES Intercellular substance: < 1:20 titer negative Specimen Container: 86255 (x2) Immunofluorescence Assay Basement membrane zone: < 1:20 titer negative Gel barrier (gold or tiger top)

Screens reflex to titers at an additional charge: Clinical Use: 1.0 (0.5) mL serum Intercellular Substance Antibody Titer (CPT: 86256). Epidermal antifbodies are found in the bullous disorders: bullous Basement Membrane Zone Antibody Titer (CPT: 86256). pemphigoid (antibasement membrane antibodies) and pemphigus vulgaris (intercellular substance antibodies). Performed: referred-A turn around: 5-7 days

82505 EPINEPHRINE, PLASMA Accompanies report Specimen Container: 82491 High Performance Liquid Chromatography Sodium heparin (green top), pre-chilled Clinical Use: Epinephrine is a catecholamine. Measurement 4.0 (2.5) mL FROZEN heparinized plasma is useful in patients with suspected pheochromocytoma, Centrifuge within 30 minutes of collection and neuroblastoma, or paraganglioma. transfer plasma to a plastic, screw cap vial and freeze.

Overnight fasting is required.

Performed: referred-A turn around: 7-10 days

86669 EPSTEIN BARR ANTIBODY PANEL I Accompanies report Specimen Container: 86664 Enzyme Immunoassay Gel barrier (gold or tiger top) 86665 (x2) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Primary infection by EBV causes infectious monocucleosis, 2.0 (1.0) mL serum usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders, including tumors. VCA-IgM typically appears approximately 4-6 weeks after initial infection and declines to undetectable in approximately 4-6 weeks after initial infection and declines to undetectable in 1 month in Performed: referred-A young children and up to 3 months in others. turn around: 3-5 days

86920 ERYTHROPROTEIN (EPO) Accompanies report Specimen Container: 82668 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Elevated levels of serum erythropoietin (EPO) occur in patients 1.0 (0.5) mL serum with anemias, due to increased red cell destruction in hemolytic anemia and also in secondary polycythemias associated with impaired oxygen delivery to the tissues, impaired pulmonary oxygen exchange, abnormal hemoglobins with increased oxygen affinity, constriction of the renal vasculature, and inappropriate EPO secretion caused by certain renal and extrarenal tumors. Normal or depressed levels may occur in anemias, due to increased oxygen delivery to tissues, in Performed: referred-A hypophosphatemia and in polycythemia vera. turn around: 3-5 days

12670 ESTRADIOL Accompanies report Specimen Container: 82670 Chemilluminescence Gel barrier (gold or tiger top) Clinical Use: Diagnostic applicatios of estradiol assays include an assessment 1.0 (0.5) mL serum of ovarian function in a wide variety of situations (menstrual disorders, precocious or delayed puberty, assisted reproduction protocols). For men, estradiol measurement may be useful in the evaluation of gynecomastia. Performed :daily turn around: next day

82672 ESTROGENS, TOTAL Accompanies report Specimen Container: 82672 Radioimmunoassay Gel barrier (gold or tiger top) Clinical Use: Estrogens are secreted by the gonads, adrenal glands and 1.5 (1.0) mL serum placenta. Total Estrogens provide an overall picture of estrogen Performed: referred-A status for men and women. turn around: 3-5 days

82679 ESTRONE (E1) Accompanies report. Specimen Container: 82679 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Estrone is primarily derived from metabolism of androstenedione 1.0 (0.3) mL serum in peripheral tissues, especially adipose tissues. Individuals with Transfer serum to plastic, screw-cap vial obesity have increased conversion of androstenedione to Estrone leading to higher concentrations. In addition, an increase in the ratio of Estrone to Estradiol may be useful in assessing menopause in women. Performed: referred-A turn around: 7-10 days

82692 ETHOSUXIMIDE (ZARONTIN ) 50-100 mcg/mL Specimen Container: 80168 Immunoassay No additive (red top) Detection limit 10 mcg/mL 1.0 (0.5) mL serum Transfer serum to plastic, screw-cap vial Clinical Use: Ethosuximide is an anticonvulsant used to treat seizures. Gel barrier (gold or tiger top) tubes are not acceptable NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Ethosuximide levels are monitored to assure adequate therapeutic Performed: referred-A levels are achieved and to avoid toxicity. turn around: 3-5 days

85210 FACTOR II ACTIVITY 70-150% of normal Specimen container: 85210 Photometric Clot Detection 3.2% Sodium Citrate (light blue top) Clinical Use: 2.0 (1.0) mL platelet-poor plasma, FROZEN Bleeding disorders may be due to inherited or acquired deficiencies of a clotting factor. Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 3-5 days

85250 FACTOR IX ACTIVITY, PLASMA 60-160% of normal Specimen container: 85250 Photometric Clot Detection 3.2% Sodium Citrate (light blue top) Clinical Use: 2.0 (1.0) mL platelet-poor plasma, FROZEN Faxtor IX deficiency is also known as hemophilia B (Christmas disease). It is also helpful in the evaluation of a prolonged aPTT. Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 3-5 days

85220 FACTOR V ACTIVITY, PLASMA 65-150% of normal Specimen container: 85250 3.2% Sodium Citrate (light blue top) Photometric Clot Detection Clinical Use: Factor V activity is used to evaluate both hereditary (rare) and 2.0 (1.0) mL platelet-poor plasma, FROZEN acquired (liver disease, inhibitors, intravascular coagulation) deficiencies. Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 3-5 days

83913 FACTOR V, LEIDEN MUTATION Negative for the following mutation: Specimen container: 83891 Invader Assay/Signal Amplification R506Q EDTA (lavender top) 83892 83908 Clinical Use: 5.0 (3.0) mL Whole Blood 83912 Factor V Mutation (Leiden) is a point mutation that causes 83896 (x2) resistance of factor V degradation by activated protein C. Transport at room temperature. This mutation is associated with increased risk of venous Performed: referred-A thrombosis. turn around: 5-7 days

85355 FACTOR VIII INHIBITOR PANEL (INCLUDES ACTIVITY) Accompanies report Specimen container: 85335 Enzyme Immunoassay 3.2% Sodium Citrate (light blue top) 85240 Photometric Clot Detection Clinical Use: The presence of alloantibodies against factor VIII activity is a 6.0 mL platelet-poor plasma, FROZEN If Factor VIII Inhibitor, EIA Screen, is positive, then Factor VIII Human Inhibitor complication of treatment in hemophilia A, while the presence of will be performed at an additional charge [CPT code(s): 85335]. autoantibodies may develop spontaneously in patients with Submit a total of 6.0 mL, 2.0 mL in each of acquired Factor VIII-C deficiency. The detection of Factor VIII 3 separate tubes. If Factor VIII Human Inhibitor is < 2.1 or > 0.4, then Nijmejan Assay will be inhibitor is of importance in these patients. Factor VIII inhibitor EIA performed at an additional charge [CPT code(s): 85335]. assay is a quick method for the detection of Factor VIII inhibitor. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 7-10 days

85242 FACTOR VIII ACTIVITY, PLASMA 50-180% of normal Specimen container: 85240 Clotting Assay 3.2% Sodium Citrate (light blue top) Clinical Use: Factor VIII activity is used most commonly in evaluating for 2.0 (1.0) mL platelet-poor plasma, FROZEN deficiencies (i.e. hereditary and aquired hemophilia A). Low levels may also be sen in association with von Willebrand Disease. Platelet-poor plasma: Centrifuge light blue-top Elevated levels >200% are considered a thrombophilia risk factor. tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 3-5 days

85260 FACTOR X ACTIVITY, PLASMA 70-150% of normal Specimen container: 85260 Photometric Clot Detection 3.2% Sodium Citrate (light blue top) Clinical Use: Factor X Activity is used to evaluate for hereditary or acquired 3.0 (1.0) mL platelet-poor plasma, FROZEN deficiencies (liver disease, vitamin K deficiency, Warfarin, amyloidosis). It is also used in the investigation of a prolonged Platelet-poor plasma: Centrifuge light blue-top aPTT and PT. tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 3-5 days

85270 FACTOR XI ACTIVITY 65-150% of normal Specimen container: 85270 Photometric Clot Detection 3.2% Sodium Citrate (light blue top) Clinical Use: Factor XI is used to evaluate for a deficiency state - Hemophilia C. 1.0 (0.5) mL platelet-poor plasma, FROZEN It is also helpful in the evaluation of a prolonged aPTT. Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes within 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid WBC/platelet layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma Performed: referred-A into a new plastic screw- cap vial, freeze. turn around: 3-5 days

82705 FECAL FAT, QUALITATIVE Normal Specimen container: 82705 Sudan Stain Sterile, screw-cap container Clinical Use: Results may indicate malabsorption or maldigestion. False 2.0 (1.0) g stool, FROZEN positive results can occur due to mineral oil or castor oil present in the specimen. Large number of neutral fat globules may Transport frozen indicate steatorrhea. Performed: referred-A turn around: 3-5 days

82710 FECAL LIPIDS, TOTAL Accompanies report Speciemn Container: 82710 Nuclear Magnetic Resonance Spectroscopy 1 gallon, plastic leakproof container, with screw-cap NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Excessive fat in stool, steatorrhea, is useful in diagnosing patients 20.0 (3.0) grams 72-Hour Stool, FROZEN with malabsorption and maldigestion, e.g., pancreatic failure. In Keep refrigerated urine collection period. addition, results may be useful in monitoring patients receiving exogenous enzyme therapy and those with chronic diarrhea. Transport entire container, frozen

Patient should be on a diet including 100 grams of fat per day for 3 days before collection and during Performed: referred-A the collection period. turn around: 7-10 days

82490 FELBAMATE (FELBATOL) 30-50 mcg/mL Specimen Container: 80299 High Performance Liquid Chromatography No additive (red top) Clinical Use: Felbamate is an antiepileptic drug used to treat patients with a 1.0 (0.5) mL serum variety of types of seizures. Therapeutic drug monitoring is useful optimize dose and avoid toxicity. Optimum time to collect sample: 1 hour before next dose. Do not use gel barrier tubes.

Performed: referred-A Do not use gel barrier tubes. turn around: 5-7 days

12728 FERRITIN Male: 22 - 300 ng/mL Specimen Container: 82728 Chemilluminescence Female: 10 – 291 ng/mL Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum Useful in the diagnosis of hypochromic, microcytic anemias. Decreased in iron deficiency anemia and increased in iron Performed: daily overload. turn around: next day

85376 FIBRINOGEN 175-425 mg/dL Specimen Container: 85384 Clotting Assay 3.2% Sodium citrate (light blue top) Clinical Use: Fibrinogen is essential for the formation of a blood clot. Deficiency 1.0 (0.5) mL FROZEN plasma can produce mild to severe bleeding disorders. Transfer plasma to a plastic, screw-cap vial and freeze.

Vacutainer® tubes must be filled completely to ensure Performed: referred-A the proper 9:1 blood to anticoagulant ratio is achieved. turn around: 3-5 days

88276 FISH, PRADER WILLI Interpretive report Specimen Container: 88271 Fluorescence In Situ Hybridization Sodium heparin (green top) 88273 Clinical Use: 88291 Rule out submicroscopic chromosomal deletion associated with 5.0 (2.0) whole blood Prader-Willi syndrome. Transport at room temperature

Clinical history and reason for referral are Performed: referred-A required with test order. turn around: 14-21 days

88274 FISH, WILLIAMS Interpretive report Specimen Container: 88271 Fluorescence In Situ Hybridization Sodium heparin (green top) 88273 Clinical Use: 88291 Rule out submicroscopic chromosomal deletion associated with 5.0 (2.0) whole blood Williams syndrome. Transport at room temperature

Clinical history and reason for referral are Performed: referred-A required with test order. turn around: 14-21 days

FLUCONAZOLE 80316 Accompanies report NICL Laboratories/2011 Specimen Container: 80299 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE High Performance Liquid Chromatography No addivitve (red top) Clinical Use: Fluconazole is a triazole antifungal drug used in the treatment and 2.0 (1.0) mL FROZEN serum. prevention of superficial and systemic fungal infections. Centrifuge and immediately separate serum into a plastic, screw-cap vial. Freeze and transport frozen.

Performed: referred-A Gel barrier (gold or tiger top) tubes are not acceptable. turn around: 5-7 days

82735 FLUORIDE, PLASMA 0.02-0.08 mg/L Specimen Container: 82735 Ion-Specific Electrode Sodium heparin (green top)

Performed: referred-A 4.0 (2.5) mL plasma, transfer to plastic screw-cap vial turn around: 5-7 days

82496 FLUOXETINE (PROZAC ) Accompanies report Specimen Container: 83789 Liquid Chromatography/Tandem Mass Spectrometry No addivitve (red top) Clinical Use: Fluoxetine is an antidepressant drug that is also used in the 4.0 (2.5) mL serum, transfer to plastic, screw-cap vial treatment of bulimia nervosa and obsessive-compulsive disorder. Therapeutic drug monitoring is useful to avoid toxiciity. is useful to Optimum time to collect sample: 10-14 hours post Performed: referred-A optimize dose and avoid toxicity. oral dose. turn around: 5-7 days

80020 FLUPHENAZINE (PROLIXIN ) Accompanies report Specimen Container: 84022 Gas Chromatography No addivitve (red top) Clinical Use: Therapeutic drug monitoring is useful to avoid toxiciity. is useful to 4.0 (2.2) mL serum, transfer to plastic, screw-cap vial Performed: referred-A optimize dose and avoid toxicity. turn around: 5-7 days

20086 FOLATE AND VITAMIN B12 Folate: 3.37 - 24 ng/mL Specimen Container: 82607 Chemiluminescence Vitamin B12: 211 - 911 pg/mL Gel barrier (gold or tiger top) 82746

Clinical Use: 1.0 (0.5) mL serum Folic acid deficiency is common in pregnant women, alchholics, in patients whose diets do not include raw fruits and vegetables, Folate is light sensitive. Minimize exposure to and in people with structural damage to the small intestine. Low light during sample handling and storage. Foil levels can be the result of primary Vitamin B12 deficiency that wrap samples to protect from light. decreases the ability of cells to take up folic acid.

82747 FOLATE, RBC 82747 Immunochemiluminometric Assay > 280 ng/mL Specimen Container: EDTA (lavender top) Clinical Use: Folate levels have diagnostic significance in nutritional deficiencies, 1.0 (0.5) mL whole blood especially in cases of severe alcoholism, function damage to the upper third of the small bowel, pregnancy and various forms of Perform hematocrit. Please specify on the megaloblastic anemia. Since serum folate levels are subject to request form and on the vial the hematocrit result. rapid changes reflecting diet and absorption, RBC folate may be a better diagnostic tool since the levels remain fairly constant. Folate is light sensitive. Minimize exposure to light during sample handling and storage. Foil Performed: referred-A wrap samples to protect from light. turn around: 3-5 days

12746 FOLATE, SERUM 60 yrs 3.37 – 24 ng/mL Specimen Container: 82746 Chemilluminescence Gel barrier (gold or tiger top) Clinical Use: Folic acid deficiency is common in pregnant women, alchholics, 1.0 (0.5) mL serum in patients whose diets do not include raw fruits and vegetables, and in people with structural damage to the small intestine. Low Folate is light sensitive. Minimize exposure to levels can be the result of primary Vitamin B12 deficiency that light during sample handling and storage. Foil Performed: daily decreases the ability of cells to take up folic acid. wrap samples to protect from light. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: next day

80323 FONDAPARINUX SODIUM < 0.10 mcg/mL Specimen Container: 80299 Chromogenic 3.2% Sodium Citrate. (light blue top) The therapeutic range for Fondaparinux is 1.20-1.26 mcg/mL, measured 3 hours post dose. 1.0 (0.5) mL FROZEN plasma Transfer plasma to plastic, screw-cap vial and freeze. The prophylactic range for Fondaparinux is 0.39-0.50 mcg/mL, measured 3 hours post dose.

Clinical Use: The chromogenic anti-Xa method is the assay of choice for determining the plasma concentration of Arixtra against Performed: referred-A calibration curve prepared from Arixtra (Fondaparinux). turn around: 3-5 days

83910 FRAGILE X - XSENSE®, FRAGILE X WITH REFLEX Accompanies report Specimen Container: 83891 Polymerase Chain Reaction EDTA (lavender top) 83898 Southern Blot Clinical Use: 83900 Capillary Electrophore Fragile X syndrome is the most common known form of inherited 5.0 (3.0) mL whole blood 83912 mental retardation, affecting 16 to 25 of 100,000 males. 83909 (x2) Reflex criterion: If the Fragile X PCR result is not Normal, Gray Zone, or Prevalence among females is approximately half what is reported Transport at room temperature Premutation, then the Fragile X Southern Blot will be performed at an additional charge for males. In almost every case, the disorder arises from an expansion of a CGG repeat polymorphism in the 5′ untranslated Performed: referred-A region of the FMR1 gene. turn around: 10-14 days

FRAGILE X - XSENSE®, FRAGILE X WITH REFLEX AND 83891 CHROMOSOME ANALYSIS Accompanies report Specimen Container: 83891 Chromosome Analysis EDTA (lavender top) and Sodium heparin (green top) 83898 Polymerase Chain Reaction Clinical Use: and 83900 Tissue Culture Fragile X syndrome is the most common known form of inherited Sodium heparin (green top) 83912 Southern Blot mental retardation, affecting 16 to 25 of 100,000 males. 88230 Capillary Electrophoresis Prevalence among females is approximately half what is reported 5.0 (3.0) mL EDTA whole blood 88262 for males. In almost every case, the disorder arises from an and 88291 expansion of a CGG repeat polymorphism in the 5′ untranslated 5.0 (3.0) mL Sodium heparinized whole blood 83909 (x2) region of the FMR1 gene. Two (2) specimens are required for this test:

Performed: referred-A Transport at room temperature turn around: 3-4 weeks

80186 FREE DILANTIN (FREE PHENYTOIN) 1.0 - 2.0 mcg/mL Specimen Container: 80186 Immunoassay No additive (red top) Clinical Use: Free phenytoin is especially useful in patients with altered 1.0 (0.5) mL serum phenytoin binding to protein (e.g. uremia or individuals having Transfer serum to a plastic, screw-cap vial. abnormally low levels of albumin, such as nephrotic syndrome. Free phenytoin in serum correlates better with the various other Optimal time to collect sample: 4 hours post oral dose free compartments of the body than does the total drug and is probably a better estimate of the "active drug level" at the Do not use Gel barrier (gold or tiger top) tubes Performed: referred-A recepter site and agrees more with the clinical response. turn around: 3-5 days

83877 FREE KAPPA & LAMBDA, w/K/L RATIO, SERUM Free Kappa: 3.3-19.4 mg/L Specimen Container: 83883 (x2) Immunoturbidimetric Free Lambda: 5.7-26.3 mg/L No additive (red top) Free K/L Ratio: 0.26-1.65 1.0 (0.5) mL serum Clinical Use: Transfer serum to a plastic, screw-cap vial. Measurement of the amounts of the different light chain types aids in the diagnosis and monitoring of multiple myeloma, lymphocytic neoplasms, Waldenstrom's macroglobulinemia, and connective Performed: referred-A tissue diseases, such as systemic lupus erythematosus. turn around: 3-5 days

83833 FREE KAPPA & LAMBDA, w/RATIO, URINE Accompanies report Specimen Container: 83883 (x2) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Nephelometric Urine collection container, leak-proof Clinical Use: Measurement of the amounts of the different light chain types aids 5.0 (3.0) mL random urine, refrigerated in the diagnosis and monitoring of multiple myeloma, lymphocytic neoplasms, Waldenstrom's macroglobulinemia, and connective Performed: referred-A tissue diseases, such as systemic lupus erythematosus. turn around: 3-5 days

14439 FREE T-4 0.6 – 1.55 ng/dL Specimen Container: 84439 Chemilluminescence Gel barrier (gold or tiger top) Clinical Use: Performed: daily Test is for diagnosis of hypothyroidism and hyperthyroidism. 1.0 (0.3) mL serum turn around: next day

84439 FREE T4 BY EQUILIBRIUM & TOTAL T4 Accompanies report Specimen Container: 84439 Equilibrium Dialysis Gel barrier (gold or tiger top) 84436 Clinical Use: Free T4 by equilibrium dialysis is the most accurate measure of 1.0 (0.8) mL serum Free T4. Results are independent of the concentration of the T4-binding proteins, the presence of molecular variants of these proteins, or circulating autoantibodies. Free T4 is useful in Performed: daily distinguishing euthyroidism from thyroid disease. turn around: 3-5 days

86954 FRUCTOSAMINE (PBG) 190-270 umol/L Specimen Container: 82985 Colorimetric Gel barrier (gold or tiger top) Clinical Use: Fructosamine reflects intermediate glycemic control (over 1-2 1.0 (0.5) mL serum (over 1-2 weeks). Testing is often complement glucose (immediate glycemic control) and hemoglobin A1c testing Performed: referred-A (long-term glycemic control). turn around: 3-5 days

13001 FSH-FOLLICLE-STIMULATING HORMONE Group FSH Reference Range Specimen Container: 83001 Chemilluminescence Normally menstuating females: Gel barrier (gold or tiger top) Follicular phase 2.5 - 10.2 mIU/mL Midcycle Peak 3.4 - 33.4 mIU/mL 1.0 (0.5) mL serum Luteal Peak 1.5 - 9.1 mIU/mL Pregnant: less than 0.3 mIU/mL Post menopausal: 23.0 - 116.3 mIU/mL

Male: 1.4 - 18.1 mIU/mL

Clinical Use: This test is useful in the differential diagnosis of pituitary and Performed: daily gonadal insufficiency and in children with precocious puberty. turn around: next day

20084 FSH AND LH Accompanies report Specimen Container: 83001 Chemilluminescence Gel barrier (gold or tiger top) 83002 Clinical Use: This test is useful in the differential diagnosis of pituitary and 1.0 (0.5) mL serum Performed: daily gonadal insufficiency and in children with precocious puberty. turn around: next day

86651 FTA-ABS, CONFIRMATORY Nonreactive Specimen Container: 86780 Indirect Immunofluorescence Assay Gel barrier (gold or tiger top) Clinical Use: The FTA-ABS is specific for treponemal diseases, including 1.0 (0.2) mL serum syphilis, although false positive results may occur. The test is Performed: referred-A most commonly used for confirmation of reaginic tests. turn around: 3-5 days

86331 FUNGAL ANTIBODIES DID Accompanies report Specimen Container: 86612 Immunodiffusion NICL Laboratories/2011 Gel barrier (gold or tiger top) 86635 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: 86698 Includes: Blastomyces, Candida, Coccidiodes and Histoplasma Antibodies This panel is designed to assist in determining the causative 2.0 (1.0) mL serum 86606 (x3) agent in cases of suspected fungal-associated respiratory Performed: referred-A infection. turn around: 7-10 days

87103 FUNGUS CULTURE, BLOOD No fungus isolated Specimen Container: 87103 Culture Bactec® Myco/F Lytic aerobic blood bottle

5.0 (1.0) whole blood in a Bactec® Myco/F Lytic aerobic blood bottle

Performed: referred-A Transport at room temperature turn around: 30-35 days

87102 FUNGUS CULTURE- MISCELLANEOUS SOURCE No fungus seen/isolated Specimen Container: 87102 Culture Sterile container, leak-proof Clinical Use: Primary specimen from a source other than hair, skin, or nails Fungi can infect the cerebral spinal fluid, other body fluids, and Biopsy, fresh (unfixed) tissue, CSF, sputum, bone tissues. These infections occur more commonly among patients marrow, urine or stool who are immunocompromised. Early diagnosis and effective Performed: referred-A treatment can reduce the likelihood of severe sequelae. turn around: 40-45 days

87101 FUNGUS CULTURE-SKIN, HAIR, NAILS No fungus seen/isolated Specimen Container: Calcofluor White Stain Sterile container, leak-proof Culture Clinical Use: Skin, hair, and nails (all containing keratin), can become Skin, hair and nail specimens Includes smear infected with dermatophytes. These superficial fungal infections may be treated with antifungal drugs. Cleanse skin with alcohol before scraping. Remove with forceps, scrape skin or scalp scales, clip nails and include keratin scrapings.

Performed: referred-A Transport at room temperature turn around: 40-45 days

87205 FUNGUS SMEAR No fungus seen Specimen Container: 87206 Calcofluor White Stain Sterile container, leak-proof Clinical Use: Sputum, Tissue, or Body Fluids may become infected with fungus. 3.0 (1.0) mL sputum, tissue or body fluid These fungal infections range in severity. Proper diagnosis can Performed: referred-A guide selection of therapy. turn around: 3-5 days

82955 G6PD, QUANTITATIVE 4.6-13.5 U/g Hb Specimen Container: 82955 Kinetic EDTA (lavender top) Clinical Use: Includes hemoglobin level G-6-PD is the most common enzyme deficiency in the world. 1.0 (0.5) mL whole blood, refrigerated Newborns with G-6-PD may have prolonged and more pronounced neonatal jaundice than other newborns. Older individuals are subject to hemolytic anemia that can be Performed: referred-A induced by some foods, drugs, and infections. turn around: 3-5 days

80029 GABAPENTIN (NEURONTIN) 2.7-4.1 mcg/mL (peak), Specimen Container: 80299 Gas Chromatography following a single dose of 900-1800 mg/day. EDTA (lavender top)

4.0-8.5 mcg/mL (peak), following multiple 3.0 (1.0) mL plasma following multiple doses of 900-1800 mg/day administration. Centrifuge blood for 5-6 minutes. Separate plasma Clinical Use: from red cells as soon as possible, transfer plasma Gabapentin is an anticonvulsant drug commonly used as to a plastic, screw-cap tube. adjunctive therapy to treat partial seizures. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity. Collect specimen two hours after last dose at NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE steady-state.

Performed: referred-A Do not use gel barrier tubes. turn around: 5-7 days

83545 GANGLIOSIDE GD1b ANTIBODY IgM Accompanies report Specimen Container: 83520 Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Ganglioside GD1a Antibody IgM is associated with the presence 1.0 (0.2) mL serum of multifocal motor neuropathy, sometimes in association with IgM monoclonal gammopathy. Antibody testing can aid in the A fasting sample is required diagnosis of multifocal motor neuropathy or predominantly Performed: referred-A motor neuropathy. turn around: 5-7 days

83534 GANGLIOSIDE GM-1 ANTIBODIES IgG, IgM Accompanies report Specimen Container: 83520 x2 Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Ganglioside GM-1 Antibody IgG is associated with Guillain-Barre 1.0 (0.2) mL serum syndrome, particularly the acute motor axonal neuropathy variant. Antibody IgM is associated with chronic multifocal motor A fasting sample is preferred. Performed: referred-A neuropathy. turn around: 5-7 days

82941 GASTRIN RIA Accompanies report Specimen Container: 82941 Immunoassay Gel barrier (gold or tiger top) Clinical Use: For the diagnosis and monitoring of gastrin-secreting tumors, 1.0 (0.2) mL FROZEN serum gastric ulcer, Zollinger-Ellison syndrowm. Increased in pernicious Transfer serum to a plastic, screw-cap vial and freeze. anemia. Overnight fasting for a minimum of 12 hours is Performed: referred-A required. turn around: 3-5 days

27491 GC and CHLAMYDIA-AMP DNA PROBE Negative Specimen Container: 87491 Roche Amplicor/Amplified DNA probe M4RT transport kit 87591 Clinical Use: C. trachomatis, the number one cause of sexually Cervical/endocervical swab, Male Urethral swab or transmitted disease in the United States, is responsible Conjunctival swab in M4RT. for an estimated 3-4 million new cases annually. Infants born to women with chlamydial infection of the cervix are Maintain at room temperature. at risk of acquiring an infection during vaginal birth. Gonococcal and chlamydial urethritis may coexist. Do not use collection kit if media is yellow.. Demonstrating the presence of N. gonorrhoeae is important in initiating appropriate therapy to prevent the spread of infection. Performed: tues, thur turn around: 2-5 days

17591 GC, AMP DNA PROBE Negative Specimen Container: 87591 Roche Amplicor/Amplified DNA probe M4RT transport kit Clinical Use: Neisseria gonorrhoeae (gonococci) is the causative agent Cervical/endocervical swab, Male Urethral swab or of gonorrhoeae. In men, this disease generally results Conjunctival swab in M4RT. in anterior urethritis, accompanied by purulent exudate. In women, the disease is most often found in the cervix, Maintain at room temperature. but the vagina and uterus may also be infected. Performed: tues, thur Do not use collection kit if media is yellow.. turn around: 2-5 days

14696 GENTAMICIN, PEAK 5-10 mcg/mL Specimen Container: 80170 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Gentamicin is an aminoglycoside NICLantibiotic Laboratories/2011 used in the treatment 1.0 (0.2) mL serum TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE gram-positive and gram-negative bacterial infections, especially Pseudomonas, Proteus, Klebsiella and Staphylococcus. Gentamicin is potentially nephrotoxic and ototoxic. Serial Collect peak at the end of a 60 minute IV infusion, monitoring of peak and trough serum levels may provide the 30 minutes after the end of a 30 minute IV infusion, Performed: daily clinician with information to maintain safe and therapeutic levels. or 50 minutes after an IM dose. turn around: next day

14697 GENTAMICIN, RANDOM 0-10.0 mcg/mL Specimen Container: 80170 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Gentamicin is an aminoglycoside antibiotic used in the treatment 1.0 (0.2) mL serum gram-positive and gram-negative bacterial infections, especially Pseudomonas, Proteus, Klebsiella and Staphylococcus. Gentamicin is potentially nephrotoxic and ototoxic. Serial monitoring of peak and trough serum levels may provide the Performed: daily clinician with information to maintain safe and therapeutic levels. turn around: next day

14695 GENTAMICIN, TROUGH LEVEL 0-2.0 mcg/mL Specimen Container: 80170 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Gentamicin is an aminoglycoside antibiotic used in the treatment 1.0 (0.2) mL serum gram-positive and gram-negative bacterial infections, especially Pseudomonas, Proteus, Klebsiella and Staphylococcus. Collect just prior to next dose. Gentamicin is potentially nephrotoxic and ototoxic. Serial monitoring of peak and trough serum levels may provide the Performed: daily clinician with information to maintain safe and therapeutic levels. turn around: next day

12297 GGT (GAMMA-GLUTAMYL TRANFERASE) Adult: Specimen Container: 82977 Spectrophotometric Female: 1 – 37 U/L Gel barrier (gold or tiger top) Male: 2 – 41 U/L 1.0 (0.2) mL serum Pediatric: 0-6 days 10 – 270 U/L 6 days-12 years 1 – 120 U/L

Clinical Use: Elevated GGT is found in all forms of liver disease. Measurement of GGT is used in the diagnosis and treatment of alcoholic cirrhosis, as well as primary and secondary liver tumors. It is more sensitive than alkaline phosphatase, the transaminases, and leucine aminopeptidase in detecting obstructive jaundice, cholangitis, and cholecystitis. Normal levels of GGT are seen in skeletal diseases; thus, GGT in serum can be used to determine whether a disease, suggested by elevated Performed: daily alkaline phosphatase, is skeletal or hepatobiliary. turn around: next day

87015 GIARDIA & CRYPTOSPORIDIUM Ag Giardia Ag, Stool, EIA Specimen Container: 87015 Enzyme Immunoassay Not detected 10% formalin, Ecofix or SAF container 87272 Direct Immunofluorescence Assay 87329 Cryptosporidium Antigen 10.0 (5.0) mL stool None detected Stool must be collected without contamination by urine or water. Add a sufficient amount of stool to bring the liquid level to the Fill to Here line on the Formalin. Mix contents throughly until Performed: referred-A homogenous. turn around: 5-7 days

87233 GIARDIA LAMBLIA ANTIGEN Not detected Specimen Container: 86317 Immunoassay 10% formalin, Ecofix or SAF container 87329 Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Giardia is a protozoan that can cause diarrhea. Infection occurs 10.0 (5.0) mL stool after ingestion of contaminated food or water. Antigen detection is considered an alternative to stool examination. Stool must be collected without contamination by urine or water. Add a sufficient amount of stool to bring the liquid level to the Fill to Here line on the Formalin. Mix contents throughly until Performed: referred-A homogenous. turn around: 5-7 days

86674 GIARDIA LAMBLIA IgG Ab Accompanies report Specimen Container: 86674 Indirect Immunofluorescence Assay No additive (red top) Clinical Use: Recent or current infection by Giardia lamblia is suggested by 1.0 (0.5) mL serum, transfer to a plastic, screw-cap vial either detection of specific IgM antibody or a fourfold increase in IgG and/or IgA antibody titers between acute and convalescent sera. Positive IgG and/or IgA titers without Performed: referred-A detectable IgM suggest past infection. turn around: 5-7 days

83420 GLIADIN ANTIBODY, IgG <11 U/mL Negative Specimen Container: 83516 Immunoassay 11-17 U/mL Equivocal Gel barrier (gold or tiger top) >17 U/mL Positive 1.0 (0.5) mL serum Clinical Use: Celiac Disease is characterized by the presence of Gliadin Antibody. Such patients display a hypersensitivity to glutun (wheat) in their diet. The antibody is undetectable when patients with hypersensitivity are placed on a gluten-free diet. Antibody IgA is more specific and IgG is more sensitive assay Performed: referred-A to Celiac Disease. turn around: 3-5 days

83521 GLIADIN/GLUTEN ANTIBODY, IGA <11 U/mL Negative Specimen Container: 83516 Enzyme Immunoassay 11-17 U/mL Equivocal Gel barrier (gold or tiger top) >17 U/mL Positive 1.0 (0.5) mL serum Clinical Use: Celiac Disease is characterized by the presence of Gliadin Antibody. Such patients display a hypersensitivity to glutun (wheat) in their diet. The antibody is undetectable when patients with hypersensitivity are placed on a gluten-free diet. Antibody IgA is more specific and IgG is more sensitive assay Performed: referred-A to Celiac Disease. turn around: 3-5 days

83533 GLIADIN/GLUTEN IgG, IgA, Ab <11 U/mL Negative Specimen Container: 83516 (x2) Enzyme Immunoassay 11-17 U/mL Equivocal Gel barrier (gold or tiger top) >17 U/mL Positive 1.0 (0.5) mL serum Clinical Use: Celiac Disease is characterized by the presence of Gliadin Antibody. IgA is more specific and IgG is more sensitive to Performed: referred-A Celiac Disease. turn around: 3-5 days

83520 GLOMERULAR BASEMENT MEMBRANE ANTIBODIES, IGG < 1.0 AI Specimen Container: 83520 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Glomerular Basement Membrane Antibody is present in one fourth 1.0 (0.5) mL serum of patients with Goodpasture's syndrome. This syndrome consists Performed: referred-A of glomerulonephritis and pulmonary hemorrhage. turn around: 3-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 82943 GLUCAGON, PLASMA Accompanies report Specimen Container: 82943 Extraction • Radioimmunoassay EDTA (lavender top) Clinical Use: Glucagon measurement is useful primarily when considering a 3.0 (1.1) mL FROZEN plasma glucagon-secreting tumor of the pancreas. Glucagon is also Transfer to a plastic, screw-cap vial, freeze. used to diagnose glucagon deficiency in patients with Performed: referred-A hypoglycemia. Overnight fasting is required. turn around: 7-10 days

12947 GLUCOSE 0-6 days: 20-90 mg/dL Specimen Container: 82947 Spectrophotometric 6days-2 years: 60-110 mg/dL Gel barrier (gold or tiger top) >2 years: 70-110 mg/dL 1.0 (0.5) mL serum Clinical Use: Centrifuge within 1 hour of collection. Diagnosis of diabetes mellitus and evaluation of carbohydrate Performed: daily metabolism. Overnight fast is preferred. turn around: next day

12952 GLUCOSE, 1 HOUR PRENATAL 70-135 mg/dL Specimen Container: 82947 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: >135 mg/dL are considered abnormal. A prenatal glucose 1.0 (0.5) mL serum tolerance test is recommended to determine the presence of Centrifuge within 1 hour of collection. gestational diabetes. Specimen should be collected 1 hour following the the administration of a 50 gram glucose load. Performed: daily turn around: next day

12950 GLUCOSE, 2 HR POST PRANDIAL 70-139 mg/dL Specimen Container: 82947 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: Serum glucose levels may be abnormally high (hyperglycemia) 1.0 (0.5) mL serum or abnormally low (hypoglycemia). Glucose measurements are Centrifuge within 1 hour of collection. used in the diagnosis and treatment of carbohydrate metabolic disorders, including diabetes mellitus, idiopathic hypoglycemia, Specimen should be collected 2 hours following the and pancreatic islet cell neoplasm. the administration of a 75 gram glucose load.

Performed: daily turn around: next day

22951 GLUCOSE TOLERANCE TEST, 3 HOUR Fasting: 70 - 110 mg/dL Specimen Container: 82951 Spectrophotometric 1/2 hour: 70 - 200 mg/dL Sodium fluoride (gray top) 1 hour: 70 - 200 mg/dL 2 hour: 70 - 200 mg/dL 5.0 (2.0) mL whole blood 3 hour: 70 - 120 mg/dL Collect a fasting specimen. Immediately thereafter, The response to oral glucose is considered normal when the 2 the adult patient is given a 75 g dose of Glucose, hour glucose level is less than 140 mg/dL and all values between and specimens are obtained ½, 1, 2, and 3 hours 0-2 hours are less than 200 mg/dL. When the fasting glucose level later. is less than 126 mg/dL and the 2 hour is between 140 mg/dL and 199 mg.dL, the patient is said to have an impaired glucose Note: Children should receive 1.75 g Glucose per kg tolerance. Two diagnostic tests on two different days showing a ideal body weight, up to 75 g. high glucose level, indicates that the person has diabetes. Label test request and specimen with fasting or Performed: daily timed collection with the time of collection. turn around: next day

14947 GLUCOSE, FASTING 70-110 mg/dL Specimen Container: 82947 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: Diagnosis of diabetes mellitus and evaluation of carbohydrate 1.0 (0.5) mL serum metabolism. Centrifuge within 1 hour of collection.

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: daily Fasting specimen is required. turn around: next day

83509 GLUTAMIC ACID DECARB (GAB) ≤1.0 U/mL Specimen Container: 83519 Radioimmunoassay Gel barrier (gold or tiger top) Clinical Use: Glutamic Acid Decarboxylase (GAD-65) Antibody is useful to 1.0 (0.5) mL serum diagnose insulin dependent diabetes mellitus (IDDM, Type I Transfer to a plastic, screw-cap vial, refrigerate. diabetes), to assess risk for development of IDDM, to predict onset of IDDM, and risk of development of related endocrine disorders, e.g., thyroiditis. Before clinical onset, Type I diabetes is characterized by lymphocytic infiltration of the islet cells, and by circulating autoantibodies against a variety of islet cell antigens, including GAD-65, IA-2 (a tyrosine phosphatase-like Performed: referred-A protein), and insulin (IAA). turn around: 3-5 days

83878 GLYCOGEN STORAGE DISEASE TYPE Ia MUTATION Ai Accompanies report Specimen Container: 83890 Polymerase Chain Reaction EDTA (lavender top) 83891 Clinical Use: 83900 1) To identify disease causing mutations in individuals affected 83909 with Glycogen Storage Disease Type Ia. 4.0 (3.0) mL Whole Blood 83912 2) To identify carriers in high risk ethnic groups or people with Transport at room temperature 83914 (x2) positive family history. 83892 (x3) 3) Prenatal diagnosis of Glycogen Storage Disease Type Ia for Performed: referred-A at risk couples. turn around: 10-12 days

23999 GLYCOHEMOGLOBIN/AIC Accompanies report Specimen Container: 83036 HPLC EDTA (lavender top) Clinical Use: Test is used to assess long term diabetic control in diabetes 3.0 (1.0) mL Whole Blood Performed: mon-fri mellitus. turn around: 1-3 days

GONADATROPIN RELEASING HORMONE Accompanies report Specimen Container: 83727 83727 Radioimmunoassay Gel barrier (gold or tiger top) Patient should not be on any Steroid, ACTH, Gonadotropin, or Estrogen medications, if possible, for at least 48 hours 1.0 (0.5) mL FROZEN serum before specimen collection. Transfer to a plastic, screw-cap vial, freeze

Patient should not be on any Steroid, ACTH, Gonadotropin, or Estrogen medications, if possible, Performed: referred-A for at least 48 hours before specimen collection. turn around: 7 -10 days

47205 GRAM STAIN Accompanies report Specimen Container: 87205 Microscopic Examination Culture transport swab (pink cap) The Gram Stain is a critical test for the rapid, presumptive diagnosis of infectious agents and also serves to assess the Primary specimen from any source the quality of clinical specimens. Please specify site of specimen, collection, and Performed: daily associated clinical symptoms. turn around: next day

83003 GROWTH HORMONE (HGH) Adults (≥20 years) Specimen Container: 83003 Immunoassay ≤10.0 ng/mL Gel barrier (gold or tiger top) Children (<20 years) ≤13.0 ng/mL 1.0 (0.5) mL serum

Clinical Use: Random growth hormone collection should be Measurement of GH is primarily used for the diagnosis and performed on fasting patients who have rested treatment of disorders of growth hormone secretion, including for at least 30 minutes prior to collection. GH excess (acromegaly) and deficiency. Growth hormone measurements in children are usedNICL in Laboratories/2011 the evaluation of short TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE stature and help differentiate short stature due to low GH Performed: referred-A production from other causes of growth failure. turn around: 3-5 days

83498 17-HYDROXYPROGESTERONE Accompanies report Specimen Container: 83498 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: 17-Hydroxyprogesterone is elevated in patients with congenital 1.0 (0.3) mL serum, transfer to a plastic screw-cap vial. adrenal hyperplasia (CAH). CAH is a group of autosomal recessive diseases, characterized by a deficiency of cortisol and an excess of ACTH concentration. 17-Hydroxyprogesterone is also useful in monitoring cortisol replacement therapy and in Performed: referred-A evaluating infertility and adrenal and ovarian neoplasms. turn around: 7-10 days

83524 21-HYDROXYLASE ANTIBODY Accompanies report Specimen Container: 83519 Radiobinding Assay Gel barrier (gold or tiger top) Clinical Use: 21-Hydroxylase Antibody is present in patients with 1.0 (0.2) mL serum autoimmune destruction of the adrenal glands, leading to Addison's disease. Antibody is also seen in autoimmune Performed: referred-A polyglandular syndrome. turn around: 7-10 days

87338 H. PYLORI ANTIGEN, STOOL Not detected Specimen Container: 87338 Enzyme Immunoassay Sterile,plastic, leak-proof container Clinical Use: Colonization with H. pylori is associated with increased risk of 0.5 mL of semisolid stool, or 20 mm diameter of patients developing gastritis, peptic ulcer disease, and gastric solid stool, FROZEN. adenocarcinoma. Stool antigen testing provides a sensitive measure of infection including during and after treatment. Watery, diarrheal stool is not acceptable.

Performed: referred-A Transport frozen turn around: 7-10 days

86677 H. PYLORI IgA, IgM, IgG Negative Specimen Container: 86677 No additive (red top) A positive result indicates that the patient has antibody to H. pylori. It does not differentiate between an active or past 1.0 (0.3) mL serum, transfer to a plastic screw-cap vial. infection. The clinical diagnosis must be interpreted in conjunction with the clinical signs and interpreted in conjunction

Clinical Use: Colonization with H. pylori is associated with increased risk of patients developing gastritis, peptic ulcer disease, and gastric adenocarcinoma. Serologic testing is recommended only for symptomatic patients. Antibodies IgG, IgA, and IgM provide higher sensitivity than either test alone. Antibody titers may be elevated for years in infected individuals. Following treatment, Performed: referred-A titers generally decrease but may not become undetectable. turn around: 5-7 days

16677 H. PYLORI IgG Accompanies report Specimen Container: 86677 Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Colonization with H. pylori is associated with increased risk of 1.0 (0.2) mL serum patients developing gastritis, peptic ulcer disease, and gastric adenocarcinoma. Serologic testing is recommended only for symptomatic patients. Antibodies IgG, IgA, and IgM provide higher sensitivity than either test alone. Antibody titers may be elevated for years in infected individuals. Following treatment, Performed: tues, Friday titers generally decrease but may not become undetectable. turn around: 1-5 days

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 86684 HAEMOPHILUS INFLUENZA B IgG 1.0 mcg/mL or more Specimen Container: 86684 Enzyme Immunoassay No additive (red top) The precise level of antibody required for protection is not known; however, geometric mean levels of 1.0 mcg/mL are 1.0 (0.3) mL serum, transfer to a plastic screw-cap vial. considered to be indicative of long-term protection.

Clinical Use: Performed: referred-A For evaluation of pre and post-vaccination antibody levels. turn around: 7-10 days

80305 HALDOL (HALOPERIDOL) Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Monitoring the haloperidol concentration is used to ensure 1.0 (0.3) mL serum, transfer to a plastic screw-cap vial. compliance and to avoid toxicity of this antipsychotic drug. Haloperidol is used to treat psychotic disorders, control tics Collect 11-17 hours after last dose. and vocal utterances associated with Giles de la Tourette Performed: referred-A syndrome, and combative, explosive hyperexcitability in children. turn around: 7-10 days

83010 HAPTOGLOBIN Adults: 43-212 mg/dL Specimen Container: 83010 Fixed Rate Time Nephelometry Gel barrier (gold or tiger top) Clinical Use: Decreased haptoglobin is found in hemolytic disease, 1.0 (0.5) mL serum hepatocellular disease and infectious mononucleosis. Increased level is found in inflammatory disease in the presence Overnight fasting is preferred. Performed: referred-A of tissue necrosis and in general acute inflammatory conditions. turn around: 3-5 days

87516 HBV DNA, QUALITATIVE PCR Not detected Specimen Container: 87516 Real-Time PCR EDTA (lavender top) 87517 The method used in this test is Real-Time PCR of the precore region of the circular HBV genome. This test was performed using 3.0 (2.5) mL FROZEN plasma, collected in 2 EDTA the COBAS®AmpliPrep/COBAS®TaqMan® 48 Analyzer HBV Test (lavende rtop) tubes. Separate plasma into 2 separate, Test Kit (Roche Molecular Systems, Inc.). plastic screw-cap vials and freeze.

Clinical Use: Transport frozen HBV viral load and resistance tests are used in the management of therapy of HBV-infected in dividuals. Resistance to any of the antiviral drugs is detected by an increase in the patient's viral load and detection of viral mutations that confer resistance to to the drugs. Sufficient virus is needed to obtain results by the HBV drug resistance assay. Viral quantitation of HBV by real-time PCR will determine if there is sufficient virus to perform Performed: referred-A the resistance test. turn around: 3-5 days

84702 HCG BETA, TUMOR MARKER Accompanies Report Specimen Container: 84702 Immunoassay Gel barrier (gold or tiger top) Clinical Use: hCG is a glycoprotein hormone produced by the 1.0 (0.3) mL serum syncytiotrophoblast of the placenta and secreted during normal pregnancy and with pathologic conditions such as Performed: referred-A hydatidiform mole, choriocarcinoma and testicular neoplasm. turn around: 3-5 days

14701 HCG, SERUM QUAL Negative Specimen Container: 84703 Chemilluminescence Gel barrier (gold or tiger top) Clinical Use: Human chorionic gonadotropin (hCG) is a glycoprotein hormone 1.0 (0.3) mL serum secreted by the developing placenta shortly after fertilization. In normal pregnancy, hCG can be detected in both urine and serum as early as 7 to 10 days after conception. The appearance of hCG in both urine and serum soon after conception, and its NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE subsequent rapid rise in concentration during early gestational growth, make it an excellent marker for the early detection of pregnancy.

12998 HCG, SERUM QUANT Accompanies Report Specimen Container: 84702 Chemilluminescence Gel barrier (gold or tiger top) Clinical Use: Human chorionic gonadotropin (hCG) is a glycoprotein hormone 1.0 (0.3) mL serum produced by the placenta. The hormone is an excellent marker for pregnancy. Healthy, non-pregnant females have low to undetectable hCG levels. During pregnancy, hCG concentrations increase then show a gradual decrease after the first trimester. Unusually low or rapidly declining levels may indicate an abnormal condition such as ectopic pregnancy or impending spontaneous Performed: daily abortion. turn around: next day

12996 HCG, URINE QUAL Negative Specimen Container: 84703 Immunoassay Sterile urine container, leak-prof Clinical Use: This test is specific for hCG beta subunit and 10.0 (3.0) mL first morning urine specimen preferred, Performed: daily offers sensitivity necessary to detect pregnancy or a random specimen. as early as 10 days post conception. turn around: next day

13718 HDL CHOLESTEROL Female: 50 – 96 mg/dL Specimen Container: 83718 Spectrophotometric Male: 50 – 72 mg/dL Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.3) mL serum HDL cholesterol is inversely related to the risk for cardiovascular disease. It increases following regular exercise, moderate alcohol consumption, and with oral estrogen therapy. Decreased levels are associated with obesity, stress, cigarette smoking and Performed: daily diabetes mellitus. turn around: next day

82177 HEAVY METAL PANEL, 24 HR URINE Accompanies report Specimen Container: 82175 Inductively Coupled Plasma-Mass Spectrometry 24 hour urine container, acid washed, no preservative 83655 Clinical Use: 83825 Test components: Arsenic, Lead, Mercury Excessive exposure to Heavy Metals can cause acute and 30.0 (10.0) mL aliquot of a well mixed 24 hour urine, chronic toxicity. Heavy Metals Panel is intended to evaluate collected with no preservative. Transport refrigerated. and monitor exposure to heavy metals and evaluate the process of detoxification. Specify total 24-hour volume on request form.

Patient should refrain from eating seafood, or taking mineral and herbal supplements for at Performed: referred-A least 3 days before specimen collection. turn around: 5-7 days

83015 HEAVY METAL SCREEN, URINE Accompanies report Specimen Container: 82135 Inductively Coupled Plasma-Mass Spectrometry Acid washed, metal free container, leak-proof 82175 Clinical Use: 83825 Test components: Arsenic, Lead, Mercury Excessive exposure to Heavy Metals can cause acute and 100 mL random urine collected with no preservative chronic toxicity. Heavy Metals Panel is intended to evaluate and monitor exposure to heavy metals and evaluate the process Performed: referred-A of detoxification. turn around: 5-7 days

83650 HEAVY METAL GROUP BLOOD Accompanies report Specimen Container: 83655 Inductively Coupled Plasma-Mass Spectrometry EDTA Trace Element (royal blue top) 82175 Clinical Use: 83825 Test components: Arsenic, Lead, Mercury Useful in the dianosis of toxicity due to Arsenic, Lead or Mercury. 10.0 (6.0) mL whole blood, refrigerated

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Patient should refrain from eating seafood, or taking mineral and herbal supplements for at Performed: referred-A least 3 days before specimen collection. turn around: 5-7 days

86680 HELICOBACTER PYLORI ANTIBDOY Negative Specimen Container: 86677 Enzyme Immunoassay Gel barrier (gold or tiger top) H. pylori testing measures antibodies to H. pylori and is not recommended for the diagnosis of active infection. 1.0 (0.2) mL serum infection.

Clinical Use: Helicobacter pylori IgM antibody responses occur soon after initial acquisition of H. pylori and levels then return to baseline. If therapy is inadequate and a recurrence occurs, an IgM antibody Performed: referred-A response may again be observed. turn around: 3-5 days

84003 HELICOBACTER PYLORI IgA Negative Specimen Container: 86677 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Colonization with H. pylori is associated with increased risk of 1.0 (0.2) mL serum patients developing gastritis, peptic ulcer disease, and gastric adenocarcinoma. Serologic testing is recommended only for symptomatic patients. Antibody IgA may be elevated for years in infected individuals. Following treatment, titers generally Performed: referred-A decrease, but may not become undetectable. turn around: 3-5 days

83917 HEMOCHROMATOSIS DNA MUTATION ANALYSIS See Laboratory Report Specimen Container: 83891 Polymerase Chain Reaction (PCR) EDTA (lavender top) 83892 (x2) Fluorescent Restriction Fragment Length Polymorphism Clinical Use: 83900 Hereditary Hemochromatosis (HH) is an inherited disorder 5.0 (3.0) mL whole blood 83909 wherein the body accumulates excess iron. This test establishes Transport at room temperature 83912 HH diagnosis in individuals with abnormal iron study results and Performed: referred-A identifies at-risk family members. turn around: 10-14 days

15018 HEMOGLOBIN Accompanies report Specimen Container: 85018 Cyanmethaemoglobin EDTA (lavender top) Clinical Use: Hemoglobin is the usual method for determining anemia. It is 3.0 (1.0) mL whole blood Performed: daily used to calculate indices. turn around: next day

25017 HEMOGLOBIN AND HEMATOCRIT Accompanies report Specimen Container: 85027 Cyanmethaemoglobin EDTA (lavender top) Calculation Clinical Use: Usual method for determining anemia. It is used to calculate 3.0 (1.0) mL whole blood Performed: daily indices. turn around: next day

83021 HEMOGLOBIN A2, QUANT. Age Specimen Container: 83021 High Performance Liquid Chromatography 0-1 month: < 1.0 % EDTA (lavender top) 1-3 months: < 2.3 % > 3 mos-6 mos: < 2.5 % 3.0 (1.0) mL whole blood > 6 mos-1 year: < 2.7 % > 1 year: 1.8-3.5 %

Clinical Use: Hemoglobin A2 levels have special application to the diagnosis of β-thalassemia trait, which may be present even though peripheral blood smear is normal. (This reflects the underlying genetic spectrum of β-thalassemia,NICL which Laboratories/2011 in reality is a complex TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE of 20 to 30 distinct conditions.) The microcytosis and other morphologic changes of beta-thalassemia trait must be differentiated from iron deficiency. Low MCV may include the majority of β-thalassemia trait patients but does not differentiate iron deficient individuals. Low Hb A2 levels occur in untreated iron deficiency. If the β-thalassemia is associated with iron deficiency, the Hb A2 level falls, making the differentiation even more difficult (corrected after iron therapy). The most definitive evidence for presence of β-thalassemia trait is genetic (family study). Offspring of a person with thalassemia major will have beta-thalassemia trait. Hb A2 may be increased in megaloblastic anemia and may be decreased in sideroblastic anemia, Hb H disease, and Performed: referred-A erythroleukemia. turn around: 3-5 days

82500 HEMOGLOBIN F Age: Specimen Container: 83021 High Performance Liquid Chromatography 0-3 months: 40.0%-85.0% EDTA (lavender top) > 3 mos-6 mos: 8.0%-40.0% > 6 mos-1 year: 8.0% 5.0 (1.0) mL whole blood > 1 year: < 2.0% No age (adult assumed): < 2.0% Clinical Use: Fetal hemoglobin is increased in sickle cell anemia, leukemias, beta-thalassemia and hereditary persistence of fetal hemoglobin. The production of fetal hemoglobin may be triggered as a Performed: referred-A response to sickle crisis. turn around: 3-5 days

83051 HEMOGLOBIN, FREE, PLASMA 0.0-6.9 mg/dL Specimen Container: 83051 Colorimetric Sodium heparin (green top) Clinical Use: This test is used to evaluate hemolytic anemia, especially 1.0 ( 0.2) mL plasma. intravascular hemolysis. Plasma hemoglobin is increased with Centrifuge plasma within 1 hour of collection, transfer intravascular hemolysis, ABO incompatible transfusion, traumatic the plasma to sterile, plastic, screw-cap vial, and hemolysis, falciparum malaria, burns, and march hemoglobinuria. transport refrigerated . Increase may occur in some cases of extravascular hemolysis, delayed transfusion reaction, slight increase in sickle cell anemia, Performed: referred-A and β-thalassemia. turn around: 3-5 days

83022 HEMOGLOBINOPATHY EVAL Accompanies report Specimen Container: 85041 Electrophoresis EDTA (lavender top) 85018 High Performance Liquid Chromatography Clinical Use: 85014 Electronic cell sizing/counting Hemoglobinopathy Evaluation examines specimens for common 5.0 (1.0) mL whole blood 83021 Cytometry variant hemoglobins such as S and C as well as most other less Transport at room temperature. common variant hemoglobins. Patient age and ethnicity are necessary for proper interpretation. Blood transfusions within the past 4 Performed: referred-A months may affect results. turn around: 3-5 days

86024 HEPARIN INDUCED PLAT Ab Heparin Induced Platelet Ab, Negative Normal O.D. Specimen Container: 86022 Enzyme-Linked Immunosorbent Assay (Optical Density) cutoff is less than 0.400. No additive (red top)

Clinical Use: 1.0 (0.5) mL FROZEN serum The ELISA method detects antibodies directed against platelet factor 4/Heparin complexes. These antibodies are found in some Transfer serum in a plastic, screw-cap vial and freeze. some patients who are undergoing heparin therapy. Test is helpful in the diagnosis of Heparin-induced thrombocytopenia. A positive result is indicative of the presence of heparin-induced antibodies; however, false positives may occur, due to the presence of immune complexes or other immunoglobulin aggregates. A negative result suggests the absence of heparin-induced antibodies; low titer, low avidity antibodies may not be detected. Other clinical and laboratory findings should be used in conjunction withNICL this Laboratories/2011 test result before TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: referred-A diagnosing heparin-induced thrombocytopenia. turn around: 7-10 days

86030 HEPARIN-INDUCED THROMBOCYTOPENIA PANEL Accompanies report Specimen Container: 86022 (x2) Enzyme-Linked Immunosorbent Assay No additive (red top) Radiobinding 14C Serotonin Radiolabel Clinical Use: Heparin therapy can induce thrombocytopenia, a decreased 2.0 (1.0) mL FROZEN serum Test components: Heparin Induced Platelet Antibody, Serotonin Release Assay, Unfractionated Heparin platelet count, due to antibody stimulaton such as platelet factor 4 (PF4) antibody. Transfer serum into two separate plastic, screw-cap Performed: referred-A vials and freeze. turn around: 5-7 days

20167 HEPATIC FUNCTION PANEL Accompanies report Specimen Container: 80076 Various Gel barrier (gold or tiger top) Clinical Use: Test components: Albumin, Alkaline phosphatase, ALT, AST, Total Bilirubin, Direct Bilirubin, Total Protein The Hepatic Function Panel is used evaluate the liver for 1.0 (0.5) mL serum injury, infection, or inflammation. Performed: daily turn around: next day

20128 HEPATIC FUNCTION W/GGTP Accompanies report Specimen Container: 80076 Gel barrier (gold or tiger top) 82977 Test components: Albumin, Alkaline phosphatase, ALT, AST, Total Bilirubin, Direct Bilirubin, Total Protein, GGTP Clinical Use: The Hepatic Function Panel is used evaluate the liver for 1.0 (0.5) mL serum injury, infection, or inflammation. Performed: daily turn around: next day

86297 HEPATITIS A ANTIBODY, TOTAL Nonreactive Specimen Container: 86708 Immunoassay Gel barrier (gold or tiger top) Clinical Use: HAV antibody indicates prior or acute infection with, or 1.0 (0.5) mL serum Performed: referred-A immunization to, Hepatitis A virus. turn around: 3-5 days

16299 HEPATITIS A ANTIBODY, IGM Nonreactive Specimen Container: 86709 Gel barrier (gold or tiger top) Immunoassay Clinical Use: IgM antibodies against Hepatitis A Virus (HAV) are detected 1.0 (0.5) mL serum soon after onset of symptoms. Persistence of the IgM response is extremely variable, with specific IgM detected for less than one month in some cases and greater than one year in others. In most cases, IgM antibodies against HAV persist for a period of three to six months after which they decline to levels that are below detection. Anti-HAV IgM detection can be useful for the differential diagnosis of hepatitis A from other forms of viral Performed: referred-A hepatitis. turn around: 3-5 days

20059 HEPATITIS ASYMPTOMATIC PROFILE Nonreactive Specimen Container: 87340 Chemiluminescence Gel barrier (gold or tiger top) 86706 Clinical Use: Test components: HBsAg, HBsAb Hepatitis B virus (HBV) is a major cause of liver disease and is 1.0 (0.5) mL serum endemic worldwide. The virus can be transmitted through direct contact with blood and body fluids including sexual contact. The incubation period for HBV infection can range from 1 to 6 months, Performed: mon-fri averaging around 6 to 8 weeks. turn around: 1-3 days

16290 HEPATITIS B CORE ANTIBODY, IGM Nonreactive Specimen Container: 86705 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Hep B Core-specific IgM class antibodyNICL Laboratories/2011 has been detected in 1.0 (0.5) mL serum TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE acute infections and is a reliable marker for acute disease. In some cases, Hep B Core IgM antibody may be the only specific marker for the diagnosis of acute infection with Performed: mon-fri Hepatitis B virus. turn around: 1-3 days

86289 HEPATITIS B CORE ANTIBODY, TOTAL Nonreactive Specimen Container: 86704 Immunoassay Gel barrier (gold or tiger top) Clinical Use: This assay does not distinguish between total B core antibody 1.0 (0.5) mL serum IgG and IgM detected before or at the onset of symptoms; however, such reactivity can persist for years after illness, and may even outlast anti-HBs. Occasionally, Hepatitis B core antibody may be the only marker of either current or past Hepatitis B infection. HBV vaccination leads to development Performed: referred-A of HBsAb, but not to HbcAb. turn around: next day

16291 HEPATITIS B SURFACE ANTIBODY Nonreactive Specimen Container: 86706 Chemiluminescence Gel barrier (gold or tiger top)

The detection of anti-HBS is indicative of a prior immunologic 1.0 (0.5) mL serum Performed: mon-fri exposure to the antigen or vaccine. turn around: 1-3 days

16287 HEPATITIS B SURFACE ANTIGEN Nonreactive Specimen Container: 87340 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Surface antigen usually appears in the serum after an 1.0 (0.5) mL serum incubation period of 1 to 6 months following exposure to Hepatitis B virus and peaks shortly after onset of symptoms. It typically disappears within 1 to 3 months. Persistence of Hepatitis B surface antigen for greater than 6 months is a Performed: mon-sat prognostic indicator of chronic Hepatitis B infection. turn around: 1-3 days

86706 HEPATITIS B SURFACE ANTIGEN, QUANT ≥10 mIU/mL Specimen Container: 86317 Immunoassay Gel barrier (gold or tiger top) Patients with results < 10 mIU/mL should have the following message appended to the report: Patient does not have 1.0 (0.5) mL serum immunity to hepatitis B virus.

Patients with results ≥10 mIU/mL should have the following message appended. to the report: Patient has immunity to hepatitis B virus

Clinical Use: This assay is used to determine immune status for hepatitis B as > 10 mIU/mL per CDC Guidelines. See Hepatitis in the Infectious Disease chapter, Performed: referred-A Interpretive Information section. turn around: 3-5 days

87517 HEPATITIS B VIRUS DNA, QN Accompanies report Specimen Container: 87517 Real-Time PCR Gel barrier (red top) Clinical Use: Test is useful in monitoring therapy and disease progression. 3.0 (2.5) mL FROZEN serum

Transfer serum into 2 separate plastic, screw-cap Performed: referred-A vials and freeze. turn around: 3-5 days

86295 HEPATITIS BE ANTIBODY Nonreactive Specimen Container: 86707 Immunoassay Gel barrier (gold or tiger top) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: HBeAb appears in the early convalescence of HBV infection. 1.0 (0.5) mL serum Performed: referred-A With carrier state and chronic hepatitis, HbeAb may not develop. turn around: 3-5 days

86293 HEPATITIS BE ANTIGEN Nonreactive Specimen Container: 87350 Immunoassay Gel barrier (gold or tiger top) Clinical Use: HBeAg indicates active HBV replication. Infectivity is evaluated 1.0 (0.5) mL serum based on HBeAg and HBsAg. When HBeAg persists much longer than 10 weeks, the patient is likely to develop chronic hepatitis Performed: referred-A and be a carrier. turn around: 3-5 days

16302 HEPATITIS C VIRUS ANTIBODY Nonreactive Specimen Container: 86803 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: The presence of anti-HCV indicates that an individual may 1.0 (0.5) mL serum have been infected with HCV, may harbor infectious HCV, and/or may be capable of transmitting HCV infection. Although the majority of infected individuals may be asymptomatic, HCV infection may develop into chronic hepatitis, cirrhosis, and/or Performed: mon-fri increased risk of hepatocellular carcinoma. turn around: 1-3 days

16303 HEPATITIS C ANTIBODY REFLEX RIBA Nonreactive Specimen Container: 86803 Chemiluminescence Gel barrier (gold or tiger top) Recombinant Immunoblot Assay 1.0 (0.5) mL serum If Hepatitis C Antibody is Reactive,

Hepatitis C Antibody, RIBA, will be added at an additional charge (CPT 86804).

Performed: mon-fri turn around: 1-5 days

89272 HEPATITIS C PCR - QUAL Not detected Specimen Container: 87521 Reverse Transcriptase-Polymerase Chain Reaction EDTA (lavender top) Clinical Use: Used to confirm Hepatitis C infection and demonstrate resolution 2.0 (0.6) mL FROZEN plasma of infection. Limit of detection is 50 IU/mL Centrifuge within 6 hours of collection, transfer to Performed: referred-A plastic, screw-cap vial, freeze immediately. turn around: 3-5 days

89271 HEPATITIS C RNA BY bDNA Accompanies report Specimen Container: 87522 Branched DNA EDTA (lavender top) Clinical Use: Quantitative RNA by bDNA is useful in confirming HCV infection, 2.0 (0.6) mL FROZEN plasma assessing prognosis (before initiation of therapy), prescribing individualized therapy, predicting response to therapy, and Centrifuge within 6 hours of collection, transfer to Performed: referred-A monitoring response to therapy. plastic, screw-cap vial, freeze immediately. turn around: 3-5 days

86303 HEPATITIS C VIRUS RIBA Negative Specimen Container: 86804 Recombinant Immunoblot Assay Gel barrier (gold or tiger top) Clinical Use: This test is used as a follow-up if the Anti-HCV screening test 1.0 (0.5) mL serum is positive.

89273 HEPATITIS C VIRUS RNA BY PCR, Accompanies report NICL Laboratories/2011 Specimen Container: 87902 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE VIRAL LOAD EDTA (lavender top) PCR Clinical Use: Test is useful in monitoring therapy and disease progression. 3.0 (2.5) mL FROZEN plasma

Centrifuge within 6 hours of collection, transfer to 2 separate, plastic, screw-cap vials, freeze Performed: referred-A immediately. turn around: 3-5 days

86692 HEPATITIS DELTA ANTIBODY TOTAL Accompanies report Specimen Container: 86692 Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Hepatitis D virus (HDV) infection occurs in association with 1.0 (0.5) mL serum HBV infection. A positive result for HDV total antibody may indicate either acute or chronic HDV infection.

Performed: referred-A turn around: 5-7 days

86795 HEPATITIS E Ab, IgG & IgM Accompanies report Specimen Container: 86790 (x2) No additive (red top) Clinical Use: Hepatitis E virus (HEV) is the major etiologic agent of 1.0 (0.2) mL serum enterically transmitted non-A, non-B hepatitis worldwide and has a high case-fatality rate in pregnant women. Both IgM and IgG antibody to HEV (anti-HEV) are produced, following infection. The titer of IgM anti-HEV declines rapidly during early convalescence; IgG anti-HEV persists and appears to provide at least short-term protection Performed: referred-A against disease. turn around: 5-7 days

87526 HEPATITIS G VIRUS (HGV) RNA, QUAL, PCR Accompanies report Specimen Container: 87526 Real-Time PCR No additive (red top) Reverse Transcriptase-Polymerase Chain Reaction Clinical Use: Real-Time Reverse transcription-PCR (RT-PCR) is used to 1.0 (0.2) mL serum detect the HGV RNA genome in specimens. Performed: referred-A turn around: 10-14 days

20166 HEPATITIS PANEL, ACUTE Nonreactive Specimen Container: 80074 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Diagnosis of acute hepatitis caused by Hepatitis A,B, or C. 5.0 (2.0) mL serum Hepatitis A, IgM, Hepatitis B Core Antibody, IgM Hepatitis B Surface Antigen Hepatitis C Antibody

Performed: mon-fri turn around: 1-3 days

20049 HEPATITIS SYMPT PROFILE Nonreactive Specimen Container: 87340 Immunoassay Gel barrier (gold or tiger top) 86709 Clinical Use: 86705 Test Components: Diagnosis of acute hepatitis caused by Hepatitis A or B. 3.0 (1.5) mL serum Hepatitis A, IgM, Hepatitis B Core Antibody, IgM Hepatitis B Surface Antigen

Performed: mon-fri turn around: 1-3 days

87522 HEPTIMAX® HCV RNA Accompanies report Specimen Container: 87522 Polymerase Chain Reaction EDTA (lavender top) Transcription Mediated-Amplification Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE HCV RNA quantitative assays are used to confirm infection, 5.0 (3.0) mL FROZEN plasma monitor disease progression, and therapy. HEPTIMAX® provides the broadest linear range available for HCV quantitation. Centrifuge within 6 hours of collection, transfer to 2 separate, plastic, screw-cap vials, freeze Performed: referred-A immediately. turn around: 5-7 days

86170 HERPES ANTIBODY I&II IgG For both HSV-1 and HSV-2 Type-Specific IgG Ab Specimen Container: 86695 Immunoassay < 0.90 Negative Gel barrier (gold or tiger top) 86696 0.90-1.10 Equivocal > 1.10 Positive 1.0 (0.2) mL serum

Clinical Use: Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually Performed: referred-A required for diagnosis or treatment. turn around: 3-5 days

86697 HERPES PROFILE #1 Accompanies Report Specimen Container: 86694 Various Gel barrier (gold or tiger top) 86695 Clinical Use: 86696 Herpes Simplex Virus (HSV) is responsible for several clinically Test Components: significant human viral diseases, with severity ranging from 2.0 (1.0) mL serum Herpes Simplex Virus IgM Antibody, Reflex to Titer inapparent to fatal. Clinical manifestations include genital tract HSV 1/2 (IgG), Type-Specific Abs (HerpeSelect®) infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. IgM HSV antibodies in infants may be helpful in the diagnosis of neonatal infection. IgM antibody usually appears within the first 4 weeks of life in infected infants and persists for many months. IgM suggests a recent HSV exposure but does not differentiate between primary infection Performed: referred-A and reactivation. turn around: 3-5 days

87159 HERPES SIMPLEX CULTURE None isolated Specimen Container: 87252 Rapid Culture VCM Collection Kit B Clinical Use: Do not use collection kit if media is yellow. Herpes simplex virus (HSV) is responsible for several clinically significant human genital tract infections, neonatal herpes, 3.0 (1.0) mL biopsy, conjunctival, endocervical, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. endourethral specimen, vesicle/fluid scraping, or throat swab

Transport refrigerated Performed: referred-A turn around: 3-5 days

87258 HERPES SIMPLEX VIRAL CULTURE PROGRESSIVE Negative Specimen Container: 87255 Rapid Culture with Typing (HSV may not be isolated from lesions 5 days after onset.) VCM Collection Kit B Do not use collection kit if media is yellow. Clinical Use: Herpes simplex virus (HSV) is responsible for several clinically 3.0 (1.0) mL biopsy, conjunctival, endocervical, significant human genital tract infections, neonatal herpes, endourethral specimen, vesicle/fluid scraping, or meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. throat swab

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Transport refrigerated

Performed: referred-A turn around: 3-5 days

86694 HERPES SIMPLEX VIRUS IgM Ab, REFLEX TO TITER Not detected Specimen Container: 86694 Enzyme-Linked Immunosorbent Assay (ELISA) Gel barrier (gold or tiger top) Clinical Use: Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from 1.0 (0.5) mL serum inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. IgM HSV antibodies in infants may be helpful in the diagnosis of neonatal infection. IgM antibody usually appears within the first 4 weeks of life in infected infants and persists for many months. IgM suggests a recent HSV exposure but does not differentiate between primary infection Performed: referred-A and reactivation. turn around: 3-5 days

87529 HERPES SIMPLEX VIRUS, 1 & 2 DNA, PCR HSV 1 & 2 DNA: Not detected Specimen Container: 87529 Real-Time PCR VCM Collection Kit B This assay detects the presence of herpes simplex virus (HSV) Do not use collection kit if media is yellow. DNA by real-time PCR amplification of the HSV glycoprotein B gene. If HSV is detected, it is further categorized as HSV-type 1 1.0 (0.3) mL body fluid, sputum, vitreous fluid, or HSV-type 2, using probes unique to each subtype. These bronchial brush/wash, results should be interpreted in conjunction with the patient's clinical history and other relevant diagnostic information. Transport refrigerated

Clinical Use: DNA testing is analytically more sensitive than culture, especially in patients with encephalitis or meningitis. DNA testing may be useful in diagnosis of infection in neonates. Neonates who have been exposed to HSV can develop disseminated infection and encephalitis. Encephalitis is usually due to HSV I, whereas meningitis is usually due to HSV II. DNA testing provides reliable Performed: referred-A means to define the Type. turn around: 3-5 days

87305 HERPES SIMPEX & VARICELLA ZOSTER VIRUS CULTURE Accompanies report Specimen Container: 87254 (x2) Rapid Culture VCM Collection Kit B Clinical Use: Do not use collection kit if media is yellow. Both HSV and VZV cause a multitude of human diseases and are particularly severe in patient whose immune systems are immature 2-3 mL biopsy, conjunctival, bronchial lavage/ wash, (neonates), suppressed (drug therapy), or compromised (elderly, or throat swab AIDS), HSV infections include genital lesions, cold sores, phayngitis, ocular keratosis and encephalitis. VZV causes both Transport refrigerated chickenpox and shingles, representing different clinical manifestations of the same infection with VZV. The different Please note: This test is not performed on skin clinical manifestations of VZv can be indistinguishable from those sources. For skin sources, order Herpes Simplex / Performed: referred-A of HSV. Varicella-Zoster Culture/DIF, Test 87259 turn around: 7-10 days

HERPES SIMPEX & VARICELLA ZOSTER VIRUS 87259 CULTURE/DIF Not isolated Specimen Container: 87273 Centrifugation Enhanced Culture with Immunofluorescence VCM Collection Kit B 87274 Direct Immunofluorescence Assay Clinical Use: Do not use collection kit if media is yellow. 87290 Both HSV and VZV cause a multitude of human diseases and are 87254 (x2) Components: particularly severe in patient whose immune systems are immature Vesicular, Oral, Genital (external), or Skin lesions Herpes simplex/Varicella zoster virus Rapid Cult (neonates), suppressed (drug therapy),NICL Laboratories/2011 or compromised (elderly, TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Herpes Simplex Virus and Varicella-Zoster Virus DIF AIDS), HSV infections include genital lesions, cold sores, Transport refrigerated phayngitis, ocular keratosis and encephalitis. VZV causes both chickenpox and shingles, representing different clinical manifestations of the same infection with VZV. The different clinical manifestations of VZv can be indistinguishable from those Performed: referred-A of HSV. turn around: 7-10 days

83497 5 - HIAA (SEROTONIN), RANDOM 2-10 years: 12.0 mg/g creat or less Specimen Container: 83497 High Performance Liquid Chromatography > 10 years: 10.0 mg/g creat or less Sterile urine container, leak-prof

Clinical Use: 10.0 (5.0) mL random urine, FROZEN Values above 10 mg/24 hours occur in carcinoid syndrome. Slight elevations also occur in nontropical sprue and after Transport frozen reserpine administration. Drugs which can interfere with testing due to physiologic response: Acetaminophen, alpha and beta Patient should avoid food high in indoles: avocado, blockers, atenolol, bromocriptine, broncholdilators, clonidine, banana, tomato, plum, walnut, pineapple, and digoxin, isoniazid, L-dopa, labetelol, methyldopa, monoamine eggplant. Patient should also avoid tobacco, tea, and oxidase inhibitors, nitroglycerin, sympathomimetic amines, coffee for 3 days before specimen collection. phenobarbital, phenothiazines, phentolamine, reserprine, Performed: referred-A salicylates, tricyclic antidepressants. turn around: 3-5 days

83088 HISTAMINE PLASMA Accompanies report Specimen Container: 83088 Immunoassay EDTA (lavender top) Clinical Use: Histamine is a mediator of the allergic response. Histamine 1.0 (0.5) mL FROZEN plasma. release causes itching, flushing, hives, vomiting, syncope, and Transfer plasma to a plastic, screw-cap vial and freeze. even shock. In addition, some patients with gastric carcinoids may exhibit high concentrations of Histamine. Transport frozen

Avoid taking allergy causing drugs, antihistamines, oral corticosteroids, and substances which block H2 Performed: referred-A receptors for at least 24 hours before collection. turn around: 5-7 days

86266 HISTONE ANTIBODIES Negative: < 1.0 Specimen Container: 83516 Enzyme Immunoassay Weak positive: 1.0-1.5 Gel barrier (gold or tiger top) Moderate positive: 1.6-2.5 Strong positive: > 2.5 1.0 (0.3) mL serum

Clinical Use: Overnight fasting is preferred. Histones are lysine-rich and arginine-rich basic proteins of eukaryotic cells which are predominantly found as complexes with DNA. Antibodies to histones are detected in approximately 30% to 60% of patients with systemic lupus erythematosus (SLE), but their presence in about 95% of patients with drug-induced lupus Performed: referred-A is more important diagnostically. turn around: 5-7 days

84017 HISTOPLASMA ANTIBODIES Accompanies report Specimen Container: 86998 (x2) Complement Fixation Gel barrier (gold or tiger top) Clinical Use: Histoplasmosis, caused by infection by H. capsulatum, is 1.0 (0.3) mL serum usually asymptomatic or mild. Some patients develop chronic chronic pulmonary histoplasmosis or acute disseminated histoplasmosis that is often life-threatening. Complement fixation assesses antibodies to the yeast and mycelial forms. Approximately 90-95% of patients with histoplasmosis have Performed: referred-A detectable antibodies. turn around: 5-7 days

87385 HISTOPLASMA ANTIGEN URINE Accompanies report Specimen Container: 87385 Immunoassay Sterile urine container, leak-prof NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Histoplasma Antigen in Urine may be used to support the 10.0 (1.0) mL random urine, transport refrigerated. diagnosis of histoplasmosis in immunocompromised patients and in patients with disseminated histoplasmosis Histoplasma antigen levels may also be used to monitor therapeutic response Performed: referred-A in patients. turn around: 5-7 days

16702 HIV 1/0/2 ENHANCED Non-Reactive Specimen Container: 86703 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: HIV is the virus that causes Acquired Immunodeficiency Syndrome 1.0 (0.3) mL serum Performed: mon-fri (AIDS). turn around: 1-3 days

87901 HIV-1 GENOTYPING, PR & RT None detected Specimen Container: 87901 RT-PCR and DNA Sequencing EDTA (lavender top)

1.0 (0.5) mL FROZEN plasma. ` Transfer plasma to a plastic, screw-cap vial and freeze.

Performed: referred-A Transport frozen turn around: 7-10 days

83895 HIV-1 RNA bDNA, QUANT Accompanies report Specimen Container: 87536 Branched DNA EDTA (lavender top) Clinical Use: Measurement of HIV-1 plasma levels (viral load) provides a 1.0 (0.5) mL FROZEN plasma. direct assessment of viremia and should be used in conjunction Transfer plasma to a plastic, screw-cap vial and freeze. with CD4+ T-cell counts. HIV-1 RNA, quantitation is useful in patients to assess prognosis, monitor progression of HIV-1 Transport frozen infection, determine when to initiate therapy, and monitor the Performed: referred-A effectiveness of antiretroviral therapy. turn around: 3-5 days

86691 HIV-1 WESTERN BLOT w/REFLEX TO HIV-2 Negative Specimen Container: 86689 Immunoblot Gel barrier (gold or tiger top) Immunoassay Clinical Use: WB/Screen HIV-1 is the virus that causes Acquired Immunodeficiency 1.0 (0.3) mL serum Syndrom (AIDS). Western blot and EIA-positivity have a combined specificity of greater that 99.9%. Western blot results may be indeterminate with early HIV-1 infection, in patients with autoimmune disease, and in women who are pregnant. Rarely, HIV-1 Western blot indeterminate results may be due to HIV-2 infection in a patient who has been exposed to HIV-2. The Western blot is useful to confirm Performed: referred-A repeatedly reactive EIA results. turn around: 3-5 days

87537 HIV-1, QUAN, REAL TIME PCR Accompanies report Specimen Container: 87536 Real-Time PCR EDTA (lavender top) Clinical Use: This test is intended for use in conjunction with clinical 3.0 (2.5) mL FROZEN plasma. presentation and other laboratory markers of disease progress Centrifuge within 6 hours of collection, transfer for the clinical management of HIV-1 infected patients. plasma to a plastic, screw-cap vial and freeze.

Performed: referred-A Transport frozen turn around: 3-5 days

86702 HIV-2 EIA ANTIBODY SCREEN HIV-2 AB, EIA: Nonreactive Specimen Container: 86702 Immunoassay HIV-2 AB, IB: Negative No additive (red top)

If HIV-2 Antibody, EIA is repeatedly reactive, HIV-2 Antibody, Immunoblot* Clinical Use: 1.0 (0.5) mL serum, transfer to a plastic, screw-cap vial will be performed at an additional charge (CPT code: 86689). HIV-2 is closely related to HIV-1 regardingNICL Laboratories/2011 nucleic acid TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE sequence and clinical disease. HIV-2 is endemic to West To protect patient confidentiality, we recommend Africa with nearly all cases in the United States identified using a unique code number in place of patient's in citizens or travelers from West Africa. Rarely, HIV-1 name on the specimen vial and the test requisition. Western blot indeterminate results may be due to HIV-2 Tube must be labeled with patient identifier and infection in a patient who has been exposed to HIV-2. The submitted only for HIV testing. Performed: referred-A Immunoblot is useful to confirm repeatedly reactive EIA results. turn around: 5-7 days

86693 HIV-2, IMMUNOBLOT Negative Specimen Container: 86689 Immunoblot No additive (red top) Clinical Use: HIV-2 is closely related to HIV-1 regarding nucleic acid 1.0 (0.5) mL serum, transfer to a plastic, screw-cap vial sequence and clinical disease. HIV-2 is endemic to West Africa with nearly all cases in the United States identified To protect patient confidentiality, we recommend in citizens or travelers from West Africa. Rarely, HIV-1 using a unique code number in place of patient's Western blot indeterminate results may be due to HIV-2 name on the specimen vial and the test requisition. infection in a patient who has been exposed to HIV-2. The Tube must be labeled with patient identifier and Performed: referred-A Immunoblot is useful to confirm repeatedly reactive EIA results. submitted only for HIV testing. turn around: 5-7 days

83927 HLA-B CLASS I DNA TYPING Accompanies report Specimen Container: 83891 PCR followed by Sequence Specific Oligonucleotide Probes ACD-A (yellow top) 83900 83912 10.0 (5.0) mL Whole Blood 83896 (x30)

Performed: referred-A Transport at room temperature. turn around: 10-14 days

86596 HLA-B27 HISTOCOMPATIBILITY ANTIGEN Accompanies report Specimen Container: 86812 Flow Cytometry ACD-B (yellow top) Clinical Use: HLA B27 is found in 90% of patientswith ankylosing spondylitis and 10.0 (5.0) mL Whole Blood 80% in Reiter's disease. Ankylosing spondylitis affects 1 in 1000 Caucasians. Ankylosing spondylitis is 10 times more common Transport at room temperature. among individuals with HLA-B27 compared to individuals without Performed: referred-A this antigen. turn around: 3-5 days

86817 HLA-DQ CLASS II DNA TYPEING Accompanies report Specimen Container: 83891 PCR followed by Sequence Specific Oligonucleotide Probes ACD-A (yellow top) 83900 83912 10.0 (5.0) mL Whole Blood 83896 (x15)

Transport at room temperature.

Performed: referred-A turn around: 10-14 days

82131 HOMOCYSTEINE Males: < 11.4 umol/L Specimen Container: 83090 Immunoassay Females: < 10.4 umol/L Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum An elevated concentration of Homocysteine is an.independent risk factor for cardiovascular disease. Place the specimen in a refrigerator for 30 minutes after collection. Centrifuge the specimen as soon as Performed: referred-A possible after complete clot formation has taken place. turn around: 3-5 days

87621 HPV DNA, HIGH & LOW RISK Not detected Specimen Container: 87621(x2) DNA Hybridazation, Hybrid Capture (Digene) Cytyc PreservCyt (ThinPrep) Solution Clinical Use: Digene Transport Media (STM) HPV is the causative agent of cervical dysplasia and cervical carcinoma. NICL Laboratories/2011 Cervical specimens: TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Use the cervical broom to collect cells from the cervix and place into the Cytyc PreservCyt solution. Transport at room temperature.

Biopsy specimens: Performed: referred-A Digene media, FROZEN turn around: 5-7 days

87626 HPV DNA, HIGH RISK, ANAL-RECTAL Not detected Specimen Container: 87621 Hybrid Capture with Signal Amplification Digene Transport Media (STM) Clinical Use: This test is used to deect the presence of HPV DNA in anorectal Anal rectal specimens: mucosa. Collect using the Cervical Sampler brush included in the collection kit. Transport brush in Digene STM. Assure that the brush is submerged correctly in the transport media and that the cap is securely tightened Performed: referred-A to prevent leakage in transit. turn around: 5-7 days

86696 HSV 1 IgG, TYPE-SPECIFIC ANTIBODY (HERPESELECT®) HSV Type-1 Specific IgG Ab Specimen Container: 86695 Immunoassay Negative: < 0.90 Gel barrier (gold or tiger top) Equivocal: 0.90-1.10 Positive: > 1.10 1.0 (0.2) mL serum

Clinical Use: This assay is type specific and will differentiate between HSV-1 HSV-2 infections. A single positive result only indicates previous immunologic exposure and the level of antibody response may not be used to determine active infection or disease stage. The test should be repeated in 4-6 weeks when negative or equivocal results are obtained in suspected early herpes simplex disease. turn around: 3-5 days

86695 HSV 1/2 IgM & TYPE SPECIFIC IgG (HERPESELECT®) Accompanies report Specimen Container: 86694 Immunoassay Gel barrier (gold or tiger top) 86695 Clinical Use: 86696 The [HerpeSelect®] test system uses recombinant type-specific 1.0 (0.5) mL serum HSV-1 and HSV-2 antigen to detect only type-specific IgG antibodies. Detection of IgG to both HSV-1 and HSV-2 in a single specimen therefore indicates dual infection by HSV-1 and HSV-2. In-house validation studies revealed a sensitivity of 100% for both the HSV-1 IgG ELISA and the HSV-2 IgG ELISA, when compared to Western blot; specificity was 98% for both assays.

The HSV IgM ELISA detects type-common, as well as type-specific, IgM antibodies; thus, the type-specificity of any HSV IgM antibodies detected cannot be reliably determined. All samples giving an equivocal or positive IgM ELISA result are confirmed HSV IgM 1/2 IFA at an additional charge. As with the HSV IgM ELISA, however, Performed: referred-A IgM reactivity in the IFA is not type-specific. turn around: 5-7 days

86791 HTLV - I/ II, PROGRESSIVE Nonreactive Specimen Container: 86790 Chemiluminescence Assay Gel barrier (gold or tiger top) Immunoassay Clinical Use: LIA HTLV-I is associated with adult T-cell lymphoblastic leukemia and 1.0 (0.5) mL serum B-cell chronic lymphocytic leukemia. HTLV-II is less common and If the HTLV-I/II Antibody is Reactive, then HTLV-I/II. Confirmatory Assay, is associated with neoplasias of the CD8 T lymphocytes. Blood will be performed at an additional charge (CPT: 86689). donor screening began in 1998.

Performed: referred-A turn around: 3-5 days

HUMAN METAPNEUMOVIRUS, DFA 87301 Not detected NICL Laboratories/2011 Specimen Container: 87299 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Direct Immunofluorescence Assay VCM Collection Kit A Clinical Use: This procedure detects viral infection caused by human 2.0 mL Nasal wash/aspirate or nasopharyngeal swab Metapneumovirus (MPV). MPV is a member of the Paramyxoviridae family of viruses, along with Respiratory Syncytial Virus (RSV), the Collect 2 mL nasopharyngeal aspirates/washes in parainfluenzas, and several other well-known human pathogens. equal volumes of VCM transport media . MPV causes a spectrum of respiratory illness, ranging from mild or upper respiratory tract infections to severe bronchiolitis and Collect nasopharyngeal swabs directly into VCM pneumonia. Severe disease, leading to hospitalization, can occur transport media. in very young children, the elderly, and the immunocompromised. The clinical presentation and epidemiology of MPV are very Transport refrigerated. similar to those of RSV, and infection by these two viruses cannot be distinguished by clinical signs alone. Simultaneous coinfections with other respiratory viruses have also been documented. MPV Performed: referred-A seems to be most active in the late winter and early spring. turn around: 3-5 days

83888 HUMAN PLATELET Ag 1 GENOTYPE Accompanies report Specimen Container: 83890 Polymerase Chain Reaction EDTA (lavender top) 83891 Clinical Use: 83912 HPA polymorphism can lead to alloimunization, which clinically 5.0 (1.0) mL whole blood 83894 (x2) can manifests as NATP (neonatal alloimmune thrombocytopenia) 83898 (x2) or PTP (post-transfusion thrombocytopenia purpura). HPA-1 Transport at room temperature genotyping allows screening for potential neonatal immunizaion in pregnancy.

Performed: referred-A turn around: 5-7days

82780 HUMORAL IMMUNITY PANEL #3 Accompanies report Specimen Container: 82785 Various Gel barrier (gold or tiger top) 86648 Clinical Use: 86684 Test components: Humoral Immunity Panel is used to identify functional deficiencies 4.0 (2.0) mL serum 86774 Diptheria Antitoxoid Ab, Haemophilus Influenzae Type B Antibody (IgG), IgA, IgG, IgM, of the humoral immune system. Immune responses to vaccination 82784 (x3) IgG Subclasses 1-4, Immunoglobulins A, G, and M, IgE, Immunoglobulin G subclasses, with proteins (diptheria and tetanus toxoids) and pneumococcal 82787 (x4) Strep pneumoniae IgG Ab (6 Serotypes), Tetanus Antitoxoid Ab (EIA) polysacaccharides are evaluated for pre and/or post-vaccination 86317 (x6) antibody levels. Performed: referred-A turn around: 5-7days

82812 HUNTINGTON DISEASE MUTATION ANALYSIS Accompanies report Specimen Container: 83891 Fluorescent Polymerase Chain Reaction EDTA (lavender top) 83900 Clinical Use: 83909 To confirm the clinical diagnosis of Huntington Disease (HD) in 5.0 (3.0) mL whole blood 83912 affected individuals; to provide pre-symptomatic predictive diagnosis of HD in individuals with positive family history; to Specimen stability is crucial. Store and ship room identify individuals at risk of having affected offspring; to provide temperature immediately. Do not freeze. prenatal diagnosis in appropriate situations. Waiver signed by the referring healthcare professional must accompany all specimens or be received in the within 4 days of the blood draw. Performed: referred-A turn around: 2-3 weeks

86607 HYPERSENSITIVITY PNEUMONITIS STANDARD PANEL None detected Specimen Container: 86331 Immunodiffusion Gel barrier (gold or tiger top) 86609 (x2) Clinical Use: 86671 (x2) Hypersensitivity pneumonitis (HP) is an immune-mediated disease 1.0 (0.5) mL serum 86606 (x3) of the alveolar walls and terminal airways induced by inhalation in sensitized individuals of organic dusts that may contain thermo- philic actinomycetes, fungi or animal proteins. Most patients with asymptomatic individuals exposed to organic dust antigens can Performed: referred-A also test positive. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 7-10-days

88340 IBD GENERATION II (PROMETHEUS® IBD SEROLOGY 7) Accompanies report Specimen Container: 83520 Enzyme-Linked Immunosorbent Assay Gel barrier (gold or tiger top) 86021 Clinical Use: 86609 ® PROMETHEUS IBD Serology 7 helps identify IBD and 2.0 (0.5) mL serum 86255 (x2) differentiates between ulcerative colitis and Crohn’s disease. 86671 (x2) This test includes the proprietary and patented markers anti-CBir1, anti-OmpC and DNAse-sensitive pANCA process that helps identify patients with IBD and utilizes Smart Diagnostic Performed: referred-A Algorithm* technology to improve predictive accuracy. turn around: 7-10-days

83502 IGF BINDING PROTEIN 3 (IGFBP-3) Accompanies report Specimen Container: 83519 Immunoassay Gel barrier (gold or tiger top) Clinical Use: IGFBP-3 is the major carrier of insulin-like growth factors. IGFBP-3 1.0 (0.5) mL serum is Growth Hormone (hGH) responsive. Therefore, concentrations are elevated with acromegaly and decreased with hypopituitarism. Ratios of IgF-1/IGFBP-2 amd IGFBP-2/IGFBP-3 are useful as Performed: referred-A markers of hGh action and in evaluating short stature. turn around: 3-5 days

86334 IGG SUBCLASSES, SERUM Accompanies report Specimen Container: 82787 (x4) Nephelometric Gel barrier (gold or tiger top) Clinical Use: Measurement of IgG subclasses may be helpful in the management 1.0 (0.5) mL serum and understanding of immunodeficiency diseases, hypersensitivity Performed: referred-A states, and conditions involving susceptability to infection. turn around: 3-5 days

80222 IMIPRAMINE & DESPRAMINE (TOFRANIL) Imipramine + Desipramine: 150-300 mcg/L Specimen Container: 80174 High Performance Liquid Chromatography No additive (red top) Detection limit: 5 mcg/L 3.0 (1.0) serum, transfer to a plastic, screw-cap vial. Clinical Use: Imipramine is a tricyclic antidepressant used in the treatment of depressive disorders. The drugs are specifically useful in treatment of autonomous or endogenous depressions. Imipramine is metabolized to desipramine, which is also an active tricyclic Performed: referred-A antidepressant. Toxicity can lead to arrhythmias, coma, and death. turn around: 3-5 days

86338 IMMUNE COMPLEX ASSAY, RAJI CELL Raji Cell Immune Complex: < 15 ug Eq/mL Specimen Container: 86332 Enzyme Immunoassay No additive (red top) Clinical Use: Detects circulating immune complexes (CIC) with C3 deposited 1.0 (0.5) mL FROZEN serum on the complex. Transfer serum into 2 separate vials and freeze within Performed: referred-A 1 hour of collection. turn around: 7-10 days

86337 IMMUNE COMPLEX, C1q BINDING ASSAY ≤ 25.1 mcg Eq/mL Specimen Container: 86332 Immunoassay No additive (red top) Clinical Use: Assay detects circulating immune complexes, which are capable 1.0 (0.5) mL FROZEN serum Performed: referred-A of activating the classical complement pathway. Transfer serum to plastic, screw-cap vial and freeze. turn around: 3-5 days

84168 IMMUNOFIXATION PROFILE I, SERUM Accompanies report Specimen Container: 86334 Immunofixation Electrophoresis Gel barrier (gold or tiger top) 84165 Clinical Use: 82784 (x3) Test components: See individual tests 5.0 (2.5) mL serum IgA, IgG, IgM, Immunofixation (serum), Immunoglobulins A, G and M, NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Protein electrophoresis, Total Protein Overnight fasting is preferred.

Performed: referred-A turn around: 3-5 days

86335 IMMUNOFIXATION, SERUM No monoclonal proteins detected. Specimen Container: 86334 Immunofixation Gel barrier (gold or tiger top) Clinical Use: Monoclonal increases in IgG or IgA are often associated with 1.0 (0.5) mL serum diseases such as multiple myeloma, lymphoma, or leukemia. A monoclonal increase in IgM is commonly associated with Performed: referred-A Waltenstrom's macroglobulinemia. turn around: 3-5 days

86325 IMMUNOFIXATION, URINE No monoclonal proteins seen Specimen Container: 86335 Immunofixation 24-hour urine collection container, no preservative Clinical Use: Immunofixation is useful in evaluation of monoclonal free light chains and other monoclonal gammopathies seen in light disease, 50.0 (10.0) mL aliquoit of a well mixed 24-hr urine multiple myeloma, Waldenstrom's macroglobulinemia, amyloidosis, collected with no preservative. and other lymphoproliferative disorders. Increased polyclonal free light chains in urine may be seen in glomerular leak syndromes Performed: referred-A and in infection or inflammation. turn around: 3-5 days

82781 IMMUNOGLOBULIN A, G, M w/K & L QUANTITATION Accompanies report Specimen Container: 83883 (x2) Nephelometric Gel barrier (gold or tiger top) 82784 (x3) Clinical Use: Components: IgA, IgG, IgM, Kappa/Lambda Light Chain, Total See individual tests 2.0 (0.5) mL serum

Performed: referred-A turn around: 3-5 days

82789 IMMUNOGLOBULIN A Accompanies report Specimen Container: 82784 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: Approximately 1 in 1000 people has IgA deficiency. Individuals 1.0 (0.5) mL serum with low concentrations of IgA may be asymptomatic or have sinopulmonary, gastrointestinal (including sprue-like illness), Performed: referred-A rheumatic, or autoimmune diseases. turn around: 3-5 days

82784 IMMUNOGLOBULIN D (IGD) < 179 mg/L Specimen Container: 82784 Nephelometry No additive (red top) Clinical Use: IgD may be useful in diagnosing abnormal protein metabolism 2.0 (0.5) mL serum and in identifying and monitoring unusual monoclonal Transfer serum to plastic, screw-cap vial. gammopathies. Increased IgD is typically a key indicator of Performed: referred-A hyperimmunoglobulinemia D and periodic fever syndrome (HIDS). turn around: 3-5 days

82785 IMMUNOGLOBULIN E (IGE) Accompanies report Specimen Container: 82785 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test is for diagnosis of allergic disease. A normal IgE level does 1.0 (0.5) mL serum Performed: referred-A exclude the possible presence of an allergic disorder. turn around: 5-7 days

86332 IMMUNOGLOBULIN G (IgG) Accompanies report Specimen Container: 82784 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: Measurement of IgG is used in the diagnosis and treatment of 1.0 (0.5) mL serum immune deficiency states, protein-loosing conditions, chronic Centrifuge within 1 hour of collection. infections, liver disease, as well as specific diseases such as multiple sclerosis, mumps, meningitis, and immunoglobulin G Overnight fasting is preferred. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: referred-A myeloma. turn around: 3-5 days

82805 IMMUNOGLOBULIN G (IgG) SUBCLASSES Accompanies report Specimen Container: 82787 (x4) Nephelometric No additive (red top) Clinical Use: Measurement of IgG subclasses may be helpful in the 2.0 (1.0) mL serum management and understanding of immunodeficiency diseases, Transfer serum to plastic, screw-cap vial. hypersensitivity states, and conditions involving susceptability to Performed: referred-A infection. Overnight fasting is preferred. turn around: 3-5 days

82786 IMMUNOGLOBULIN M Accompanies report Specimen Container: 82784 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: Measurements of IgM are used in the diagnosis and treatment 1.0 (0.5) mL serum of immune deficiency states, protein-loosing conditions, Centrifuge within 1 hour of collection. Waldenstrom’s macroglobinemia, chronic infections, and liver Performed: referred-A disease. Overnight fasting is preferred. turn around: 3-5 days

86328 IMMUNOGLOBULIN A, G, M Accompanies report Specimen Container: 82784 (x3) Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: See individual tests 2.0 (1.0) mL serum Centrifuge within 1 hour of collection.

Performed: referred-A Overnight fasting is preferred. turn around: 3-5 days

82787 IMMUNOGLOBULINS, 24 HOUR URINE Accompanies report Specimen Container: 82784 (x3) Immunoturbidimetric 24 Hour Urine Collection Container, no preservative

50.0 (10.0) mL aliquot of well mixed 24-hr urine, Performed: referred-A refrigerated. turn around: 3-5 days

86008 INFLUENZA VIRUS, TYPES A & B ANTIBODIES < 1:8 Specimen Container: 86710 (x2) Complement Fixation Interpretive Criteria Gel barrier (gold or tiger top) < 1:8 Antibody not detected ≥ 1:8 Antibody detected 1.0 (0.5) mL serum

Single titers of ≥1:64 are indicative of recent infection. Titers of 1:8 to 1:32 may be indicative of either past or recent infection, since CF antibody levels persist for only a few months. A fourfold or greater increase in titer between acute and convalescent specimens confirms the diagnosis.

Clinical Use: Influenza Type A and B viruses cause seasonal outbreaks of the flu. Each winter, approximately 10-20% of the population are Performed: referred-A infected. Both Type A and B are included in the flu vaccine. turn around: 3-5 days

27400 INFLUENZA A or B ANTIGEN Negative Specimen Container: 87254 (x2) Rapid Chromatographic Immunoassay VCM Collection Kit A Clinical Use: Do not use if media is yellow. Influenza viruses are common human respiratory pathogens and are a major cause of widespread epidemics. Rapid detection Nasopharyngeal swab or wash or Throat swab of influenza provides the basis for treating individuals with antiviral in M4 media. Performed: daily drugs and for managing outbreaks by providing vaccinations. turn around: next day

83525 INSULIN < 17 uIU/mL Specimen Container: 83525 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Immunoassay Gel barrier (gold or tiger top) Insulin analogues may demonstrate non-linear cross-reactivity cross-reactivity in this assay. Interpret results accordingly. 1.0 (0.5) mL serum

Clinical Use: Fasting specimen required For diagnosis and monitoring of diabetes and insulin-secreting Performed: referred-A tumors. turn around: 3-5 days

86339 INSULIN AUTOANTIBODIES Accompanies report Specimen Container: 86337 Radiobinding Assay Gel barrier (gold or tiger top) Clinical Use: Type 1 diabetes is characterized by a lymphocytic cell infiltrate 1.0 (0.2) mL serum of the pancreatic islets. Insulin Antibody is useful in assessing is useful in assessing lower titers of autoantibody in patients with diabetes, detecting insulin autoantibody in patients who are 'prediabetic,'' and in detecting autoantibody in patients with Performed: referred-A other autoimmune disorders. turn around: 5-7 days

83542 INSULIN, FREE Accompanies report Specimen Container: 83527 Immunoassay Gel barrier (gold or tiger top) Clinical Use: The free insulin measurement is helpful in interpreting blood 1.0 (0.5) mL serum sugar concentration and its relationship to insulin injections in insulin-treated patients with insulin antibodies. Insulin levels Fasting specimen required vary widely in specimens taken from nonfasting individuals. Insulin analogues may demonstrate nonlinear cross-reactivity Performed: referred-A in this assay. Interpret results accordingly. turn around: 5-7 days

84305 INSULIN LIKE GROWTH FACTOR-1 (IGF -1) Accompanies report Specimen Container: 84305 Liquid Chromatography/Mass Spectrometry Gel barrier (gold or tiger top) Clinical Use: Measuring IGF-I is useful in several growth-related disorders. 1.0 (0.3) mL serum Dwarfism, caused by deficiency of growth hormone (hypopituitarism), results in decreased serum levels of IGF-I, while acromegaly (growth hormone excess) results in elevated levels of IGF-I. IGF-I measurements are also helpful in assessing nutritional status; levels are reduced in undernutrition and Performed: referred-A restored with a proper turn around: 7-10 days

86850 INTERFERON-BETA (IFNB) ANTIBODY NEUTRALIZATION <1:20 Specimen Container: 86849 Tissue Culture/Neutralization No additive (red top) Clinical Use: Highly elevated levels of neutralizing antibodies (NAbs>1:1000) to 1.0 (0.5) mL FROZEN serum inteferon-beta used as therapy in patients with multiple sclerosis Transfer serum to a plastic, screw-cap vial and freeze. have been reported to correlate with predictable loss of interferon- beta bioactivity. In patients with elevated Nab levels from >1:20 to <1:100, interferon-beta bioactivity may still be present, but does not necessarily correlate to the exact Nab titer, and continued patient monitoring may be warrented. There is not apparent loss of interferon-beta bioactivity in patient who test positive in the binding antibody assay, but negative for Nabs; however continued Performed: referred-A patient monitoring may also be warrented in this instance as well. turn around: 7-10 days

86340 INTRINSIC FACTOR BLOCKING ANTIBODY Negative Specimen Container: 86340 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Intrinsic Factor, produced by cells lining the stomach, binds 1.0 (0.3) mL serum vitamin B12 (cyanocobalamin) to facilitate absorption of the NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE vitamin. absorption of the vitamin. Blocking antibody impedes Samples should not be collected from a patient who the action of Intrinsic Factor, as observed in approximately has received Vitamin B12 injection therapy within the Performed: referred-A half of the patients who develop pernicious anemia. last week. turn around: 3-5 days

80038 IODIDE, SERUM/PLASMA Accompanies report Specimen Container: 82491 Ion Chromatography No additive (red top) Clinical Use: Iodine is an essential element that is required for thyroid hormone 1.0 (0.3) mL serum production. The measurement of iodine serves as an index of Transfer serum to a plastic, screw-cap vial adequate dietary iodine intake and iodine overload, particularly Performed: referred-A from iodine-containing drugs such as amiodarone. turn around: 7-10 days

13545 IRON, SERUM 33 – 180 ug/dL Specimen Container: 83540 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: Serum measurements are useful in the diagnosis of iron deficiency 1.0 (0.5) mL serum; gel barrier tube and hemochromatosis. Performed: daily Centrifuge specimen within 1 hour of collection turn around: next day

23550 IRON & TIBC Iron: 33-180 ug/dL Specimen Container: 83540 Spectrophotometric Iron Binding Capactity: 155-300 ug/dL Gel barrier (gold or tiger top) 83550

Clinical Use: 1.0 (0.5) mL serum; gel barrier tube Serum iron quantification is a useful aid in confirming the diagnosis of iron-deficiency anemia or hemochromatosis. The measurement Centrifuge specimen within 1 hour of collection of total iron binding in the same specimen may facilitate the clinician's ability to distinguish between low serum iron levels, caused by iron deficiency from those related to inflammatory neoplastic disorders. The assay for iron measures the amount of iron, which is bound to transferrin. The total iron binding capacity (TIBC) measures the amount of iron that would appear in blood if all the transferrin were saturated with iron. It is an indirect measurement of transferrin concentrations, but is expressed as Performed: daily an iron measurement. turn around: next day

20082 IRON, TIBC, & TRANS SAT * Iron: 33-180 ug/dL Specimen Container: 83540 Iron Binding Capactity: 155-300 ug/dL Gel barrier (gold or tiger top) 83550 % Transferrin Saturation: 15-57% 1.0 (0.5) mL serum; gel barrier tube Clinical Use: Serum iron quantification is a useful aid in confirming the diagnosis Centrifuge specimen within 1 hour of collection of iron-deficiency anemia or hemochromatosis. The measurement of total iron binding in the same specimen may facilitate the clinician's ability to distinguish between low serum iron levels, caused by iron deficiency from those related to inflammatory neoplastic disorders. The assay for iron measures the amount of iron, which is bound to transferrin. The total iron binding capacity (TIBC) measures the amount of iron that would appear in blood if all the transferrin were saturated with iron. It is an indirect measurement of transferrin concentrations, but is expressed as an iron measurement.

To obtain the percent saturation, the serum iron is divided by the TIBC, which gives the actual amount of saturated transferrin. The percent saturation is low in iron deficiency and high in iron Performed: daily storage diseases. turn around: next day

83540 IRON, RANDOM URINE Accompanies report NICL Laboratories/2011 Specimen Container: 83540 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Atomic Absorption Sterile urine container, leak-prof Cinical Use: Diagnosis of hemochromatosis, hemolytic anemia, paroxysmal 10.0 (1.0) mL random urine nocturnal hemoglobinemia, and impaired biliary clearance (limited Performed: referred-A value). turn around:3-5 days

86341 ISLET CELL ANTIBODIES, WITH REFLEX TO TITER Accompanies report Specimen Container: 86341 Indirect Immunofluorescence Assay Gel barrier (gold or tiger top) Cinical Use: Type 1 diabetes is characterized by lymphocytic cell infiltrate of 2.0 (0.5) mL serum; gel barrier tube If the screen is positive, the test will reflex to a titer the pancreatic islets. Measurement of GAD-65, ICA-512, and at an additional charge (CPT 86341). Insulin Antibody is a highly sensitive means to assess risk and predict onset of Type I diabetes. There is a correlation between Performed: referred-A the number of positive antibodies and the antibody titers turn around:3-5 days

80282 ITRACONAZOLE LEVEL, HPLC Accompanies report Specimen Container: 82492 High Performance Liquid Chromatography No additive (red top) Cinical Use: Itraconazole is an antifungal drug useful for the treatment of 2.0 (1.0) mL FROZEN serum blastomycosis, histoplasmosis, coccidioidomycosis, sporotrichosis, Transfer serum to a plastic, screw-cap vial and freeze. ringworm, Tinea versicolor, and aspergillosis, as well as for Performed: referred-A therapy for oral and esophageal candidiasis (thrush). turn around:5-7 days

85390 JAK2 MUTATION, CELL BASED Accompanies report Specimen Container: 83891 Polymerase Chain Reaction EDTA (lavender top) 83896 Sequencing Cinical Use: 83898 The JAK2 tyrosine kinase (V617F) was detected in most patients 5.0 (4.0) mL whole blood 83912 (> 80%) with polycythemia vera (PV), 30-50% of patients with Record draw time and date on the specimen tube. 83902 (x2) either essential thrombocythemia (ET) or myelofibrosis. This mutation permits a new molecular classification of MPDs. This Transport at room temperature. assay quantitatively detects the JAK2 V617F mutation, which is important in terms of monitoring disease progression and Specimens must be received in the laboratory, Performed: referred-A and responses during therapy. Monday-Thursday. within 24 hours of collection. turn around:10-14 days

87799 JC POLYOMA VIRUS DNA, QN PCR < 500 copies/mL Specimen Container: 87799 Real-Time PCR Gel barrier (gold or tiger top) Cinical Use: JC Virus is the cause of progressive multifocal 1.0 (0.3) mL FROZEN serum leukoencephalopathy (PmL), a severe demyelinating disease Transfer serum to a plastic, screw-cap vial and freeze. of the central nervous system. PmL is a particular concern for individuals infected with the human immunodeficiency virus. Allow blood to clot at room temperature and Quantification of JC virus DNA is based upon real-time PCR separate serum from cells within 1 hour of amplification and detection of JCV genomic DNA. The quantitative collection. Performed: referred-A range of this assay is 500-35,000,000 copies/mL turn around: 3-5 days

84176 KAPPA/LAMBDA LIGHT CHAINS, RANDOM URINE <2.00 mg/dL Specimen Container: 83883 (x2) Nephelometric Sterile urine container, leak-prof Cinical Use: Polyclonal immunoglobulin light chains (kappa and lambda) 2.0 (0.2) mL random urine, refrigerated normally occur in a ratio of 2:1, whereas monoclonal immunoglobulin light chains exhibit only one type of light chain, either kappa or lambda. A kappa:lambda ratio outside of 2:1 Performed: referred-A is an indication of a monoclonal gammopathy. turn around: 3-5 days

83884 KAPPA/LAMBDA LIGHT CHAIN, TOTAL Kappa: 74-295 mg/dL Specimen Container: 83883 (x2) Nephelometric Lambda: 32-156 mg/dL Gel barrier (gold or tiger top) Kappa/Lambda Ratio: 1.3-2.7 1.0 (0.6) mL serum Cinical Use: The predominant presence of eitherNICL KappaLaboratories/2011 and Lambda light TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE chain protein in sera, cytoplasm of plasma cells and lymphocyte Performed: referred-A cells suggests a clona lymphoproliferative process. turn around: 3-5 days

11045 KETONES, SEMI-QUANTITATIVE Negative Specimen Container: 82009 colorimetric Gel barrier (gold or tiger top) or Cinical Use: Sterile urine container, leak-prof Under conditions of abnormal carbohydrate metabolism such as occurs in diabetes mellitus, ketones accumulate in the blood 1.0 (0.5) mL serum (ketonemia) and are excreted in the urine (ketonuria). The or accumulation of ketone bodies is often the cause of acidosis 3.0 (1.0) mL random urine and coma in diabetics. Performed: daily turn around: next day

83586 17-KETOSTEROIDS Accompanies report: Specimen Container: 83586 Colorimetric 24 hour urine collection container, with 25 mL 50% Cinical Use: Acetic Acid 17-ketosteroids can be used as indicators of adrenal and testicular and to a lesser extent the ovarian function. 100.0 (20.0) mL aliquot of a well mixed 24-hr urine.

Please specify on the request form and on the urine container the patient's age and sex and the total Performed: daily 24-hour urine volume. turn around: 3-5 days

87220 KOH PREP No fungus seen Specimen Container: 87206 Microscopic Examination Sterile, leak-proof container Cinical Use: Sputum, tissue, or body fluids may become infected with fungus. Sputum, tissue, body fluids or other primary specimens These fungal infections range in severity. Proper diagnosis can Performed: referred-A guide selection of therapy. Transport refrigerated. turn around: 3-5 days

13620 LACTATE DEHYDROGENASE (LDH) 0-6 days: 290-500 U/L Specimen Container: 83615 Spectrophotometric 6 days-2 years: 210-500 U/L Gel barrier (gold or tiger top) 2 years-12 years: 80-250 U/L 12 years-59 years: 109-206 U/L 1.0 (0.5) mL serum >60 years: 102-233 U/L

Cinical Use: Elevations in serum lactate dehydrogenase occur from myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary emboli, malignancies, and Performed: daily muscular dystrophy. turn around: next day

83605 LACTIC ACID, PLASMA 4-16 mg/dL Specimen Container: 83605 Spectrophotometric Sodium fluoride(gray top) Cinical Use: Lactic Acid is the end product of the anaerobic metabolism of 2 .0 (0.5 ) mL FROZEN plasma. glucose. The blood Lactic Acid concentration is affected by its Transfer plasma to a plastic, screw-cap vial and freeze. production in muscle cells and erythrocytes and it rate of metabolism in the liver. During exercise, blood lactate can Sample should be collected without the use of a increase up to ten times of normal levels. tourniquet; avoid hand-clenching. If a tourniquet has been used, it should be released for one minute before drawing blood. Collected blood should be cooled on ice immediately and separated from the Performed: referred-A cells within 3 hours. turn around: 3-5 days

80298 LAMICTAL (LAMOTRIGINE) 4.0 -18.0 mcg/mL Specimen Container: 80299 Liquid Chromatography Tandem Mass Spectrometry No additive (red top) Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Lamotrigine is an anticonvulsant drug used as adjunctive 1.0 (0.5) mL serum treatment for refractory partial seizures. Collect specimen 1/2 to 1 hour before next dose.

Performed: referred-A Do not use Gel barrier (gold or tiger top) tube turn around: 3-5 days

83626 LDH ISOENZYMES Accompanies report Specimen Container: 83615 Electrophoresis Gel barrier (gold or tiger top) 83625 Clinical Use: Test is a diagnostic aid for myocardial infarction; also for 2.0 (0.5) mL serum, room temperature only malignancies, anemias, and acute liver and muscle injury. Centrifuge serum specimens within 1 hour of collection, transfer serum to clean, plastic, screw-capped vial(s), and send at room temperature to the laboratory.

Performed: referred-A Do not refrigerate or freeze specimens. turn around: 3-5 days

83721 LDL DIRECT LDL Direct Cholesterol: <130 mg/dL Specimen Container: 83721 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: LDL cholesterol is a key factor in the pathogenesis of 1.0 (0.5) mL serum atherosclerosis and coronary artery disease (CAD), while HDL cholesterol has often been observed to have a protective effect. Patient should fast 9-12 hours before specimen Even within the normal range of total cholesterol concentrations, collection. 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 Performed: referred-A to the blood vessel wall, which enhance turn around: 3-5 days

83658 LEAD, BLOOD Birth to 6 years: < 5 mcg/dL Specimen Container: 83655 Atomic Spectroscopy > 6 years: < 10 mcg/dL EDTA Trace Element (royal blue top) or EDTA (lavender top) Clinical Use: Children are especially susceptible to neurologic damage from 3.0 (1.0) mL whole blood lead and acute neurologic toxicity may develop without previous symptoms. For contamination control during blood collection, use powderless gloves, and wash the draw site with soap and water, then dry with a clean, low lint towel. If water is unavailable, the skin may be cleansed using foaming Performed: referred-A soaps or using alcohol prep pads. turn around: 3-5 days

86253 LEGIONELLA ANTIBODY, IGG ≤0.90 Units Negative Specimen Container: 86713 Indirect Immunofluorescence Assay 0.91-1.09 Units Equivocal Gel barrier (gold or tiger top) ≥1.10 Units Presumptively positive 1.0 (0.2) mL serum Clinical Use: Legionnaire's disease is associated with pneumonia and other illnesses. Seroconversion may be delayed and cross-reactivity with other organisms limits the application of serology in clinical Performed: referred-A care. turn around: 5-7 days

86713 LEGIONELLA ANTIBODY, IgM Accompanies report Specimen Container: 86713 Indirect Immunofluorescence Assay Gel barrier (gold or tiger top) Clinical Use: Legionella can cause a broad clinical spectrum of disease, 1.0 (0.2) mL serum ranging fom asymptomatic infection to rapidly progressing pneumonia. Legionellosis is a CDC notifiable disease and is associated with two clinically and epidemiologically distinct illnesses: (1) Legionnaire's disease, which is characterized by NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE fever, myalgia, cough, and pneumonia and (2) Pontiac fever, Performed: referred-A a milder illness without pneumonia. turn around: 5-7 days

85540 LEUKOCYTE ALK PHOS * 85540

10299 LEVETIRACETAM (KEPPRA) 6 – 46 mcg/mL Specimen Container: 80299 Colormetic No additive (red top) A reference range for levetiracetam has not been well established. Tentative ranges for seizure control have 1.0 (0.5) mL been proposed. These include concentrations from 6 to Transfer serum to a plastic, screw-cap vial. 46 mcg/mL. However these ranges have not been validated by adequate controlled trials and the relationship between serum concentration and clinical effect have not been well defined. Levetiracetam drug concentrations should be used in conjunction with information available from clinical evaluations and other diagnostic procedures. Circulating levels of levetiracetam may be affected by compliance, renal function, pregnancy, drug-drug interactions, timing of the sample draw, and progression in severity of the disease, as well as, addition or withdrawal of concomitant drugs which may interact pharmacodynamically with circulating levels of levetiracetam.

Clinical Use: Levetiracetam is an anticonvulsant used as adjunct therapy to treat adult partial seizures. As multiple anticonvulsants are administered, it is important to monitor its level to (1) optimize Performed: tues, fri therapy, (2)assure compliance, and (3) to avoid toxicity. turn around: 1-4 days

82135 LEVULINIC ACID (DELTA AMINO), 24 HR URINE Accompanies report Specimen Container: 82135 Colorimetric 24 hour urine collection container with 30 mL 6 N HCL Clinical Use: ALA is a precursor to uroporphyrin, coproporphyrin, and 100.0 (1.0) mL aliquot of a well-mixed 24-hr urine protoporphyrin. Concentrations of ALA are greatly increased collection. in many patients with acute neurological forms of porphyrias and in some patients with chronic alcohol abuse. Please specify on the request form and on the Performed: referred-A urine container the total 24-hour urine volume. turn around: 3-5 days

80284 LEXAPRO (ESCITALOPRAM) Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Therapeutic drug monitoring 1.0 (0.4) mL Performed: referred-A Transfer serum to a plastic, screw-cap vial. turn around: 7-10 days

13002 LH (LUTENIZING HORMONE) Group LH Reference Range Specimen Container: 83002 Normally menstuating females: Gel barrier (gold or tiger top) Follicular phase 1.9 - 12.5 mIU/mL Midcycle Peak 8.7 - 76.3 mIU/mL 1.0 (0.5) mL serum Luteal Peak 0.5 - 16.9 mIU/mL Pregnant: up to 1.5 mIU/mL Post menopausal: 15.9 - 54.0 mIU/mL Contraceptives: 0.7 – 5.6 mIU/mL

Male: 1.4 - 18.1 mIU/mL

Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE This test is usful in the differential diagnosis of pituitary and Performed: daily gonadal insufficiency and in children with precocious puberty. turn around: next day

13690 LIPASE 0 - 60 U/L Specimen Container: 83690 Colorimetric Gel barrier (gold or tiger top) Clinical Use: Lipase measurements are used primarily in the diagnosis and 1.0 (0.5) mL serum Performed: daily treatment of pancreatic disorders. turn around: next day

83604 LIPID ASSOCIATED SIALIC ACID (LASA) 12 -25 mg/dL Specimen Container: 84275 Colorimetric Gel barrier (gold or tiger top) Lipid-Associated Sialic Acid (LASA) is useful in conjunction with other tests in monitoring patients with a variety of neoplasms 1.0 (0.5) mL serum including lung, breast, gastrointestinal, leukemia, lymphoma, Performed: referred-A sarcoma, and Hodgkin's disease. turn around: 5-7 days

20064 LIPID PANEL Accompanies report Specimen Container: 80061 Various Gel barrier (gold or tiger top) Clinical Use: Components: The tests in a lipid panel are used to determine the risk of 1.0 (0.5) mL serum Total Cholesterol, Triglycerides, HDL Cholesterol, LDL (calculated) coronary heart disease. These tests are good indicators of whether someone is likely to have a heart attack or stroke Patient should fast 10-12 hours prior to collection. caused by blockage of blood vessels or hardening of the arteries. Performed: daily turn around: next day

20062 LIPID PANEL W/HDL (AMA) Accompanies report Specimen Container: 80061 Various Gel barrier (gold or tiger top) Clinical Use: Components: The tests in a lipid panel are used to determine the risk of 1.0 (0.5) mL serum Total Cholesterol, Triglycerides, HDL Cholesterol, coronary heart disease. These tests are good indicators of Cholesterol/HDL Ratio, and LDL-Chol Calculated whether someone is likely to have a heart attack or stroke Patient should fast 10-12 hours prior to collection. caused by blockage of blood vessels or hardening of the arteries. Performed: daily turn around: next day

20162 LIPID PANEL WITH VLDL (CALCULATED) Accompanies report Specimen Container: 80061 Various Gel barrier (gold or tiger top) Clinical Use: Components: The tests in a lipid panel are used to determine the risk of 1.0 (0.5) mL serum Total Cholesterol, Triglycerides, HDL Cholesterol, coronary heart disease. These tests are good indicators of LDL, VLDL whether someone is likely to have a heart attack or stroke Patient should fast 10-12 hours prior to collection. caused by blockage of blood vessels or hardening of the arteries. Performed: daily turn around: next day

86318 LIPOPROTEIN A, SERUM < 75 nmol/L Specimen Container: 83695 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: Elevated concentrations of Lp(a) are associated with increased 1.0 (0.5) mL serum Performed: referred-A risk of coronary artery disease. turn around: 3-5 days

13725 LITHIUM 0.5 - 1.5 mEq/L Specimen Container: 80178 Ion Selective Electrode Gel barrier (gold or tiger top) Clinical Use: Lithium is used to treat manic-depressive disorders and the 1.0 (0.5) mL serum manic phase of affective disorders,including mania. The therapeutic window is relatively small. Therapeutic drug monitoring Performed: daily is useful to optimize dose and avoid toxicity. turn around: next day NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

86378 LIVER KIDNEY MICROSOME (LKM-1) IgG AB LKM-1 IgG Autoabs EIA <20.1 Units Specimen Container: 86376 Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: LKM-a IgG antibodies are typically found in Autoimmune Hepatitis 1.0 (0.5) mL serum Type 2. The major liver kidney microsome target antigen is Performed: referred-A cytochrome P450 2D6. turn around: 3-5 days

80155 LORAZEPAM (ACTIVAN ) 50-240 ng/mL Specimen Container: 80154 High Performance Liquid Chromatography No additive (red top) Clinical Use: Therapeutic drug monitoring is useful to optimize dose 2.0(1.0) mL serum Performed: referred-A and avoid toxicity. Transfer serum to a plastic, screw-cap vial. turn around: 5-7 days

83791 LUDIOMIL (MAPROTILINE) Accompanies report Specimen Container: 80299 Liquid Chromatography/Mass Spectrometry No additive (red top) Clinical Use: Maprotiline is used to treat depression, manic depression and 2.0(1.0) mL serum anxiety. Therapeutic drug monitoring is useful to optimize dose Transfer serum to a plastic, screw-cap vial. and avoid toxicity. Optimum time to collect sample is 10-14 hours post oral dose.

Performed: referred-A Do not use Gel barrier (gold or tiger top) tubes. turn around: 5-7days

83373 LUPUS ANTICOAGULANT PROFILE Accompanies report Specimen Container: 85597 Enzyme Immunoassay 3.2% Sodium Citrate (light blue top) and 85610 Clot Detection Clinical Use: No additive (red top) 85613 Antiphospholipid antibodies are found in a wide range of 85670 Test components: conditions, either transiently such as in some infectious 6.0 (4.0) mL FROZEN Platelet-Poor plasma 85730 (x2) Anti-Cardiolipin Antibody Panel, dRVVT Screen w/rfl dRVVT Confirm & dRVVT1:1 Mix, diseases, or more persistantly in autoimmune diseases such and 86147 (x2) Mixing Study, Prothrombin Time with INR, PTT-LA w/Reflex to Hexagonal Phase Confirmation, as SLE. Antiphospholipid antibodies are associated with fetal 1.0 (0.6) mL FROZEN serum Thrombin Clotting Time loss, endocarditis, stroke, heart attack and autoimmune Transfer serum to plastic, screw-cap vial and freeze hemolytic anemia. Platelet Poor Plasma Collection Instructions: 1) Draw one red top tube to remove tissue fluid contamination. 2) Draw 4 light blue top tubes, filled to the appropriate level. (Do not overfill or underfill) 3) Invert gently 6 times to mix, process immediately. 4) Centrifuge for 15 minutes at 2500 x g 5) Using a plastic pipette, remove plasma, taking care to avoid the wbc/platelet buffy layer, and place into a plastic vial. 6) Centrifuge a second time for 15 minutes and transfer platelet-poor plasma into 4 separate plastic, screw-cap vials. Label tubes appropriately. 7) Freeze immediately. Performed: referred-A turn around: 3-5 days

85611 LUPUS ANTICOAGULANT PROFILE #3 Accompanies report Specimen Container: 85610 Various 3.2% Sodium Citrate (light blue top) 85613 Clinical Use: 85730 (x2) Test components: Antiphospholipid antibodies are found in a wide range of 6.0 (4.0) mL FROZEN Platelet-Poor plasma Activated Partial Thromboplastin Time, dRVVT Screen w/rfl dRVVT Confirm & dRVVT1:1 Mix, conditions, either transiently such as in some infectious Mixing Study, Prothrombin Time with INR diseases, or more persistantly in autoimmune diseases such Platelet Poor Plasma Collection Instructions: as SLE. Antiphospholipid antibodies are associated with fetal 1) Draw one red top tube to remove tissue fluid loss, endocarditis, stroke, heart attack and autoimmune contamination. hemolytic anemia. 2) Draw 4 light blue top tubes, filled to the appropriate NICL Laboratories/2011 level. (Do not overfill or underfill) TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 3) Invert gently 6 times to mix, process immediately. 4) Centrifuge for 15 minutes at 2500 x g 5) Using a plastic pipette, remove plasma, taking care to avoid the wbc/platelet buffy layer, and place into a plastic vial. 6) Centrifuge a second time for 15 minutes and transfer platelet-poor plasma into 4 separate plastic, screw-cap vials. Label tubes appropriately. Performed: referred-A 7) Freeze immediately. turn around: 3-5 days

86617 LYME DISEASE Ab (IgG), WESTERN BLOT Negative Specimen Container: 86617 WESTERN BLOT Gel barrier (gold or tiger top) Clinical Use: Lyme disease is caused by the bacterium, Borrelia burgdorferi, 1.0 (0.1) mL serum and is transmitted by ticks. Western blot testing qualitatively examines, with high specificity, antibodies in a patient's specimen. Western blot testing is appropriate for confirming a Detected Performed: referred-A EIA or IFA test result. turn around: 3-5 days

84182 LYME DISEASE Ab (IgG, IgM), WESTERN BLOT B. burgdorferi IgG Ab: Negative Specimen Container: 86617 (x2) WESTERN BLOT B. burgdorferi IgM Ab: Negative Gel barrier (gold or tiger top) Caution must be used in supporting a diagnosis of B. burgdorferi infection, when sera are Western blot IgM positive and Western 1.0 (0.2) mL serum blot IgG negative after the initial 4-week period from onset. Because the likelihood of a false-positive test result is high for these individuals, a positive IgM test alone is not recommended for use in determining active disease in persons will illness of longer than one month's duration.

Clinical Use: Lyme disease is caused by the bacterium, Borrelia burgdorferi, and is transmitted by ticks. Western blot testing qualitatively examines, with high specificity, antibodies in a patient's specimen. Western blot testing is appropriate for confirming a Detected Performed: referred-A EIA or IFA test result. turn around: 3-5 days

86259 LYME DISEASE ANTIBODIES < 0.91: Negative Specimen Container: 86618 Immunoassay Gel barrier (gold or tiger top) Western Blot Clinical Use: Lyme disease is caused by the bacterium, Borrelia burgdorferi, 1.0 (0.5) mL serum Positive EIA results will be confirmed by and is transmitted by ticks. Western blot testing qualitatively Lyme IgG and IgM Western Blot at an additional charge. examines, with high specificity, antibodies in a patient's specimen. Western blot testing is appropriate for confirming a Detected Performed: referred-A EIA or IFA test result. turn around: 3-5 days

86361 LYMPHOCYTE SUBSET PANEL 4 Accompanies report Specimen Container: 86360 Flow Cytometry EDTA (lavender top) Clinical Use: Assists in evaluating helper/suppressor cell immune status in 5.0 (1.0) mL whole blood immunodeficiency diseases such as AIDS. Performed: referred-A Transport at room temperature turn around: 3-5 days

86360 LYMPHOCYTE SUBSET/NK CELL Accompanies report Specimen Container: 86360 EDTA (lavender top) 86357 Flow Cytometry Clinical Use: 86355 Immunophenotyping analysis may assist in evaluating cellular 5.0 (1.0) mL whole blood 86359 immunocompetency in suspected cases of primary and Performed: Mon-Sat a.m. and p.m secondary immunodeficiency states. Transport at room temperature turn around: next day NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

85548 LYSOZYME (MURAMIDASE) 7.0-15.0 mcg/mL Specimen Container: 85549 Gel barrier (gold or tiger top) Clinical Use: Enzymatic Lysozyme plays an important role in a host's defense against 2.0 (1.0) mL FROZEN serum microorganisms. Lysozyme concentrations are increased in Centrifuge serum specimens within 1 hour of collection, patients with acute myelocytic leukemia with monocytic transfer serum to a plastic, screw-cap vial, freeze differentiation (FAB M4/M5). Concentrations may also be increased in patients with other leukemias, sacoidosis, and infections such as tuberculosis. With sarcoidosis, Lysozyme Performed: referred-A may be useful in monitoring disease and treatment. turn around: 3-5 days

87556 M. TUBERCULOSIS COMPLEX BY TMA No M. tuberculosis Complex rRNA detected Specimen Container: 87556 Transcription Mediated-Amplification Sterile, leak-proof container College of American Pathologists recommend that.all specimens submitted for Mycobacterium tuberculosis Complex Direct 5.0 (3.0) mL Sputum, Bronchial brush/wash, or Direct detection by TMA be cultured for Mycobacterium Transtracheal aspirate, refrigerated. tuberculosis. Specimen source is required. Test will not be Performed: referred-A performed unless specimen source is provided. turn around: 5-7 days

13740 MAGNESIUM, SERUM 1.6 - 2.4 mg/dL Specimen Container: 83735 Spectrophotometric Gel barrier (gold or tiger top) Clinical Use: Magnesium measurements are used in the diagnosis and 1.0 (0.5) mL serum treatment of hypomagnesemia (abnormally low plasma levels of magnesium) and hypermagnesemia (abnormally high plasma levels of magnesium). Magnesium is decreased in chronic nephritis, acute pancreatitis, and alcoholic cirrhosis, and after prolonged parenteral administration. It is increased in acute Performed: daily or chronic renal failure and Addison's disease. turn around: next day

83735 MAGNESIUM, 24 HR URINE Males: 28-180 mg/24 h Specimen Container: 83735 Atomic Absorption Spectroscopy Females: 18-130 mg/24 h 24 hour urine collection container, with 25 mL 50% acetic acid Clinical Use: Urinary magnesium concentrations often decline before serum 10.0 (1.0) mL aliquot of a well mixed 24-hr urine concentrations. Adverse effects, such as cardiac arrhythmias, specimen. can be observed while serum concentrations are within range. Please specify on the request form and on the urine Performed: referred-A container the total 24-hour urine volume. turn around: 3-5 days

83737 MAGNESIUM, RANDOM URINE w/CREATININE 22 - 130 mg/g Creat Specimen Container: 83735 Atomic Absorption Sterile urine container, leak-prof 82570 Clinical Use: Urinary magnesium concentrations often decline before serum 10.0 (0.5) mL random urine, refrigerated concentrations. Adverse effects, such as cardiac arrhythmias, Performed: referred-A can be observed while serum concentrations are within range. turn around: 3-5 days

87207 MALARIA/BABESIA IDENTIFICATION None detected Specimen Container: 87207 Microscopic Examination A single negative result does not rule out the possibility of a EDTA (lavender top) parasitic infection. If symptoms persist, suggest retesting, if clinically indicated. 1.0 (0.5) mL whole blood, room temperature

Clinical Use: Blood samples are to be taken when the patient Malaria, a protozoan parasitic infection, remains the most presents with symptoms of malaria, and every 6 common infectious disease in subtropical and tropical parts hours for 36 hours. Specimens obtained during of the world. The mosquito genus Anopheles, spreads the febrile state yield the greatest number of parasites Plasmodium to people. Appropriate therapy depends upon in circulating blood. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE identifying the specific species found in infected erythrocytes. Babesia microti and B. divergens are tick-borne protozoan parasites that also infect erythrocytes. The clinical presentation Performed: referred-A of babesiosis can resemble malaria. turn around: 3-5 days

83800 MAPLE SYRUP DISEASE (MSUD) MUTATION ANALYSIS Accompanies report Specimen Container: 83891 Polymerase Chain Reaction EDTA (lavender top) 83900 Capillary Electrophoresis Clinical Use: 83901 1. To identify disease-causing mutations in Ashkenazi-Jewish 4.0 (3.0) mL whole blood, room temperature 83909 individuals affected with Maple Syrup Urine Disease (MSUD). 83912 2. To identify carriers in the Ashkenazi-Jewish population or in 83892 (x3) individuals with a positive family history 83914 (x3) 3. Prenatal diagnosis of Maple Syrup Urine Disease in at-risk Performed: referred-A couples turn around: 10-14 days

83513 MELATONIN Accompanies report Specimen Container: 83519 High Performance Liquid Chromatography EDTA (lavender top) Clinical Use: Altered patterns and/or levels of melatonin secretion have been 2.0 (1.0) mL FROZEN plasma reported to coincide with sleep disorders, “jet lag”, depression, Transfer plasma to a plastic, screw-cap vial, freeze. schizophrenia, hypothalamic amenorrhea, pregnancy, anorexia nervosa and some forms of cancer as well as control of sexual Patient should be drawn during the nighttime dark Performed: referred-A maturation during puberty. cycle (2-4 a.m.) for baseline specimens. Patient turn around: 14-17 days

80270 MERCAPTOPURINE, BLOOD Accompanies report Specimen Container: 80299 High Performance Liquid Chromatography EDTA (lavender top) Mercaptopurine can be administered as a drug (antineoplastic), Performed: referred-A and it is also a metabolite of azathiopurine (immunosuppressive). 3.0 (0.7) mL whole blood, FROZEN turn around: 5-7 days

83825 MERCURY, BLOOD ≤10 mcg/L Specimen Container: 83825 Inductively Coupled Plasma-Mass Spectrometry EDTA Trace Element (royal blue top) Clinical Use: The primary Clinical Use: of blood mercury is the determination 4.0 (2.0) mL whole blood, refrigerated of abnormal exposures seen at levels over 20 mcg/L. Mercury is absorbed via the respiratory tract (mercury vapors), skin, and To avoid contamination, use powderless gloves. gastrointestinal tract. Mercury poisoning can cause kidney Do not aliquot specimens. Patient should refrain damage. The chronic effect of mercury poisoning includes from eating predatory fish, such as swordfish, tuna, inflammation of mouth and gums, loosening of the teeth, kidney and shark, at least 3 days before specimen collection. Performed: referred-A damage, nervousness, depression, and spasms. turn around: 3-5 days

83830 MERCURY, RANDOM URINE Accompanies report Specimen Container: 83825 Inductively Coupled Plasma-Mass Spectrometry Urine container, acid washed/metal free 82570 Clinical Use: Mercury, a highly toxic metal, is present in select industrial 7.0 (5.0) mL random urine, refrigerated environments and in contaminated ocean fish. Urinary measurements are appropriate for assessing ongoing exposure Clinical monitoring: Collect second voided a.m. urine to inorganic mercury Industrial monitoring: Collect urine preshift.

To avoid contamination, use powderless gloves. Fish, shellfish, and kelp should not be consumed Performed: referred-A for at least one week before specimen collection. turn around: 3-5 days

83835 METANEPHRINE, FRACTIONATED 24 HOUR URINE Accompanies report Specimen Container: 83835 Liquid Chromatography/Tandem Mass Spectrometry 24 hour urine collection container, with 25 mL 6N HCL Clinical Use: Test is useful in the evaluation of pheochromocytoma. 5.0 (1.5) mL aliquot of a well mixed 24-hr urine

It is preferable for the patient to be off medications NICL Laboratories/2011 for three days before collection. Patient should avoid TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE tobacco, tea, coffee for three days before specimen collection. Common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Medications which are alpha agonists (Aldomet), alpha blockers (Dibenzyline) should be avoided 18-24 hours before Performed: referred-A specimen collection. turn around: 5-7 days

83836 METANPHRINE, FRACTIONATED PLASMA Metanephrine: ≤57 pg/mL Specimen Contaner: 83835 Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS) Normetanephrine: ≤148 pg/mL EDTA (lavender top) Total Metanephrine: ≤205 pg/mL 2.5 (1.5) mL plasma

Clinical Use: Draw specimen in a pre-chilled EDTA lavender Normetanephrine (NM) and metanephrine (MN) are the extra- top. The whole blood sample should be kept on neuronal catechol-o-methyl transferase (COMT) metabolites of wet ice until centrifuged (within two hours of the catecholamines norepinephrine and epinephrine, respectively. collection). Transfer plasma to a plastic, screw- Measurement of plasma metanephrines is more sensitive (but cap vial and refrigerate immediately. may be less specific) than measurement of catecholamines for the detection of pheochromocytoma. Proper interpretation of Patient should avoid alcohol, coffee, tea, tobacco results requires awareness of recent medication/drug history and strenuous exercise prior to collection. Overnight (e.g., antyhypertensive agents, alcohol, cocaine) and other fasting is preferred. Patients should be relaxed in pre-analytical factors (e.g., stress, severe congestive heart either a supine or upright position before blood is failure, myocardial infarction) that influence release of drawn. Performed: referred-A catecholamines and metanephrines. turn around: 3-5 days

83050 METHEMOGLOBIN 0.0 - 1.6% Specimen Contaner: 83050 Spectrophotometry EDTA (lavender top) Clinical Use: Used in diagnosing methemoglobinemia and sulfhemoglobinemia, 5.0 (0.5) mL whole blood and in identifying cyanosis due to other causes, such as Performed: referred-A congenital heart disease. turn around: 3-5 days

47109 METHICILLIN RESISTANT STAPH AUREUS SCREEN No Methicillin-resistant Staph aureus isolated Specimen Container: 87081 Culture Culture transport swab (pink cap) Clinical Use: If culture is positive, identification will be performed at an additional charge. MRSA (Methicillin resistant Staphlococci aureus) is a major Nasal or Skin specimen Antibioitic sensitivities are only performed when appropriate. cause of nosocomial infections and is highly resistant to treatment. Most transmissions occur through the contaminated hands of a Nose specimen: person carrying S. aureus. While S. aureus causes infections with Insert a premoistened swab about 2 cm. Rotate the clinical manifestations ranging from pustules to sepsis and death, swab against the nasal mucosa and submit the swab it is commonly found in the nose or on the skin of healthy in Culture Transport Medium, room temperature. individuals (asymptomatic carriers). Skin specimen: Rub premoistened swab against skin and submit the Performed: daily swab in Culture Transport Medium, room temperature. turn around: 2-4 days

87641 METHICILLIN RESISTANT STAPH AUREUS, PCR Not detected Specimen Contaner: 87641 Polymerase Chain Reaction Culture transport swab (pink cap) Clinical Use: Test is for the rapid, direct detection of nasal colonization by Nasal swab MRSA. Test aids in the prevention and control of MRSA infections in healthcare settings. Collection procedure: Swab must be inserted into nostril up to 2.5 cm (1 inch) from edge of the nare and rolled 5 times. Repeat using same swab in the other nostril. Return swab Performed: referred-A to its container immediately. turn around: 3-5 days

80283 METHOTREXATE, SERUM < 5.00 umol/L at 24 hours Specimen Contaner: 80299 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Immunoassay < 0.50 umol/L at 48 hours No additive (red top) < 0.20 umol/L at 72 hours For conventional low dose leucovorin rescue. 1.0 (0.2) mL FROZEN serum Transfer serum to plastic, screw-cap vial, freeze. Wrap in foil to protect from light. Clinical Use: Methotrexate is used primarily as a chemotherapeutic agent and occasionally in treating autoimmune diseases and ectopic Collect 24, 48, or 72 hours after dose. pregnancy. Therapeutic drug monitoring is useful in optimizing Record hours from last dose on specimen vial Performed: referred-A dose and to avoid toxicity. and on test requisition. turn around: 3-5 days

83918 METHYLMALONIC ACID & HOMOCYSTEINE Methylmalonic Acid Specimen Container: 83090 Tandem Mass Spectometry 87-318 nmol/L Gel barrier (gold or tiger top) 83921 Fluorescence polarizaton Immunoassay Homocysteine (Nutritional & Congenital) 5.4-11.9 umol/L 2.0 (1.0) mL FROZEN serum

Homocysteine levels are increased in vitamin B12 and Folate Place the specimen in a refrigerator for 30 minutes deficiencies. Methylmalonic acid (MMA) Analysis differentiates after collection. Centrifuge the specimen as soon as the two disorders. possible after complete clot formation has taken place. Transfer serum to a plastic, screw-cap vial and freeze Vitamin Defic: B12/Folate Homocysteine: Elevated/Elevated A fasting specimen is required. MMA: Elevated/Normal

Clinical Use: Methylmalonic acid (MMA) and homocysteine are useful to diagnose and monitor vitamin B12 (cobalamin) and folic acid deficiency. These tests are often useful in evaluating macrocytosis Performed: referred-A (an elevated MCV, an erythrocytic index). turn around: 3-5 days

82190 METHYLMALONIC ACID, SERUM 87-318 nmol/L Specimen Container: 83291 Tandem Mass Spectometry Gel barrier (gold or tiger top) Clinical Use: Test is useful in the determination of certain genetic disorders 1.0 (0.5) mL FROZEN serum and Vitamin B12 deficiency. Place the specimen in a refrigerator for 30 minutes after collection. Centrifuge the specimen as soon as possible after complete clot formation has taken place. Transfer serum to a plastic, screw-cap vial and freeze

Performed: referred-A A fasting specimen is required. turn around: 3-5 days

83919 METHYLMALONIC ACID, URINE Accompanies report Specimen Container: 83921 Liquid Chromatography/Tandem Mass Spectrometry Sterile urine container, leak-prof 82570 Clinical Use: Methylmalonic Acid (MMA) is useful to diagnose and monitor 2.0 (0.6) mL random urine, no preservative Vitamin B12 (cobalamin) deficiency, and to diagnose and monitor Performed: referred-A patients with methylmalonic acidemia. turn around: 7-10 days

84916 METHYLPHENIDATE (RITALIN ) 5-40 (Peak) ng/mL Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Methylphenidate is a stimulant that is useful in treating depression, 1.0 (0.5) mL FROZEN serum. narcolepsy, and childhood hyperkinesis. Methylphenidate is also Transfer to a plastic, screw-cap vial, freeze. a drug of abuse. Therapeutic drug monitoring is useful to Performed: referred-A optimize dose and avoid toxicity. Draw specimen 1-3 hours post oral dose. turn around: 7-10 days

84909 MEXILETINE (MEXITIL) Accompanies report Specimen Container: 80299 Gas Chromatography NICL Laboratories/2011 No additive (red top) TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Mexiletine is a class I B antiarrhythmic with electrophysiologic 2.0 (0.7) mL serum properties similar to lidocaine and is useful in suppression of Transfer to a plastic, screw-cap vial ventricular arrhythmias. Therapeutic drug monitoring is useful to Performed: referred-A optimize dose and avoid toxicity. Collect specimen prior to next dose. turn around: 7-10 days

22043 MICROALBUMIN, 24 HOUR * Category Results (mg/24 hours) Specimen Container: 82043 Normal < 30 24 hour Urine Collection Container, no preservative Microalbuminuria 30-299 Clinical albuminuria ≥ 300 5.0 (2.0) mL aliquot of a well-mixed 24-hr urine

The ADA recommends that at least two of three specimens collected within a 3-6 month period be abnormal before considering a patient to be within a diagnostic category.

Clinical Use: Microalbuminis is albumin excreted in the urine and is a sensitive marker of nephropathy. It is used to screen for Performed: mon-sat early renal disease patients. turn around: 1-2 days

22045 MICROALBUMIN, RANDOM URINE * No reference ranges have been established Specimen Container: 82043 Urine container, leakproof 82570 Clinical Use: Microalbuminis is albumin excreted in the urine and is a 5.0 (2.0) mL random urine, no preservative sensitive marker of nephropathy. It is used to screen for Performed: mon-sat early renal disease patients. turn around: 1-3 days

80281 MIRTAZAPINE, BLOOD Accompanies report Specimen Container: 80299 Gas Chromatography EDTA (lavender top) Clinical Use: Therapeutic drug monitoring is useful to optimize dose and avoid 3.0 (1.2) mL whole blood Performed; referred-A toxicity. turn around: 5-7 days

16300 MONO SCREEN, QUALITATIVE Negative Specimen Container: 86308 Latex Agglutination Gel barrier (gold or tiger top) Clinical Use: The diagnosis of infectious mononucleosis (IM) is suggested on 1.0 (0.5) mL serum the basis of the clinical symptoms of fever, sore throat and swollen lymph glands. The highest incidence of symptomatic IM occurs during late adolescence (15-24 years of age). Infectious Performed: mon - sat mononucleosis is caused by the Epstein-Barr Virus (EBV). turn around: next day

83925 MORPHINE, QUANTITATIVE, Urine 10-200 ng/mL Specimen Container: 83925 Gas Chromatography Mass Spectrometry No additive (red top) Clinical Use: Useful for monitoring morphine therapy. 5.0 (2.5) mL serum Performed; referred-A Transfer serum to a plastic screw-cap vial. turn around: 5-7 days

METHYLENETETRAHYDROFOLATE REDUCTASE (MTHFR) 83889 ACTIVITY Accompanies report Specimen Container: 83891 Invader Assay/Signal Amplification EDTA (lavender top) 83892 (x2) Clinical Use: 83896 (x4) This test is used for follow-up evaluation in individuals with 5.0 (3.0) whole blood 83908 (x2) hyperhomocysteinemia; evaluation of patients with venous 83912 Performed; referred-A thrombosis. turn around: 7-10 days

83904 MUCOLIPIDOSIS TYPE IV MUTATION ANLAYSIS Accompanies report Specimen Container: 83891 NICL Laboratories/2011 EDTA (lavender top) 83892 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Polymerase Chain Reaction Clinical Use: 83898 Allele specific primer extension Mucolipidosis IV (mLIV) is an autosomal recessive, lysosomal 4.0 (3.0) whole blood 83909 Fluorescent detection/color coded microspheres storage disease, characterized by psychomotor retardation, 83912 and ophthalmologic abnormalities that include corneal opacities Transport at room temperature. 83914 (x2) and retinal degeneration. This disease occurs primarily in individuals of Ashkenazi-Jewish descent, and has an estimated Performed: referred-A carrier frequency of 1 in 100 in this population. turn around: 10-14 days

86735 MUMPS AB, IgM < 8 U/mL None detected Specimen Container: 86735 Enzyme Immunoassay 8-12 U/mL Equivocal Gel barrier (gold or tiger top) > 12 U/mL Positive 1.0 (0.5) mL serum Clinical Use: Performed: referred-A Used to aid in the diagnosis of acute mumps infection. turn around: 3-5 days

16908 MUMPS IgG ≤0.90 Negative Specimen Container: 86735 Enzyme Immunoassay 0.91-1.0 Equivocal Gel barrier (gold or tiger top) ≥ 1.10 Positive 1.0 (0.1) mL serum A positive result indicates that the patient has antibody to Mumps Virus. It does not differentiate between an active or past infection. The clinical diagnosis must be interpreted in conjunction with the clinical signs and symptoms of the patient.

Clinical Use: Mumps is an acute, usually self-limited systemic illness characterized by parotidites, high fever and fatigue. One-third of infections are asymptomatic. A live atenuated vaccine is available. The Mumps EIA IgG antibody test is sufficiently Performed: referred-A sensitive to establish immune status of the patient. turn around: 3-5 days

87257 MUMPS VIRUS CULTURE Negative Specimen Container: 87252 Culture VCM Collection Kit B 87253 Clinical Use: Mumps is an acute, usually self-limited systemic illness Do not use is media is yellow characterized by parotidites, high fever and fatigue. One-third of infections are asymptomatic. 3.0 (1.0) Oral/Buccal swab or Throat swab or Saliva in VCM, refrigerate

Performed: referred-A Transport at refrigerated temperature turn around: 16-18 days

84002 MUSK ANTIBODIES Accompanies report Specimen Container: 83519 Radioimmunoassay Gel barrier (gold or tiger top) Clinical Use: Test evaluates the presence of quantitative antibodies 2.0 (1.0) mL serum Performed: referred-A to muscle-specific receptor tyrosine kinase (MuSK). turn around: 18-21 days

84241 MYASTHENIA GRAVIS PANEL 2 Accompanies report Specimen Container: 83519 (x3) Radioimmunoassay Gel barrier (gold or tiger top) Radiobinding Assay Clinical Use: Myasthenia gravis is a neurological disorder characterized by 2.0 (0.7) mL serum a decrease in acetylcholine receptors. Patients exhibit skeletal weakness and fatigability. Approximately 80% of patients with myasthenia gravis, excluding ocular involvement only, have Performed: referred-A detectable acetylcholine receptor antibody. turn around: 5-7 days

80311 MYCOPHENOLIC ACID Specimen Container: 83789 Liquid Chromatography/Tandem Mass Spectrometry 1.0-3.5 mcg/mL No additive (red top) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

Clinical Use: 1.0 (0.5) mL serum Mycophenolic acid is an immunosuppressant used in tissue Transfer to a plastic screw-cap vial. transplants. It prevents graft rejection by the Host's immune system. It is very important to monitor Its level. Too little of this drug will cause graft rejection, while too much will lead to infection. Monitoring its level is essential to optimize Performed: referred-A therapeutic effects, avoid toxicity, and assure compliance. turn around: 5-7 days

86174 MYCOPLASMA PNEUMONIA ANTIBODY, IGG ≤0.90 Negative Specimen Container: 86738 Enzyme Immunoassay 0.91-1.09 Equivocal Gel barrier (gold or tiger top) ≥ 1.10 Positive A positive result indicates that the patient has antibody to 1.0 (0.2) mL serum Mycoplasma. It does not differentiate between an active or past infection. The clinical diagnosis must be interpreted in conjunction with the clinical signs and symptoms of the patient.

Clinical Use: Mycoplasma are the smallest of the free-living organisms. M. pneumoniae causes approximately 10-20% of all cases of pneumonia. These pneumonias that can affect otherwise healthy individuals, are commonly referred to as walking Performed: referred-A and atypical pneumonias. turn around: 3-5 days

86739 MYCOPLASMA PNEUMONIA Ab, IgG & IgM Accompanies report Specimen Container: 86738 x2 Gel barrier (gold or tiger top) Clinical Use: Mycoplasma are the smallest of the free-living organisms. 2.0 (0.5) mL serum M. pneumoniae causes approximately 10-20% of all cases of pneumonia. These pneumonias that can affect otherwise healthy individuals, are commonly referred to as walking Performed: referred-A and atypical pneumonias. turn around: 3-5 days

87109 MYCOPLASMA, PNEUMONIA CULTURE Negative for Mycoplasma pneumoniae Specimen Container: 87109 Culture VCM Collection Kit B Clinical Use: Do not use if media is yellow Mycoplasma are the smallest of the free-living organisms. M. pneumoniae causes approximately 10-20% of all cases Throat swabs, Sputum, Bronchial washes, and of pneumonia. These pneumonias that can affect otherwise other respiratory sites in VCM transport medium, healthy individuals, are commonly referred to as walking refrigerated. Performed: referred-A and atypical pneumonias. turn around: 38-40 Days

83874 MYOGLOBIN, SERUM Adult Male: ≤50 mcg/L Specimen Container: 83874 Nephelometric Adult Female: ≤30 mcg/L Gel barrier (gold or tiger top)

Clinical Use: 2.0 (1.0) mL serum Test is for the assessment of skeletal muscle breakdown Performed: referred-A (Rhabdomyolysis). turn around: 3-5 days

83875 MYOGLOBIN, URINE < 28 mcg/L Specimen Container: 83874 Fixed Rate Time Nephelometry Sterile urine container, leak-prof Clinical Use: The breakdown of skeletal muscle (rhabdomyolysis) 3.0 ( 0.5) mL FROZEN random urine. releases myoglobin. Very high concentrations of Myoglobin may increase the risk of acute renal failure. Pour an aliquot of a well mixed random urine in a Performed: referred-A urine vial, freeze. turn around: 3-5 days

84230 NEURON SPECIFIC ENOLASE Accompanies report Specimen Container: 86316 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: NSE is useful in monitoring disease progression and therapy 1.0 (0.2) mL serum in patients with small cell lung cancer and neuroendocrine tumors, such as neuroblastoma, medullary thyroid carcinoma and pheochromocytoma, and other malignancies such as pancreatic Performed: referred-A islet cell carcinoma. turn around: 5-7 days

83885 NICKEL, SERUM/PLASMA Accompanies report Specimen Container: 83885 Inductively Coupled Plasma-Mass Spectrometry EDTA trace metal-free (royal blue top) Clinical Use: Test is for overexposure/poisoning determination abd 1.0 (0.4) mL plasma. Performed: referred-A evaluation of orthopedic implants. Transfer plasma to a plastic, screw-cap vial. turn around: 5-7 days

82506 NOREPINEPHRINE, PLASMA Accompanies report Specimen Container: 82491 High Performance Liquid Chromatography Sodium heparin (green top) Clinical Use: Plasma norepinephrine is an independent risk factor in patients 4.0 (2.5) mL FROZEN plasma with chronic congestive heart failure that relates to subsequent mortality. Norepinephrine is useful in evaluating patients Centrifuge within 30 minutes of collection, transfer with hypertension. plasma to a plastic, screw-cap vial and freeze.

Patient should avoid alcohol, coffee, tea, tobacco, and strenuous exercise before collection.

Performed: referred-A Overnight fasting is required. turn around: 5-7 days

11005 NORTRIPYLINE * 50-140 mcg/L Specimen Container: 80182 No additive (red top) Clinical Use: Nortriptyline is a tricyclic antidepressant used in the treatment 3.0 (1.0) mL serum. of depressive disorders. Therapeutic drug monitoring is useful Transfer serum to a plastic, screw-cap vial. in optimizing dosage and avoiding toxicity. Toxicity can lead to arrhythmias, coma and death. Collect just before next dose or at least 12 hours after last dose.

Performed: referred-A Do not use Gel barrier (gold or tiger top) tubes turn around: 3-5 days

87451 NORWALK-LIKE VIRUS (NOROVIRUS) ANTIGEN Negative Specimen Container: 87449 Enzyme Immunoassay Sterile container, leak-proof Clinical Use: Norovirus, also called Norwalk-like virus, is a major cause of viral 2.0 (1.0) g stool, FROZEN gastroenteritis and has been associated with many close-contact outbreaks including in hospitals, schools, cruise ships, and Transport frozen residential homes. Detection of Norovirus antigen is important for patient and public health management and helps to provide Performed: referred-A diagnosis of the gastroenteritis. turn around: 7-10 days

82526 N-TELOPEPTIDE (OSTEOMARK) WITH CREATININE, URINE Accompanies report Specimen Container: 82523 Chemiluminescence 24-hour Urine Collection Container, no preservative 82570 Clinical Use: Predicting skeletal response to antiresorptive therapy. In post- 2.0 (1.0) mL aliquot of a well-mixed 24-hr urine menopausal women, baseline N-Telopeptide (NTx) values are associated with significant risk of bone loss (as measured by bone mineral density). A greater than 30% decrease from baseline after 6 months of hormone replacement therapy or a greater than 40% decrease from baseline after 3 months of antiresorptive therapy (alendronate sodium) indicates a Performed: referred-A significant therapeutic effect. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 5-7 days

22274 OCCULT BLOOD, IMMUNOASSAY (1-3 SPECIMEN) Negative Specimen Container: 82274 Immunochemical Hemoccult® ICT Collection Card(s) Clinical Use: The presence of fecal occult blood in the stool is associated with 1.0 g random stool sample gastrointestinal disorders such as diverticulitis, polyps, and Crohn’s disease that may lead to colorectal cancer if not treated. Both halves of the window should be innoculated Early diagnosis by fecal occult blood screening and treatment of with samples taken from different parts of the sample. these problems has been shown to significantly reduce mortality from colorectal cancer. Immunological tests developed to detect Indicate date and time of collection on each test card. human hemoglobin are more accurate than conventional tests Performed: daily and do not require special dietary restrictions on patients. turn around: next day

22270 OCCULT BLOOD, 1-3 Specimens Negative Specimen Container: 82272 Peroxidase Activity Hemoccult slide(s) Clinical Use: Positive results suggest gastrointestinal bleeding from causes 1.0 g random stool sample including colorectal cancer, polyps, peptic ulcers, or hemorrhoids. Both windows on the Hemoccult test card should be inoculated with thin smear of the same stool for each of 1-3 samples.

Indicate date and time of collection on each test card.

Patient should avoid non-steroidal anti-inflammatory drugs such as Ibuprofen, Naproxen, or aspirin for 7 days prior to testing. Avoid Vitamin C in excess of 250 mg from either supplements or citrus fruits and juices for 3 days prior to testing, and avoid red meats Performed: mon-sat for 3 days prior to testing. turn around: 1-2 days

12273 OCCULT BLOOD, SINGLE SPECIMEN Negative Specimen Container: 82272 Peroxidase Activity Hemoccult slide Clinical Use: Positive results suggest gastrointestinal bleeding from causes Both windows on the Hemoccult test card including colorectal cancer, polyps, peptic ulcers, or hemorrhoids. should be inoculated with thin smear of the same stool.

Indicate date and time of collection on test card.

Patient should avoid non-steroidal anti-inflammatory drugs such as Ibuprofen, Naproxen, or aspirin for 7 days prior to testing. Avoid Vitamin C in excess of 250 mg from either supplements or citrus fruits and juices for 3 days prior to testing, and avoid red meats Performed: mon-sat for 3 days prior to testing. turn around: 1-2 days

84001 OLANZEPINE Accompanies report Specimen Use: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Therapeutic drug monitoring of antipsychotic drug to optimize 3.0 (2.0) mL serum dose and avoid toxicity Transfer serum to a plastic, screw-cap vial

Performed: referred-A turn around: 5-7 days

83930 OSMOLALITY, SERUM 280 - 300 mosmol/kg Specimen Container: 83930 Freezing Point Depression Gel barrier (gold or tiger top) Clinical Use: Serum osmolality is increased in hypernatremia, hyperglycemia, 3.0 (0.5) mL serum uremia, ethanol, methanol, or ethylene glycol overdoses, and in Performed: referred-A diabetes insipidus. turn around: 3-5 days NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

84998 OSMOLALITY, STOOL Accompanies report Specimen Container: 84999 Freezing Point Depression Plastic container, leak-proof Clinical Use: Used in conjunction with a serum osmolality to calculate an 1.0 (0.2) mL stool, FROZEN osmotic gap. Diagnosis of factitious diarrhea (where patient Performed: referred-A adds water to stool to simulate diarrhea). Formed stool will not be accepted. turn around: 3-5 days

83935 OSMOLALITY, URINE Female: 300-1090 mosmol Specimen Container: 83935 Freezing Point Depression Male: 390-1090 mosmol Sterile urine container, leak-prof

Clinical Use: 1.0 (0.2) mL random urine, refrigerated Performed: referred-A Assessing the concentrating and diluting ability of the kidney. turn around: 3-5 days

83937 OSTEOCALCIN Pediatrics: Males Females Specimen Container: 83937 Electrochemiluminescence (ECLIA) 0 - 4 years: Not established Not established Gel barrier (gold or tiger top) 5 - 9 years: 47-142 ng/mL 47-142 ng/mL 10-13 years: 49-167 ng/mL 49-167 ng/mL 14-17 years: 26-203 ng/mL 14- 85 ng/mL 1.0 ( 0.5) mL FROZEN serum. Transfer serum to a plastic, screw-cap vial, freeze. Adults: Males Females 9- 38 ng/mL 8- 32 ng/mL

Clinical Use: Osteocalcin, the most abundant noncollagen protein in bone matrix, is a bone-specific, calcium binding protein. Serum osteocalcin levels are related to the rate of bone turnover in various disorders of bone metabolism, e.g., osteoporosis, primary and secondary hyperparathyroidism, and Paget's Performed: referred-A disease. turn around: 5-7 days

47177 OVA AND PARASITES (O & P) No Ova or Parasite seen Specimen Container: 87177 Microscopic Proto-fix CLR preservative vial (white cap) 87209 Clinical Use: The detection and identification of small numbers of helminth eggs 5 g stool, add stool specimen up to the red line as and protozoa from large volumes of feces is of critical importance indicated on the stool collection vial. in the diagnosis of intestinal parasitic infections. The use of concentration procedures virtually ensures the detection of even Interfering substances-bismuth, barium (wait 7-10 small numbers of these organisms. days), antimicrobial agents (wait 2 weeks), gall bladder Performed: mon, wed, fri dye (wait 3 weeks after procedure) turn around: 1-3 days

83945 OXALATE, 24 HR. URINE Accompanies report Specimen Container: 83945 Spectrophotometric 24 hour Urine Collection Container, with 25 mL 6N HCL 82570 Clinical Use: Excessive oxalates in the urine may lead to oxalate kidney stones. 10.0 (2.0) mL aliquot of a well mixed 24-hr urine Hyperoxaluria may be due to a rare inherited metabolic disorder in which the body produces excess of the salt oxalate leading to Patient should refrain from taking excessive amounts stone formation. of Ascorbic Acid or Oxalate-rich foods (i.e. spinach, coffee, tea, chocolate, rhubard) for at least 48 hours Performed: referred-A before the collection period. turn around: 3-5 days

83507 PANCREATIC POLYPEPTIDE Accompanies report Specimen Container: 83519 Extraction EDTA (lavender top) Radioimmunoassay Clinical Use: Pancreatic polypeptide tests are used in the assessment of 2.0 (0.6) mL plasma pancreatic tumor burden and to assist in the early diagnosis of pancreatic tumors. The measurement of pancreatic polypeptide A fasting sample is required. concentrations is also used to monitor pancreatic carcinoma Performed: referred-A therapy and to predict the recurrence of pancreatic tumors. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 7-10 days

68150 PAP SMEAR, SCREEN Negative for intraepithelial lesion or malignancy Specimen Container: P3000 Microscopic PAP-PAK Cytology Kit Clinical Use: The Conventional Pap Smear is intended for the use of screening Vaginal/cervical/endocervical smear on glass slide for the presence of atypical cells, dysplasia or cervical cancer, Spray-fix smear(s) immediately with cytology fixative. as well as all cytologic categories as defined by The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses. Patient's name must be written in pencil on frosted end of slide(s) and submitted in slide container.

Please include on the request form the patient's age Performed: mon-fri and menstrual history. turn around: 7-10 days

86179 PARAINFLUENZA ANTIBODIES (TYPES 1-3) Parainfluenza 1 Ab: < 1:8 Specimen Container: 86790 (x3) Complement Fixation Parainfluenza 2 Ab: < 1:8 Gel barrier (gold or tiger top) Parainfluenza 3 Ab: < 1:8 1.0 (0.5) mL serum ≥1:64 are indicative of recent infection. Titers of 1:8 to 1:32 may be indicative of either past or recent infection, since CF antibody levels persist for only a few months. A four-fold or greater increase in titer between acute and convalescent specimens confirms the diagnosis.

Clinical Use: Parainfluenza virus is the second most common cause of lower respiratory disease in young children. Parainfluenze Virus can Performed: referred-A cause respiratory tract illness in patients of any age. turn around: 3-5 days

86271 PARANEOPLASTIC SYNDROME Ab PANEL W/REFLEX Accompanies report Specimen Container: 86255 (x3) Indirect Immunofluorescence Assay Gel barrier (gold or tiger top) Western Blot Clinical Use: Identification of anti-neuronal antibodies aids in the diagnosis 2.0 (0.7) mL serum of autoimmune neuropathies and paraneoplastic syndromes. Performed: referred-A Overnight fasting is preferred. turn around: 5-7 days

86261 PARIETAL CELL (GASTRIC) ANTIBODIES ≤ 20.0 Units Negative Specimen Container: 83516 Enzyme-Linked Immunosorbent Assay 20.1-24.9 Units Equivocal Gel barrier (gold or tiger top) ≥ 25.0 Units Positive 1.0 (0.3) mL serum Clinical Use: Gastric Parietal Cell Antibodies are found in 90% of patients with pernicious anemia. They are also found in autoimmune Performed: referred-A chronic atrophic gastritis preceding pernicious anemia. turn around: 4-7 days

86747 PARVOVIRUS B19, IGA & IGM Specimen Container: 86747(x2) Enzyme Immunoassay <0.9 Negative Gel barrier (gold or tiger top) 0.9-1.1 Equivocal >1.1 Positive 1.0 (0.5) mL serum

IgG persists for years, and provides lifetime immunity. Results from any one IgM assay should not be used as a sole indicator of a current or recent infection. Because IgM tests can yield false positive results and low levels of IgM antibody may persist for months post infection, reliance on a single test result could be misleading. If an acute infection is suspected, consider obtaining a new specimen and submit for both IgM and IgG testing in two or more weeks.

Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Parovirus B19 is also known as "Fifth Disease", affects primarily children and causes a rash on the face, trunk, and limbs. Joint pain and swelling is more common in adults. Although one-fifth of those affected have only mild disease, patients with sickle cell anemia or similar types of chronic anemia can suffer from acute Performed: referred-A anemia. Infection during pregnancy can lead to complications. turn around: 3-5 days

68301 PATHOLOGY SPECIMEN * 88302

82109 PENTA SCREEN Accompanies report Specimen Container: 82105 Immunoassay Gel barrier (gold or tiger top) 82397 Clinical Use: 82677 Test is used to screen a woman in her second trimester of 4.0 (1.5) mL serum 84702 pregnancy for neural tube defects, Down syndrome and 86336 Performed: referred-A Trisomy 18. turn around: 5-7 days

83986 PH, BODY FLUID Reference ranges have not been established on this type of Specimen Container: 83986 Electrode of fluid for this test. Sterile container, leak-proof

Clinical Use: 2.0 (1.0) mL body fluid (specify type of fluid) Pleural, peritoneal, pericardial, and synovial fluid pH levels have been used where appropriate, in the evaluation of pneumonia, rheumatoid pleuritis, malignancy,emphysema, tuberculosis, uremia, hemothorax, esophageal rupture, and cirrhosis with Performed: referred-A spontaneous bacterial peritonitis. turn around: 3-5 days

84005 PH, FECES 5.92 - 8.00 pH units Specimen Container: 83986 Potentiometric Sterile container, leak-proof Clinical Use: As a screen for carbohydrate an fat malabsorption, and is also 5.0 (1.0) gm Stool, FROZEN. Performed: Monday-Friday Evening used to evaluate small intestinal disaccharidase deficiencies. turn around: next day

23986 PH, OTHER Normal urine : 5.0-8.0 pH Specimen Container: 83986 Colorimetric Sterile urine container, leak-prof Clinical Use: Assessment of patients with metabolic acidosis and crystalluria. 10.0 (1.0 ) mL random urine Monitoring the effectiveness of alkalinization or acidification of urine for certain medical conditions (e.g. treatment of uric acid Performed: daily nephrolithiasis). turn around: next day

12210 PHENOBARBITAL 15 – 40 mg/L Specimen Container: 80184 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Phenobarbital is an anticonvulsant drug. Therapeutic drug 1.0 (0.5) mL serum Performed: daily monitoring is useful to optimize dose and avoid toxicity. turn around: next day

84031 PHENYLALANINE Accompanies report Specimen Container: 84030 Liquid Chromatography/Tandem Mass Spectrometry Sodium heparin (green top) Clinical Use: Abnormalities in phenylalanine metabolism are autosomal 0.4 (0.2) mL FROZEN plasma recessive disorders that occur in 1 in 10,000 births. The most Transfer plasma to a plastic, screw-cap vial and freeze. common form is phenylketonuria. Heterozygotes can have Performed: referred-A transient cognitive impairment with large phenylalanine loads. Fasting specimen preferred turn around: 7-10 days NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

84107 PHOSPHATE, 24-HOUR URINE W/CREATININE Males: 220-840 mg/g creat Specimen Container: 84105 Spectrophotometric Females: 270-940 mg/g creat 24 hour Urine Collection container, with 25 mL 6N HCL 82570

Clinical Use: 10.0 (2.0) mL aliquot of a well mixed 24-hr urine Phosphorus measurements are used in the diagnosis and treatment of various disorders, including parathyroid gland Specify 24-hour total vollume on container and test Performed: referred-A and kidney diseases, and vitamin D imbalance. requisition. turn around: 3-5 days

86159 PHOSPHOLIPID ANTIBODIES PANEL Accompanies report Specimen Container: 86146 (x3) Enzyme-Linked Immunosorbent Assay Gel barrier (gold or tiger top) 86147 (x3) Enzyme Immunoassay Clinical Use: 86148 (x3) See individual tests 5.0 (2.5) mL serum Test Components: Beta 2-Glycoprotein I (IgG, IgA, IgM), Cardiolipin Ab (IgG, IgA, IgM), Phosphatidylserine Antibodies (IgG, IgA, IgM)

Performed: referred-A turn around: 3-7 days

14100 PHOSPHORUS, INORGANIC 0 - 6 days: 4 – 9 mg/dL Specimen Container: 84100 Spectrophotometric 6 days – 2 years: 4 – 8 mg/dL Gel barrier (gold or tiger top) 2 – 12 years: 3 – 6 mg/dL >12 years: 2.6 – 4.5 mg/dL 1.0 (0.5) mL serum

Clinical Use: Phosphorus measurements are used in the diagnosis and treatment of various disorders, including parathyroid gland Performed: daily and kidney diseases, and vitamin D imbalance. turn around: next day

84105 PHOSPHORUS, URINE Reference range not established for random urines Specimen Container: 84105 Spectrophotometric Sterile urine container, leak-proof Clinical Use: Phosphorus measurements are used in the diagnosis and 10.0 (1.0) random urine treatment of various disorders, including parathyroid gland Performed: referred-A and kidney diseases, and vitamin D imbalance. turn around: 3-5 days

47208 PINWORM PREP No Enterobius vermicularis seen Specimen Container: 87172 Microscopic Pinworm collection/transport container Clinical Use: Detection of pinworm (Enterobius vermicularis) eggs indicates Pinworm "paddle" used to collect specimen from the infection. The eggs are usually deposited around the anus and perianal folds of the rectum or anus Performed: mon, wed, fri are not commonly seen in feces. turn around: 1-3 days

86014 PLATELET ANTIBODY DIRECT Negative Specimen Container: 86022 Microtiter EDTA (lavender top) Clinical Use: Thrombocytopenia that is refractory to platelet transfusions 6.0 (3.0) mL whole blood may be due to direct platelet antibody. Testing is useful to Performed: referred-A differentiate immune from nonimmune disorders turn around: 3-5 days

86023 PLATELET ANTIBODY INDIRECT Negative Specimen Container: 86022 Immunoassay No additive (red top) Clinical Use: Evaluating cases of immune platelet refractoriness, post- 3.0 (1.0) mL FROZEN serum transfusion purpura, or neonatal alloimmune thrombocytopenic Transfer serum to a plastic, screw-cap vial and freeze Performed: referred-A purpura NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 3-5 days

15595 PLATELET COUNT ≤ 1 month: 115-450 THO/MM3 Specimen Container: 85049 > 1 month: 150-400 THO/MM3 EDTA (lavender top)

Clinical Use: 5.0 (1.0) mL whole blood A platelet count is used in the diagnosis of bleeding disorders, Performed: daily bone marrow disorders and some autoimmune disorders. turn around: next day

86006 PNEUMONITIS HYPERSENSITIVY SCREEN Negative Specimen Container: 86331 Immunodiffusion Gel barrier (gold or tiger top) 86606 Clinical Use: 86744 Hypersensitivity pneumonitis (HP) is an immune-mediated disease 2.0 (0.5) mL serum 86609 (x3) of the aveolar walls and terminal airways induced by inhalation in sensitized individuals of organic dusts that may contain Performed: referred-A thermophilic actinomycetes, fungi or animal proteins. turn around: 3-5 days

86658 POLIOVIRUS (TYPES 1-3), Ab <1:8 Specimen Container: 86658 (x3) Complement Fixation Gel barrier (gold or tiger top) Clinical Use: Although there is cross-reactivity among the enteroviruses, 1.0 (0.5) mL serum most healthy adults do not have detectable CF titers. Therefore, detectable titers, especially those ≥1:32, should be considered in this context. Serodiagnosis is made by demonstration of Performed: referred-A fourfold change in titers between acute and convalescent sera. turn around: 7-10 days

87253 POLIOVIRUS Ab NEUTRALIZATION <1:8 Specimen Container: 86382 (x3) Neutralization Gel barrier (gold or tiger top) Clinical Use: This sensitive procedure is recommended for vaccine 1.0 (0.5) mL serum response testing and type-specific serodiagnosis of recent Poliovirus infection. It can also serve as an aid for diagnosing immune deficiency disorders. Antibody Performed: referred-A titers to the three serotypes of poliovirus are determined. turn around: 5-7 days

84008 PORPHOBILNOGEN, RANDOM URINE 1-8 years: 0.9-2.8 mg/g Creat Specimen Container: 84110 Colorimetric 9-17 years: 0.5-2.0 mg/g Creat Sterile urine container, leak-proof ≥18 years: < 1.5 mg/g Creat 10.0 (5.0) mL random urine. Clinical Use: Urinary Porphobilinogen is the first step in the diagnosis of acute Wrap tube in foil or use amber tube to protect intermittent porphyria (AIP). AIP is an autosomal dominant from light. disorder characterized by deficiency of porphobilinogen deaminase. An acute attack usually includes gastrointestinal Performed: referred-A disturbance and neuropsychiatric disorders. turn around: 3-5 days

84016 PORPHYRINS, FRACTIONATED Accompanies report Specimen Container: 84120 High Performance Liquid Chromatography Sterile urine container, leak-proof Clinical Use: Porphyria is a group of distinct disorders, characterized by the 2.0 (1.0) mL random urine. abnormal accumulation of porphyrins or porphyrin precursors. Porphyrin fractionation of urine is useful in diagnosing porphyrin Wrap tube in foil or use amber tube to protect cutanea tarda, hereditary coproporphyria, and variegate from light. Performed: referred-A porphyria. turn around: 7-10 days

PORPHYRINS, FRACTIONATED, QUANTITATIVE, 24 HOUR 84120 URINE Accompanies report Specimen Container: 84120 High Performance Liquid Chromatography 24 hour urine collection container, with 5g sodium NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: carbonate Porphyria is a group of distinct disorders, characterized by the abnormal accumulation of porphyrins or porphyrin precursors. 2.0 (1.0) mL aliquot of a well mixed 24 hour urine. Porphyrin fractionation of urine is useful in diagnosing porphyrin cutanea tarda, hereditary coproporphyria, and variegate Wrap tube in foil or use amber tube to protect porphyria. from light.

24-hour total volume must be provided on the test Performed: referred-A request form. turn around: 7-10 days

82479 PORPHYRINS, TOTAL, PLASMA Accompanies report Specimen Container: 82491 High Performance Liquid Chromatography Sodium heparin (green top) Clinical Use: Porphyria is a group of distinct disorders, characterized by the 2.0 (0.4) mL FROZEN plasma abnormal accumulation of porphyrins or porphyrin precursors. Transfer plasma to a plastic, screw-cap vial, freeze. Porphyrin fractionation of plasma is useful in diagnosing certain types of porphyrias and in excluding porphyria in patients with Wrap tube in foil or use amber tube to protect Performed: referred-A chronic renal failure. from light. turn around: 7-10 days

14132 POTASSIUM, SERUM 3.7 – 5.1 mg/dL Specimen Container: 84132 ISE/Diluted Gel barrier (gold or tiger top) Clinical Use: Potassium measurements are useful in monitoring electrolyte 1.0 (0.5) mL serum balance in the diagnosis and treatment of disease conditions, characterized by low or high blood potassium levels. Potassium is elevated in Adrenal cortical insufficiency, acute renal failure, and in some cases of diabetic acidosis. Potassium is decreased Performed: daily in diuretic administration and renal tubular acidosis. turn around: next day

14134 POTASSIUM (PLASMA) 3.5 – 4.5 mg/dL Specimen Container: 84132 ISE/Diluted Sodium heparin (green top) Clinical Use: False elevations of potassium may be due to hemolysis 1.0 (0.5) mL plasma Or rupture of platelets during coagulation process. The Centrifuge within 2 hours of collection, transfer to a Use of plasma potassium levels should be limited to those plastic, screw-cap vial. patients with spuriously elevated or depressed potassium levels, due to blood samples left at room temperature in patients with chronic lymphocytic leukemia with very high WBC counts (false decline), and those with thrombocytosis (increased platelets) with counts in excess of one million Performed: daily (false elevation). turn around: next day

24133 POTASSIUM, 24 HR URINE 25 – 120 mEq/ 24 HR Specimen Container: 84133 ISE/Diluted 24 hour Urine Collection container, no preservative Clinical Use: Urinary excretion of potassium is increased in primary 10.0 (2.0) mL aliquot of a well mixed 24-hr urine aldosteronism. It is often increased in dehydration and in Performed: mon, wed, fri salicylate toxicity. Decreased levels are see in malabsorption. turn around: 1-3 days

16318 PRE-ALBUMIN 17.0 - 34.0 mg/dL Specimen Container: 84134 Absorbance of Complexes of Antigen Antibody Reaction Gel barrier (tiger tube) Clinical Use: Measurement of prealbumin (transthyretin) levels in serum aids 1.0 (0.5) mL serum in the assessment of nutritional status. Prealbumin levels decrease in protein-energy malnutrition and return to normal values with nutritional repletion. Increased prealbumin levels are found in patients with a positive nitrogen balance. Prealbumin has also been used to monitor nutritional therapy during the transition Performed: mon, wed, fri form total parenteral nutrition to oral or enteral feeding. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 1-3 days

82508 PREGABALIN (LYRICA), SERUM Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry Gel barrier (tiger tube) Clinical Use: Pregabalin is an anti-epileptic drug. It works by slowing down 1.0 (0.5) mL serum impulses in the brain that cause seizures. Pregabalin also affects chemicals in the brain that send signals across the nervous system. Pregabalin is used to control seizures and Performed: referred-A to treat fibromyalgia. turn around: 5-7 days

84140 PREGNENOLONE Accompanies report Specimen Container: 84140 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Pregnenolone levels have been shown to remain in the normal 0.5 (0.2) mL serum range in patients with Cushing Syndrome and hyperaldosteronism. Levels can be suppressed with dexamethasone inhibition and increased with exogenous ACTH stimulation. Pregnenolone levels have been shown to be elevated in patients with idiopathic Performed: referred-A hirsutism. turn around: 7-10 days

84141 PRIMIDONE/PHENOBARBITAL Primidone Phenobarbital Specimen Container: 80188 Immunoassay 5.0-12.0 mg/L 15.0-40.0 mg/L No additive (red top) 80184

Clinical Use: 1.0 (0.5) mL serum This deoxybarbiturate is closely related chemically to the Transfer serum to a plastic, screw-cap vial. barbiturates. It is converted to two active metabolites, phenobarbital and phenylmalonamide (PEMA). Primidone is Collect as trough, just prior to next dose. used principally in generalized toni-clonic and complex and simple partial seizures; some clinicians believe that the drug has specific usefulness for complex partial seizures. Primidone is commonly given with phenytoin but monotherapy is preferred. The conversion of primidone to phenobarbital is significantly increased Performed: referred-A when this drug is used with other antiepileptic medication. turn around: 3-5 days

83881 ProBNP, N-TERMINAL <18 Years : Not established Specimen Container: 83880 Electrochemiluminescence 18-49 Years: EDTA (lavender top) ≤300 pg/mL Normal, heart failure unlikely. ≥450 pg/mL High probability of heart failure 1.0 (0.3) mL FROEN plasma ≥50 Years: Transfer plasma to a plastic, screw-cap vial, freeze. ≤300 pg/mL Normal, heart failureunlikely. ≥900 pg/mL High probability of heart failure

Clinical Use: BNP is used to aid in the diagnosis of left ventricular dysfunction dysfunction in heart failure. In contrast with BNP, N-terminal pro-BNP does not have interference with the drug Natrecor ® Performed: referred-A used to treat left ventricular dysfunction. turn around: 3-5 days

80192 PROCAINAMIDE Procainamide Specimen Container: 80192 Immunoassay 4.0-10.0 mg/L No additive (red top) N-Acetylprocainamide No age/sex specific ranges for this test 1.0 (0.5) mL serum Procainamide, Total Transfer serum to a plastic, screw-cap vial. 5.0-30.0 mg/L Collect as trough, just before next dose. Clinical Use: Procainamide is used to treat a variety of atrial and ventricular arrhythmias. Metabolism of procainamide produces an active metabolite, N-AcetylprocainamideNICL (NAPA). Laboratories/2011 The concentration of TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE both procainamide and NAPA levels are monitored to assure adequate therapeutic levels of procainamide are achieved and Performed: referred-A to avoid toxicity. turn around: 3-5 days

84145 PROCALCITONIN (PCT) Accompanies report Specimen Container: 84145 Immunofluorescence Assay Gel barrier (gold or tiger top) Clinical Use: Used in the diagnosis of bacteremia and septicemia in adults and 2.0 (0.5) mL FROZEN serum children (including neonates), renal involvement in urinary tract Transfer serum to a plastic, screw-cap vial, freeze. infection in children, bacterial infection in neutropenic patients, and in the diagnosis, risk stratification, and monitoring of septic shock, systemic secondary infection post-surgery, as well as in severe trauma, burns, and multiorgan failure. Differential diagnosis of bacterial versus viral meningitis. Differential diagnosis of community-acquired bacterial versus viral pneumonia. Performed: referred-A Monitoring of therapeutic response to antibacterial therapy. turn around: 3-7 days

14144 PROGESTERONE Group Reference Range Specimen Container: 84144 Chemilminescence Normally menstuating females: Gel barrier (gold or tiger top) Follicular phase 0.5 - 1.40 ng/mL Luteal phase 3.34 - 25.56 ng/mL 1.0 (0.3) mL serum Mid-Luteal Peak 4.44 - 28.03 ng/mL Post menopausal: up to 0.73 ng/mL Pregnant Females: First Trimester 11.2 - 90.0 ng/mL Second Trimester 25.55 - 89.40 ng/mL Third Trimester 48.40 - 422.50 ng/mL

Clincal Use: In general, increasing progesterone levels are indicative of viable pregnancies. Testing is also done to help determine the cause of infertility, track ovulation, to help determine ectopic or failing pregnancy, and to help diagnose the cause of abnormal Performed: daily uterine bleeding. turn around: next day

84206 PROINSULIN ≤18.8 pmol/L Specimen Container: 84206 Immunoassay Gel barrier (gold or tiger top) Clincal Use: Proinsulin is strikingly elevated in PC1/3 deficiency. These 1.0 (0.8) mL FROZEN serum patients have defects in the processing of multiple peptide Transfer serum to a plastic, screw-cap vial and freeze. hormones and suffer from diabetes, adrenal insufficiency, infertility, and obesity. Proinsulin levels might be elevated in Overnight fasting is required. patients with insulin-producing islet cell tumors (insulinomas). These patients suffer from hypoglycemic attacks due to Performed: referred-A inappropriate secretion of insulin by the tumors. turn around: 5-10 days

14146 PROLACTIN Non-Pregnant Females: 2.8 – 29.2 ng/mL Specimen Container: 84146 Chemiluminescence Pregnant Females: 9.7 – 208.5 ng/mL Gel barrier (gold or tiger top) Postmenopausal Females: 1.8 – 20.3 ng/mL Male: 2.1 – 12.7 ng/mL 1.0 (0.5) mL serum

Clinical Use: Prolactin is secreted by the anterior pituitary gland and is required for normal breast development and lactation in women. Prolactin levels will rise throughout gestation. In the absence of breast feeding, prolactin levels will return to normal within three weeks after birth. Abnormally high levels of prolactin are often associated with female infertility, impotence and infertility in males, primary Performed: daily hypothyroidism, and pituitary tumors. turn around: next day NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

83401 PROMETHEUS® CELIAC PLUS Accompanies report Specimen Container: 83520 (x3) Gel barrier (gold or tiger top) 88347 Clinical Use: 82784 An evaluation of antibodies and genetic markers associated with 2.0 (0.5) mL serum 83891 celiac disease to assist physicians with diagnosis and risk Transfer serum to a plastic, screw-cap vial 83900 (x2) assessment. 83896 (x72) Performed: referred-A 83912 turn around: 7-10 days

84997 PROMETHEUS®FIBROSPECT II Accompanies report Specimen Container: 83883 Enzyme-Linked Immunosorbent Assay Gel barrier (gold or tiger top) and 83520 (x2) Nephelometric Clinical Use: EDTA (lavender top) Testing can aid physicians in differentiating no/mild liver fibrosis from moderate -to-severe liver fibrosis in patients with hepatitis C, 2.0 (0.5) mL serum and Performed: referred-A and may help reduce the number of liver biopsies required. 5.0 (3.0) mL whole blood turn around: 7-10 days

80030 PROMETHEUS®THIOPURINE METABOLITES Accompanies report Specimen Container: 82491 (x2) High Performance Liquid Chromatography EDTA (lavender top) Clinical Use: Assay includes HPLC Quant for 6-Thioguanine and for 5.0 (5.0) mL whole blood 6-Methyl Mercaptopurine. It provides the ability to pharmacologically monitor patients on Azothioprine or 6-MP therapy. Patients' dosage can be individualized based on their metabolism and adjusted for therapeutic effect. The test provides measurement of 6-TG (correlated with clinical response and leukopenia) and Performed: referred-A 6-MMP (correlated with hepatotoxicity). turn around: 7-10 days

85302 PROTEIN & ALBUMIN Accompanies report Specimen Container: 82040 Gel barrier (gold or tiger top) 84155 Clinical Use: Total Protein measurements are used in the diagnosis and 1.0 (0.5) mL serum treatment of a variety of diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders. Albumin measurements are used in the diagnosis and treatment Performed: daily of numerous diseases primarily involving the liver and/or kidneys. turn around: next day

85302 PROTEIN C, ANTIGEN 70-140% of normal Specimen Container: 85302 Enzyme Immunoassay Conditional comment will appear on reports when result is 3.2% Sodium citrate (light blue top) < 70% of normal (decreased): Decreased levels of Protein C Antigen may be found in congenital deficiency, treatment with. 1.0 (0.5) mL plasma oral anticoagulants, liver disease, D.I.C., and post surgery. Collection Instructions for Platelet Poor Plasma: Clinical Use: Centrifuge light blue-top tube 15 minutes within Aids in diagnosis of congenital deficiencies characterized by 60 minutes of collection. Using a plastic pipette, recurrent venous thrombosis. Acquired deficiencies associated remove plasma, taking care to avoid the with Protein C include: oral anticoagulant therapy, liver wbc/platelet buffy layer, and place into a plastic vial. anticoagulant therapy, liver disease, vitamin K deficiency, Centrifuge a second time and transfer platelet-poor malignancy, consumptive DIC, surgery, trauma, antibodies to plasma into a new plastic vial. Plasma must be free of Performed: referred-A Protein C and hepatic immaturity of the newborn. platelets (< 10,000/mcl). Freeze immediately turn around: 3-5 days

PROTEIN, ELECTROPHORESIS, SERUM w/M SPIKE (Total 84165 Protein & Protein Electrophoresis) Accompanies report Specimen Container: 84165 Electrophoresis Gel barrier (gold or tiger top) 84155 Spectrophotometry Clinical Use: Protein Electrophoresis evaluates the major protein fractions 3.0 (1.5) mL serum (i.e., albumin, alpha 1, alpha 2, beta and gamma proteins) to determine if there are deficiencies or excesses, as seen with macroglobulinemia, monoclonal gammopathy of undetermined Performed: referred-A significance (MGUS), and multiple myeloma. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 3-5 days

84166 PROTEIN ELECTROPHORESIS, CSF Accompanies report Specimen Container: 84185 Electrophoresis Sterile container, leak-proof Clinical Use: CSF Protein Electrophoresis is useful in identifying oligoclonal 6.0 (3.0) mL CSF band and other protein variations that are associated with Performed: referred-A multiple sclerosis and occasionally, viral illnesses. turn around: 3-5 days

84190 PROTEIN ELECTROPHORESIS, URINE Accompanies report Specimen Container: 82570 Colorimetric Sterile Urine Container, leak-proof, no preservative 84156 Electrophoresis Clinical Use: 84166 Protein electrophoresis evaluates the major protein fractions 10.0 (5.0) mL random urine found in urine. Urinary protein electrophoresis is useful in Performed: referred-A classifying the type of renal damage, if present. turn around: 3-5 days

85305 PROTEIN S ANTIGEN, FREE & TOTAL Protein S Total Antigen: 70-140% of normal Specimen Container: 85305 Immunoturbidimetric Free Protein S Male: 57-171% of normal 3.2% Sodium citrate (light blue top) 85306 Free Protein S Female: 50-147% of normal 2.0 (1.0) mL FROZEN plasma Clinical Use: Protein S deficiency may be hereditary or acquired. Acquired Collection Instructions for Platelet Poor Plasma: deficiency may be observed during pregnancy, oral anticoagulant Centrifuge light blue-top tube 15 minutes within therapy, oral contraceptive use, in liver disease, in newborn infants 60 minutes of collection. Using a plastic pipette, as well as in other clinical conditions. Deficiency of Protein S has remove plasma, taking care to avoid the been associated with a high risk of developing venous wbc/platelet buffy layer, and place into a plastic vial. thromboembolism especially in young people. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of Performed: referred-A platelets (< 10,000/mcl). Freeze immediately turn around: 3-5 days

85989 PROTEIN S FUNCTIONAL Males: 70-150% of normal Specimen Container: 85306 Clot Detection Females: 60-140% of normal 3.2% Sodium citrate (light blue top) (Total Protein & Protein Electrophoresis) Clinical Use: 2.0 (1.0) mL FROZEN plasma Protein S Activity is used to diagnose acquired and hereditary deficiencies of Protein S. Protein S Collection Instructions for Platelet Poor Plasma: deficiency is associated with increased risk of Centrifuge light blue-top tube 15 minutes within thrombosis. 60 minutes of collection. Using a plastic pipette, remove plasma, taking care to avoid the wbc/platelet buffy layer, and place into a plastic vial. Centrifuge a second time and transfer platelet-poor plasma into a new plastic vial. Plasma must be free of Performed: referred-A platelets (< 10,000/mcl). Freeze immediately turn around: 3-5 days

84180 PROTEIN, 24-HOUR URINE < 150 mg/24 h Specimen Container: 84156 Colorimetric 24 hour Urine Collection Container, no preservative Clinical Use: Proteinuria, mainly glomerular, is often a manifestation of primary 10.0 (5.0) mL aliquot of well mixed 24-hr urine renal disease although transient proteinuria may occur with fevers, thyroid disorders, and in heart disease. In the absence of renal Record 24 hour volume on the test requisition disease, the degree of proteinuria is slight, usually amounting to less than 2 grams per day. In chronic glomerulonephritis and in the nephrotic syndrome including lipoid nephrosis and in some forms of hypertensive vascular disease, protein loss may vary Performed: referred-A from a few grams to as much as 30 g/day. turn around: 3-5 days

84154 PROTEIN, TIMED URINE COLLECTION Not applicable Specimen Container: 84156 Colorimetric Sterile urine container, leak-proof , no preservative Clinical Use: Proteinuria, mainly glomerular, is NICLoften Laboratories/2011 a manifestation of primary 10.0 (2.0) mL timed urine TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE renal disease although transient proteinuria may occur with fevers, thyroid disorders, and in heart disease. In the absence of renal Specify the total timed urine volume and time of disease, the degree of proteinuria is slight, usually amounting to collection on the request form and on the container. less than 2 grams per day. In chronic glomerulonephritis and in the nephrotic syndrome including lipoid nephrosis and in some forms of hypertensive vascular disease, protein loss may vary Performed: referred-A from a few grams to as much as 30 g/day. turn around: 3-5 days

14155 PROTEIN, TOTAL <6 days: 4.8 – 7.8 gm/dL Specimen Container: 84155 Spectrophotometric 6 days – 2 yrs: 5.1 – 8.1 gm/dL Gel barrier (gold or tiger top) 2 yrs – 59 yrs: 6.0 – 8.2 gm/dL > 60 yrs: 5.3 – 7.8 gm/dL 1.0 (0.5) mL serum

Clinical Use: Total protein is useful in evaluating patients for nutritional status, liver disease, protein-losing renal and gastrointestinal diseases, and many other medical conditions. Elevated concentrations may be observed In patients with monoclonal gammopathies, autoimmune hepatitis, inflammation, and other Performed: daily medical conditions. turn around: next day

84157 PROTEIN, TOTAL, CSF < 1 month: 15-100 mg/dL Specimen Container: 84157 Colorimetric 1 mo-60 yrs: 15-45 mg/dL Sterile, leak-proof container > 60 years: 15-60 mg/dL 1.0 (0.5) mL CSF Clinical Use: CSF Total Protein is derived from ultrafiltration of plasma through the meninges and choroid plexus and intrathecal production. CSF Total Protein is useful in.identifying increased permeabillity of the blood-brain barrier or increased intrathecal production. Elevated CSF Total Protein is often consistent with central nervous system Performed: referred-A disease or trauma turn around: 3-5 days

84155 PROTEIN, URINE RANDOM Adult Males: 5-25 mg/dL Specimen Container: 84156 Colorimetric Adult Females: 5-24 mg/dL Sterile Urine container, leak-proof, no preservative

Clinical Use: 10.0 (2.0) mL random urine Total protein measurements are used in the diagnosis and treatment of a variety of diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders. Increases in urinary proteins are associated with a number of conditions among them are nephrosis, hypergammaglobulinemia, Performed: referred-A pregnancy, and destructive lesions of the kidney. turn around: 3-5 days

83880 PROTHROMBIN GENE ANALYSIS Accompanies report Specimen Container: 83891 Invader Assay/Signal Amplification EDTA (lavender top) 83892 Clinical Use: 83896 (x2) Mutations in the Factor II (Prothrombin) gene are associated 5.0 (3.0) mL whole blood 83908 Performed: referred-A with the venous thrombosis and embolism. 83912 turn around: 7-10 days

25611 PROTHROMBIN TIME (PT) PT: 9.7 – 13.7 seconds Specimen Container: 85610 Photo Optical Turbidimetric 3.2% Sodium citrate (light blue top) Clinical Use: This is a screening test for abnormalities of coagulation factors 3.5 mL whole blood or that are involved in the extrinsic pathway. Test is also used to 2.0 (1.0) mL FROZEN plasma monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders. If specimen will not be delivered to the lab within 24 hours of collection, transfer plasma to a plastic, screw- Performed: daily NICL Laboratories/2011 cap vial and freeze. TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: next day

25610 PROTHROMBIN TIME (PT) THERAPEUTIC PROTHROMBIN TIME: 20.7 – 30.5 seconds Specimen Container: 85610 Includes International Normalized Ratio (INR) INTERNATIONAL NORMALIZED RATIO: 2.0 - 3.0 3.2% Sodium citrate (light blue top) Photo Optical Calculation 3.5 mL whole blood or 2.0 (1.0) mL FROZEN plasma

If specimen will not be delivered to the lab within 24 hours of collection, transfer plasma to a plastic, screw- Performed: daily cap vial and freeze. turn around: next day

14152 PSA, COMPLEX Accompanies report Specimen Container: 84152 Chemiluminescence Gel barrier (gold or tiger top)

1.0 (0.5) mL serum Performed: daily turn around: next day

14153 PSA, DIAGNOSTIC Male: Specimen Container: 84153 Chemiluminescence 0 – 49 years: 0 – 2.5 ng/mL Gel barrier (gold or tiger top) 49 – 59 years: 0 – 3.5 ng/mL > 60 years: 0 – 4.0 ng/mL 1.0 (0.5) mL serum This test was performed using the Siemens (Bayer) chemiluminescent method. Values obtained from different assay methods cannot be used interchangeably. PSA levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease.

Clinical Use: Elevated serum PSA concentrations have been reported in men with prostate cancer, benign prostatic hypertrophy, and Performed: daily inflammatory conditions of the prostate. turn around: next day

16316 PSA, TOTAL Male: Specimen Container: 84153 Chemiluminescence 0 – 49 years: 0 – 2.5 ng/mL Gel barrier (gold or tiger top) 49 – 59 years: 0 – 3.5 ng/mL > 60 years: 0 – 4.0 ng/mL 1.0 (0.5) mL serum This test was performed using the Siemens (Bayer) chemiluminescent method. Values obtained from different assay methods cannot be used interchangeably. PSA levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease.

Clinical Use: Elevated serum PSA concentrations have been reported in men with prostate cancer, benign prostatic hypertrophy, and inflammatory conditions of the prostate.

Performed: turn around: next day

24153 PSA, TOTAL FREE AND COMPLEX * 84153 Chemiluminescence

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

23971 PTH, INTACT 14 – 72 pg/mL Specimen Container: 83970 Siemens Centaur/Chemiluminescence Gel barrier (gold or tiger top) 82310 Clinical Use: Includes: Calcium PTH measurements are used in the differential diagnosis of 1.5 (1.0) mL serum hyperparathyroidism, hypoparathyroidism, or hypercalcemia of malignancy. Assay results should be used in conjunction with other clinical data to assist the clinician in making individual Performed: daily patient management decisions turn around: 1-3 days

83541 PTH - RELATED PROTEIN 14-27 pg/mL Specimen Container: 83519 Immunoassay This is a C-terminal PTH-RP assay. Elevated results may be Sodium heparin (green top) observed in patients with renal disease. 0.5 (0.3) mL plasma Clinical Use: Centrifuge as soon as possible, transfer plasma to a Test is used in the differential diagnosis of hypercalcemia and plastic, screw-cap vial. Performed: referred-A to manage patients with solid tumors and hypercalcemia. turn around: 5-7 days

15730 PTT (PARTIAL THROBOPLASTIN) 24 – 39 seconds Specimen Container: 85730 Turbidimetric 3.2% Sodium citrate (light blue top) Clinical Use: The aPTT test is used to monitor patients on heparin therapy. 2.0 (1.0) mL FROZEN plasma This test is also used as a screening test for deficiencies of Centrifuge within 1 hour of collection, transfer plasma Performed: daily plasma coagulation factors other than Factors VII and XIII. to a plastic, screw-cap vial and freeze. turn around: next day

84210 PYRUVIC ACID (PYRUVATE) 0.30-1.50 mg/dL Specimen Container: 84210 Enzymatic EDTA (lavender top) Clinical Use: Screening for possible disorders of mitochondrial metabolism, Protein-free Filtrate: when used in conjunction with blood lactate collected at the same Collect 4.0 (2.0) mL random whole blood and time to determine the lactate-to-pyruvate ratio immediately mix with 4.0 (2.0) mL ice cold 7% or 8% Perchloric Acid. Let mixture stand for 10 minutes; then, centrifuge. Separate and submit 4.5 mL supernatant fluid for assay, refrigerated.

Please specify in comments the volumes of blood Performed: referred-A and Perchloric Acid used. turn around: next day

16480 QUANTIFERON, TB GOLD TEST Negative Specimen Container: 86480 In-Tube Method Quantiferon®-TB Gold Collection Kit The Nil value adjusts for patient sample background, heterophile •Nil Control tube (gray cap with white ring) antibody effects, or nonspecific IFN. The Mitogen serves as a •TB Antigen tube (red cap with white ring) patient positive control. The result Positive, Negative, or •Mitogen Control tube (purple cap with white ring) Indeterminate is calculated from these values using an FDA- approved algorithm run on QuantiFeron(R) software. 1) Collect 1.0 mL directly into each of the 3 tubes Data on the performance of the test in children younger than 5 contained in the Quantiferon®-TB Gold Collection Kit years of age are limited, and the CDC advises that caution is 2) Mix the tubes by SHAKING VIGOROUSLY for 5 warranted when using the assay in children aged <5 years seconds to ensure that the entire surface of the tube (MMWR 2010;59(RR-05):1-25). has been coated with blood. 3)Label tubes appropriately. Clinical Use: 4)Transport to laboratory within 12 hours of collection Tuberculosis is a communicable disease caused by infection with at room temperature. Do not refrigerate or freeze. M. tuberculosis complex. Infection results in either acute disease or Latent TB Infection (LTBI), a non-communicable asymptomatic consider medical treatment for preventing overt disease. Until recently, the tuberculin skin test was the only available method for diagnosing LTBI. Quantiferon ®-TB gold eliminates false positive NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE skin test due to BCG vaccination and most Non-Tuberculous Mycobacteria (NTM) and is an objective, reproducible QL test. hypersensitivity, and no "booster effect", whereby the first test induces a false positive response on re-testing. There is no need Performed: for follow-up patient visits to obtain test results. turn around: next day

82492 QUETIAPINE(SEROQUEL) Accompanies report Specimen Container: 82099 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Phenobarbital is an antipsychotic drug. Therapeutic drug 1.0 (0.4) mL serum Performed: referred-A monitoring is useful to optimize dose and avoid toxicity. Transfer serum to a plastic, screw-cap vial. turn around: 7-10 days

80194 QUINIDINE 2.0-5.0 mg/L Specimen Container: 80194 Immunoassay No additive (red top) Clinical Use: Quinidine is used to treat supraventricular arrhythmias. 1.0 (0.2) mL serum Therapeutic drug monitoring is useful to optimize dose and avoid Transfer serum to a plastic, screw-cap vial. toxicity. Performed: referred-A Collect as trough just before next dose turn around: 3-5 days

80306 RAPAMYCIN (SIROLIMUS) Trough: 3.0-18.0 ng/mL Specimen Container: 80195 Liquid Chromatography/Tandem Mass Spectrometry EDTA (lavender top) Clinical Use: Sirolimus is an immunosuppressant drug used to prevent organ 2.0 (1.0) mL whole blood graft refection. Therapeutic drug monitoring is useful to optimize Performed: referred-A dose and avoid toxicity. Collect 1/2-1 hour before next oral dose. turn around: 3-5 days

87261 RAPID VIRAL RESPIRATORY CULT Sc W/REFLEX Not isolated Specimen Container: 87254 Rapid Culture The following viruses are tested for: Adenovirus, Influenza virus, VCM Collection Kit A types A & B, Parainfluenza viruses 1,2,& 3, and Respiratory Do not use if media is yellow. Syncytial Virus. 2-3 mL Nasopharyngeal aspirate/wash mixed with Clinical Use: equal parts VCM media With the addition of new antiviral drugs for the treatment of or influenza, more rapid and sensitive tests for respiratory virus Nasopharyngeal or Throat swab in VCM detection and the increasing need to be more discriminating in Throat swab in VCM only on patients ≥2 years the use of antibiotics, early detection and identification of the of age infecting respiratory virus has grown substantially in importance. Viral isolation is becoming increasingly important in ruling out Performed: referred-A bacteria as the cause of respiratory infections. turn around: 5-7 days

86003 RAST ALLERGEN(S) Accompanies report Specimen Container: 86003 Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Allergen assays are used as a diagnostic aid in the clinical 1.0 (0.5) mL serum diagnosis of IgE mediated allergic disorders in conjunction with Performed: referred-A other clinical findings. Specify on test request allergen(s) desired turn around: 5-7 days

86000 RAST ANIMAL PANEL#1 Accompanies report Specimen Container: 86003 (x7) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 3.0 (1.5) mL serum Dog Dander, Cat Dander, Cow Dander, Horse Dander, diagnosis of IgE mediated allergic disorders in conjunction with Guinea Pig Epithelia, Rabbit Epithelia, Rat Epithelia other clinical findings.

Performed: referred-A turn around: 5-7 days NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

85997 RAST CEREAL GROUP Accompanies report Specimen Container: 86003 (x4) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 2.0 (1.0) mL serum Rye, Barley, Oat, Wheat diagnosis of IgE mediated allergic disorders in conjunction with other clinical findings. Performed: referred-A turn around: 5-7 days

85995 RAST FOOD GROUP Accompanies report Specimen Container: 86003 (x8) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 3.0 (1.5) mL serum Egg White, Cocoa, Corn, Egg Yolk, Milk, Peanut, Soybean, Wheat diagnosis of IgE mediated allergic disorders in conjunction with other clinical findings. Performed: referred-A turn around: 5-7 days

85992 RAST GRASSES PANEL Accompanies report Specimen Container: 86003 (x13) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 5.0 (2.5) mL serum Bahia Grass, Red Top Grass, Sweet Vernal Grass, Bermuda Grass, Brome Grass, diagnosis of IgE mediated allergic disorders in conjunction with Cultivated Rye Grass, Cultivated Wheat, Johnson Grass, June Grass (Kentucky Blue), other clinical findings. Meadow Fescue, Orchard Grass (Cocksfoot), Perennial Rye Grass, Timothy Grass

Performed: referred-A turn around: 5-7 days

86015 RAST HOUSE DUST MITE Accompanies report Specimen Container: 86003 Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Component: Dermatophagoides farinae Allergen assays are used as a diagnostic aid in the clinical 1.0 (0.3) mL serum diagnosis of IgE mediated allergic disorders in conjunction with Performed: referred-A other clinical findings. turn around: 5-7 days

86001 RAST MOLD GROUP Accompanies report Specimen Container: 86003 (x5) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 2.0 (1.0) mL serum Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, diagnosis of IgE mediated allergic disorders in conjunction with Helminthosporium Halodes, Penicillium notatum other clinical findings.

Performed: referred-A turn around: 5-7 days

85994 RAST NUT MIX GROUP Accompanies report Specimen Container: 86003 (x5) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 2.0 (1.0) mL serum Hazelnut, Almond, Brazil Nut, Coconut, Peanut diagnosis of IgE mediated allergic disorders in conjunction with other clinical findings. Performed: referred-A turn around: 5-7 days

85998 RAST PEDIATRIC GROUP Accompanies report Specimen Container: 86003 (x6) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 2.0 (1.0) mL serum Egg White, Codfish, Milk, Peanut, Soybean, Wheat diagnosis of IgE mediated allergic disorders in conjunction with other clinical findings. Performed: referred-A NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 5-7 days

85993 RAST SEAFOOD GROUP Accompanies report Specimen Container: 86003 (x5) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 2.0 (1.0) mL serum Lobster, Codfish, Clam, Shrimp, Tuna diagnosis of IgE mediated allergic disorders in conjunction with other clinical findings. Performed: referred-A turn around: 5-7 days

85999 RAST STINGING INSECT GROUP Accompanies report Specimen Container: 86003 (x6) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 2.0 (1.0) mL serum Honey Bee, Mosquito, Paper Wasp, White Faced Hornet, diagnosis of IgE mediated allergic disorders in conjunction with Yellow Hornet, Yellow Jacket other clinical findings.

Performed: referred-A turn around: 5-7 days

85990 RAST TREES PANEL Accompanies report Specimen Container: 86003 (x13) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 5.0 (2.5) mL serum Sycamore, Walnut Tree (Californian), Beech, Birch, Cottonwood, diagnosis of IgE mediated allergic disorders in conjunction with Elm, Hazel Nut Tree, Hickory/Pecan Tree, Maple (Box Elder), other clinical findings. Oak, White Ash, White Pine, Willow

Performed: referred-A turn around: 5-7 days

85886 RAST, FOOD ALLERGY PANEL Accompanies report Specimen Container: 86003 (x12) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 5.0 (2.5) mL serum Egg White, Clam, Codfish, Corn, Milk, Peanut, Scallop, diagnosis of IgE mediated allergic disorders in conjunction with Sesame Seed, Shrimp, Soybean, Walnut, Wheat other clinical findings.

Performed: referred-A turn around: 5-7 days

85885 RAST, REGION VIII UPPER RESPIRATORY Accompanies report Specimen Container: 86003 (x25) Fluorescence Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Test Components: Allergen assays are used as a diagnostic aid in the clinical 7.5 (4.0) mL serum Dog Dander, Rough Marsh Elder, Sycamore, Walnut Tree (Californian), diagnosis of IgE mediated allergic disorders in conjunction with Alternaria alternata, Aspergillus fumigatus, Bermuda Grass, Cat Dander, other clinical findings. Cladosporium herbarum, Cockroach, Common Ragweed (Short), Cottonwood,

Dermatophagoides farinae, Dermatophagoides pteronyssinus, Elm,

Hickory/Pecan Tree, IgE, Maple (Box Elder), Mountain Cedar, Oak,

Penicillium notatum, Rough Pigweed, Russian Thistle, Timothy Grass,

White Ash, White Mulberry

Performed: referred-A turn around: 5-7 days

84376 REDUCING SUBSTANCES, FECES Negative Specimen Container: 84376 Benedicts Solution Plastic, leak-proof container Clinical Use: The presence of reducing substances is useful in the diagnosis 10 (3.0) g stool, FROZEN of abnormalities in carbohydrate metabolism, i.e., sucrose and lactase. The unabsorbed sugars in stool are measured as Seal container in a plastic bag before shipping. Performed: referred-A reducing substances. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 3-5 days

20165 RENAL FUNCTION PANEL Accompanies report Specimen Container: 80069 Gel barrier (gold or tiger top) Test Components: Clinical Use: Albumin, Calcium, Chloride, Creatinine, Carbon Dioxide, The kidney performs many physiological and excretory functions. 2.0 (1.0) mL serum Glucose, Phosphorous Inor, Potassium, Sodium, BUN The renal function panel evaluates the functional state of the kidney. Performed: daily turn around: next day

84244 RENIN ACTIVITY 0.25-5.82 ng/mL/h Specimen Container: 84244 Liquid Chromatography Tandem Mass Spectrometry (LC/MS/MS) EDTA (lavender top) Clinical Use: Investigation of primary aldosteronism (eg, adrenal adenoma/ 2.0 (0.6) mL FROZEN plasma carcinoma and adrenal cortical hyperplasia) and secondary Transfer plasma to a plastic, screw-cap vial, freeze. aldosteronism (renovascular disease, salt depletion, potassium Performed: referred-A loading, cardiac failure with ascites, pregnancy, Bartter's syndrome) turn around: 7-10 days

87420 RESPIRATORY SYNCYTIAL VIRUS (RSV) ANTIBODY Not detected Specimen Container: 87807 Immunochromatography VCM Collection Kit A Clinical Use: Do not use if media is yellow Respiratory Syncytial Virus (RSV) is considered the single most important virus affecting infants and young adults, causing acute Nasopharyngeal swab in VCM lower respiratory tract illness, mainly bronchiolitis and pneumonia. or Adults are susceptible to infection but usually experience mild 2.0 mL nasopharyngeal wash/aspirate or turbinate respiratory tract illness. Elderly patients may suffer severe lower in VCM Performed: referred-A respiratory tract disease. turn around: 3-5 days

87280 RESPIRATORY SYNCYTIAL VIRUS (RSV), DIRECT, IF Negative Specimen Container: 87280 Direct Immunofluorescence Assay VCM Collection Kit A Clinical Use: Do not use if media is yellow RSV is an important cause of upper respiratory disease in children from the ages of 6 weeks to 2 years and in the elderly. Nasopharyngeal swab in VCM RSV infection can be fatal. Rapid diagnosis permits the early or administration of antiviral drugs in severe infections. 2.0 mL nasopharyngeal wash/aspirate or turbinate Performed: referred-A in VCM turn around: 3-5 days

87792 RESPIRATORY SYNCYTIAL VIRUS (RSV), RNA, RT-PCR Accompanies Report Specimen Container: 87798 Real-Time PCR VCM Collection Kit A Clinical Use: Do not use if media is yellow This test is used to determine the presence of Respiratory Synctial Virus (RSV) in a patient's specimen. Organisms may be detected Nasopharngeal, Throat swab in VCM by PCR before diagnosis by immunological methods. PCR or provides more rapid results than other methods, including culture. Sputum, bronchial lavage/wash in Sterile, leak-proof Performed: referred-A container turn around: 5-7 days

86272 RETICULIN IgG & IgA ANTIBODIES WITH REFLEX TO TITER Accompanies report Specimen Container: 86255 (x2) Immunoassay Gel barrier (gold or tiger top) Clinical Use: If the Reticulin Antibody IgG Screen is positve, Anti-Reticulin IgA and IgG occurs most frequently in patients with 1.0 (0.2) mL serum the antibody titer will be added at an additional charge (CPT: 86256). gluten sensitive enteropathy, i.e. celiac disease and If the Reticulin Antibody IgA Screen is positive, dermatitis herpetiformis. the antibody titer will be added at an additional charge (CPT: 86256).

Performed: referred-A turn around: 3-5 days

15044 RETICULOCYTE COUNT ≤ 1 month: 2.0 - 6.0% Specimen Container: 85045 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Combined Impedence > 1 month: 0.5 – 1.5% EDTA (lavender top) Flow Cytometry Immature Reticulocyte Fraction: 2.4 - 13.3% 5.0 (1.0) mL whole blood Clinical Use: The reticulocyte count is a means of assessing erythropoietic activity of the bone marrow. The reticulocyte count is elevated in patients with hemolytic anemia, megaloblastic anemia, uremia, hemorrhage (acuteand chronic), and following treatment of iron. deficiency anemia. The reticulocyte count is decreased in aplastic crisis of hemolytic anemia, pernicious anemia, siderblastic Performed: daily anemia, and in ineffective erythropoiesis as seen in thalessemia. turn around: next day

84000 RETINOL BINDING PROTEIN 1.5-6.7 mg/dL Specimen Container: 83883 Fixed Rate Time Nephelometry No additive (red top) Clinical Use: RBP may be elevated in patients with renal disease and diabetes. 1.0 (0.5) mL serum Concentrations may be decreased in patients with hepatotoxicity, Transfer serum to a plastic, screw-cap vial. hepatitis and cirrhosis. Patient must be fasting for at least 12 hours Performed: referred-A before specimen collection. turn around: 5-7 days

46430 RHEUMATOID FACTOR (RF) Negative Specimen Container: 86431 Latex Agglutination Gel barrier (gold or tiger top) Clinical Use: Markedly increased serum titers of rheumatoid factor (RF), >1:80, 1.0 (0.5) mL serum are consistent with rheumatoid arthritis (RA). Low titers (1:20-1:80) must be interpreted carefully and only used in the diagnosis or RA when signs and symptoms of RA are highly suggestive. Low titers of RF may be seen in chronic infectious disease, acute viral Performed: mon - sat disease, liver disease, sarcoidosis and lyphoproliferative diseases. turn around: 1-2 days

RHEUMATOID FACTOR (RF) WITH REFLEX, SYNOVIAL 86431 FLUID Negative Specimen Container: 86430 Latex Agglutination Sterile, screw-cap container

If screen is positive, test will reflex to 1.0 (0.3) synovial fluid a titer at an additional charge (CPT 86431).

Performed: referred-A turn around: 5-7 days

83535 RIBOSOMAL P ANTIBODIES < 1.0 AI: Negative Specimen Container: 83516 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Ribosomal P Antibody is present in 5-10% of patients with 1.0 (0.5) mL serum Performed: referred-A systemic lupus erythematosus (SLE). turn around: 3-5 days

80309 RIFAMPIN Accompanies report Specimen Container: 80299 High Performance Liquid Chromatography EDTA (lavender top) Clinical Use: Therapeutic drug monitoring for effective therapy. 3.0 (1.5) mL whole blood, FROZEN

Performed: referred-A Transport whole blood frozen. turn around: 5-7 days

80299 RISPERIDAL (RISPERDONE) Accompanies report Specimen Container: 83789 Liquid Chromatography/Mass Spectrometry No additive (red top) Clinical Use: Risperidone is an antipsychotic agent belonging to the 3.0 (1.5) mL serum benzisoxazole derivatives class. This test is used to monitor Transfer to a plastic, screw-cap vial NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Performed: referred-A drug levels for optimal therapy turn around: 5-7 days

86227 ROTAVIRUS ANTIGEN Negative Specimen Container: 87425 Enzyme Immunoassay Sterile, screw-cap container Clinical Use: Rotavirus infection is the major cause of gastroenteritis in children 2 g fresh stool from six months to two years. Infection occurs in both sporadic and edpidemic forms and is responsible for approximately half the cases of diarrhea in infants that require hospitalization worldwide. The peak of rotavirus in temperate climates occurs during the cooler months of the year. Rotavirus has also emerged as a cause of enteritis in adults, particularly in elderly immuno- Performed: referred-A compromised patients. turn around: 3-5 days

46592 RPR Nonreactive Specimen Container: 86592 Rapid plasma Reagin Gel barrier (gold or tiger top) Clinical Use: If the test is reactive, an FTA-ABS will be The RPR test is a screening test for syphilus. False positve results 1.0 (0.5) mL serum completed at an additional charge. may occur due to SLE, malaria, mononucleosis, infectious hepatitis, leprosy, brucellosis, atypical pneumonia, typhus, yaws, pinta or pregnancy. Positive results should be confirmed with specific treponemal antibody test (FTE-ABS or TP-RA). A reactive FTA-ABS confirms the presence of treponemal antibodies but Performed: mon - sat does not indicate the stage or presence of active infection. turn around: next day

16317 RUBELLA VIRUS ANTIBODY, IGG < than 10 IU/mL is not immune Specimen Container: 86762 Chemiluminescence ≥ 10 shows increasing levels of Rubella Antibody Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum Rubella is an acute exanthematous viral infection of children and adults. Rash, fever, and lymphadenopathy characterize the illness. While many infections are subclinical, this virus has the potential to cause fetal infection with resultant birth defects. Diagnosis of a rubella infection is best made serologically. In the absence of a current or recent infection, a demonstration of specific IgG on a Performed: mon, wed, fri serum sample is evidence of immunity to rubella. turn around: 1-3 days

86915 RUBELLA VIRUS ANTIBODY, IGM Specimen Container: 86762 Immunoassay < 0.90: Negative - No Rubella IgM Antibody Detected Gel barrier (gold or tiger top) 0.90-1.09: Equivocal ≥ 1.10: Positive - Rubella IgM Antibody Detected 1.0 (0.5) mL serum

Clinical Use: Rubella is an acute exanthematous viral infection of children and adults. Rash, fever, and lymphadenopathy characterize the illness. While many infections are subclinical, this virus has the potential to cause fetal infection with resultant birth defects. A positive Rubella IgM result does not necessarily indicate a current or recent infection. Without a history of exposure to Rubella or symptoms consistent with Rubella, the IgM result may be difficult to interpret. Rubella IgM can be false positive due to other causes (e.g., Parvovirus, Rheumatoid Factor, Cytomegalovirus). Rubella IgM may also persist for more than 12 months after vaccination or natural infection. For a serologic diagnosis of congennital Rubella in the neonatal period, antibody to Rubella virus should be measured in both infant and maternal sera. If IgM is detected in a newborn infant's serum, it is probable that transplacental Performed: referred-A Rubella infection has occurred. turn around: 3-5 days

16765 RUBEOLA (MEASLES) IgG ANTIBODY ≤0.90: Negative NICL Laboratories/2011 Specimen Container: 86765 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Immunoassay 0.91-1.09: Equivocal Gel barrier (gold or tiger top) ≥1.10: Positive 1.0 (0.5) mL serum Clinical Use: Measles is an acute infection caused by Rubeola Virus. After an incubation period of 10-14 days, cough, coryza, fever, and a maculopapular rash that begins several days after the intial symptoms characterize the illness. The characteristic oral, exanthem, koplik spots, is specific for measles and precedes the onset of rash. In the absence of a current or recent infection, a demonstration of specific IgG on a serum sample by enzyme Performed: mon, wed, fri immunoassay is evidence of immunity to rubeola. turn around: 1-3 days

86765 RUBEOLA IgM ANTIBODY < 1:10 Specimen Container: 86765 Immunofluorescence Assay Gel barrier (gold or tiger top) Clinical Use: Measles is an acute infection caused by Rubeola Virus. After an 1.0 (0.5) mL serum incubation period of 10-14 days, cough, coryza, fever, and a maculopapular rash that begins several days after the intial symptoms characterize the illness. The characteristic oral, exanthem, koplik spots, is specific for measles and precedes onset of rash. Results from any one IgM assay should not be used as a sole determinant of a curent or recent infection. Because an IgM test can yield false positive results and a low level of IgM antibody may persist for more than 12 months post infection, reliance on a single test result could be misleading. If an acute infection is suspected, consider obraining a new specimen for both Performed: referred-A IgG and IgM testing in two or more weeks. turn around: 3-5 days

85613 RUSSELL VIPER VENOM TIME (dRVVT) WITH REFLEX ≤ 45 sec Specimen Container: 85613 Clot Detection 3.2% Sodium citrate (light blue top) Clinical Use: If the dRVVT Screen is prolonged (> 45 seconds), the dRVVT Confirmation Diagnosis of a lupus anticoagulant (LA) requires testing with at 2.0 (1.0) mL platelet poor plasma, FROZEN will be performed at an additional charge (CPT: 85598). least 2 screening reagents, followed by confirmatory testing. The dRVVT screen, confirm, and mix satisfy international 1) Draw one red top tube to remove tissue fluid If the dRVVT Confirm is positive, a dRVVT 1:1 dilution guidelines for LA evaluations. contamination. will be performed at an additional charge (CPT: 85613). 2) Draw 2 light blue top tubes, filled to the appropriate level. (Do not overfill or underfill) 3) Invert gently 6 times to mix, process immediately. 4) Centrifuge for 15 minutes at 2500 x g 5) Using a plastic pipette, remove plasma, taking care to avoid the wbc/platelet buffy layer, and place into a plastic vial. 6) Centrifuge a second time for 15 minutes and transfer platelet-poor plasma into 3 separate plastic, screw-cap vials. Label tubes appropriately. Performed: referred-A 7) Freeze immediately. turn around: 3-5 days

86672 SACCHAROMYCES CEREVIS IgA ANTIBODY ≤20.0 Units: Negative Specimen Container: 86671 Enzyme-Linked Immunosorbent Assay 20.1-24.9 Units: Equivocal Gel barrier (gold or tiger top) ≥ 25.0 Units: Positive 1.0 (0.3) mL serum Clinical Use: Centrifuge within one hour of collection. Antibodies to Saccharomyces cerevisiae are found in approximately 75% of patients with Crohn's disease, 15% of patients with ulcerative colitis, and 5% of the healthy population. High titers of antibody increase the liklihood of disease, specifically Performed: referred-A Crohn's disease, and are associated with more aggressive disease. turn around: 7-10 days

86671 SACCHAROMYCES CEREVIS IgG ANTIBODY ≤20.0 Units: Negative Specimen Container: 86671 Enzyme-Linked Immunosorbent Assay 20.1-24.9 Units: Equivocal Gel barrier (gold or tiger top) ≥ 25.0 Units: Positive NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 1.0 (0.3) mL serum Clinical Use: Centrifuge within one hour of collection. Antibodies to Saccharomyces cerevisiae are found in approximately 75% of patients with Crohn's disease, 15% of patients with ulcerative colitis, and 5% of the healthy population. High titers of antibody increase the liklihood of disease, specifically Performed: referred-A Crohn's disease, and are associated with more aggressive disease. turn around: 3-5 days

80196 SALICYLATES, SERUM/PLASMA Therapeutic: (not for use with single dose intoxication) Specimen Container: 80196 Immunoassay Analgesic: 50.0-100.0 mcg/L No additive (red top) Anti-inflammatory: 150.0-300.0 mcg/\L 1.0 (0.5) mL serum Clinical Use: Salicylates are a class of analgesic, antipyretic, and Collect just prior to next dose. anti-inflammatory drugs that includes aspirin. Salicylate overdose results in disturbances of the central nervous system and the Do not use gel barrier tube Performed: mon - sat gastrointestinal tract as well as encephalopathy and renal failure. turn around: next day

86768 SALMONELLA TOTAL ANTIBODIES Accompanies report Specimen Container: 86768 (x5) Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Salmonella, Total Antibody, detects antibodies to Salmonella 1.0 (0.3) mL serum typhii, a common cause of gastroenteritis, diarrhea, and dysentery. Antibody results should be confirmed with stool or blood cultures. Antibodies to Salmonella flagellar (H) and somatic (O) antigens typically peak 3-5 weeks after infection. A positive result in assay is equivalent to a titer of ≥1:160 by tube agglutination (Widal). Results should not be considered diagnostic unless confirmed by Performed: referred-A culture. turn around: 5-7 days

47207 SCABIES SCRAPING No scabies present Specimen Container: 87220 Microscopic Scabies Collection Kit Clinical Use: Sarcoptes scabiei causes scabies, which is recognized by a Skin scraping in mineral oil between two microscopic nocturnal itch occurring primarily on the webbing between the slides taped together, in a sterile container. fingers spreading to the wrists, elbows, buttocks, breasts, and external genitalia. This itch and accompanying skin eruptions are delayed for several weeks after the initial infection. The rash represents a sensitization to the bite which does not correspond Performed: mon, wed, fri to the location of the active adult female. turn around: 1-3 days

86009 SCLERODERMA (SCL-70) ANTIBODIES Index Values ≤1.00 Negative Specimen Container: 86235 Immunoassay Index Values > 1.00 Positive Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum Scl-70 antibody is present in approximately 40% of patients with Progressive Systemic Sclerosis (PSS).

Performed: referred-A turn around: 5-7 days

15651 SEDIMENTATION RATE (ESR) Sed Rate, Females Specimen Container: 85651 Westergren 0-20 mm/h: Infant through 50 years EDTA (lavender top) 0-30 mm/h: From 50 years through old age 5.0 (2.0) mL whole blood Sed Rate, Males 0-15 mm/h: Infant through 50 years 0-20 mm/h: From 50 years through old age

Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE The ESR is used to differentiate inflammatory and neoplastic Performed: daily diseases and as an index of disease severity. turn around: next day

84260 SEROTONIN, SERUM Adult Reference Range for Serotonin, Serum Specimen Container: 84260 High Performance Liquid Chromatography 26-165 ng/mL Gel barrier (gold or tiger top)

Pediatric (1-12 years) Reference Range for Serotonin, Serum 2.0 (1.0) serum, FROZEN 81-349 ng/mL Transfer serum to a plastic, screw-cap vial, freeze.

Clinical Use: Patient should avoid foods high in indoles: avocado Serotonin concentrations are greatly increased in patients with banana, tomato, plum, walnut, pineapple and eggplant. carcinoid syndrome. Carcinoid tumors are associated with Patient should also avoid tobacco, tea and coffee for multiple endocrine neoplasia (MEN) types I and II. These tumors 3 days before specimen collection. Performed: referred-A are associated with flushing, diarrhea, pain and other symptoms. turn around: 3-5 days

84161 SEROTONIN, BLOOD 22-180 ng/mL Specimen Container: 84260 High Performance Liquid Chromatography Serotinin Kit: Clinical Use: •7.2 mg EDTA (lavender top) Serotonin concentrations are greatly increased in patients with •Transfer container with 35 mg Ascorbic Acid carcinoid syndrome. Carcinoid tumors are associated with multiple endocrine neoplasia (MEN) types I and II. These tumors Collection Instructions: are associated with flushing, diarrhea, pain and other symptoms. 1) Collect specimen into the EDTA 7.2 mg tube. 2) After drawing blood, mix well and immediately transfer allthe blood to the transfer container, which contains 35 mg Ascorbic Acid. 3) Mix well and freeze immediately. 4) Ship frozen

Patient should avoid foods high in indoles: avocado banana, tomato, plum, walnut, pineapple and eggplant. Patient should also avoid tobacco, tea and coffee for Performed: referred-A 3 days before specimen collection. turn around: 3-5 days

84270 SEX HORMONE BINDING GLOBULIN (SHBG) Accompanies Report Specimen Container: 84270 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Testosterone, dihydrotestosterone, and estrogens circulate in 1.0 (0.5) mL serum serum bound to Sex Hormone Binding Globulin (SHBG). SHBG concentrations are increased in pregnancy, hyperthyroidism, Specify age and sex on test requisition cirrhosis, oral estrogen administration, and by certain drugs. Concentrations are decreased by testosterone, hypothyroidism, Performed: referred-A Cushing's syndrome, acromegaly, and obesity. turn around: 3-5 days

14455 SGOT (AST) ASPARTATE AMINOTRANSFERASE) 0 - 6 days: 0 – 75 U/L Specimen Container: 84450 Spectrophotometric 6 days – 2 years: 0 – 65 U/L Gel barrier (gold or tiger top) 2 – 12 years: 0 – 43 U/L > 60 years: 9 – 35 U/L 1.0 (0.5) mL serum

Clinical Use: AST measurements are used in the diagnosis and treatment Performed: daily of certain types of liver and heart disease turn around: next day

14465 SGPT(ALT) 0 - 6 days: 0 – 60 U/L Specimen Container: 84460 Spectrophotometric 6 days – 2 years: 0 – 50 U/L Gel barrier (gold or tiger top) 2 – 12 years: 0 – 45 U/L > 60 years: 0 – 35 U/L 1.0 (0.5) mL serum

Clinical Use: ALT measurements are used in the diagnosis and treatment of NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE certain liver diseases (e.g. viral hepatitis and cirrhosis) and heart Performed: daily disease. turn around: next day

13052 SICKLE CELL SCREEN Negative Specimen Container: 85660 Hemoglobin Solubility EDTA (lavender top) Clinical Use: Sickle cell anemia is a life shortening disease which is often fatal in 5.0 (1.0) mL whole blood infants. Repeated bouts of vascular occlusion lead to accumulated damage to kidney, heart, lung, eyes and other organs. If detected early and properly treated, the life span of patients with sickle cell Performed: mon – sat disease can be increased. turn around: next day

80301 SINEMET (CARBIDOPA) Accompanies report Specimen Container: 80299 (x2) No additive (red top) Clinical Use: Therapeutic drug monitoring is useful to optimize dose and avoid 2.0 (0.7) serum, FROZEN toxicity. Immediately transfer serum to a plastic, screw-cap Performed: referred-A vial and freeze turn around: 5-7 days

86216 SJÖGREN'S ANTIBODIES (SS-A) SS-A AB Specimen Container: 86235 < 1.0 AI Negative Gel barrier (gold or tiger top) Immunoassay Clinical Use: 1.0 (0.5) mL serum Sjögren's Antibody (SS-A) is detected in most patients with Sjögren's syndrome, 40-50% of patients with spontaneous systemic lupus erythematosus (SLE), approximately 65% of patients with ANA-negative SLE, 20%of patient's with polymyositis, 5% of patients with rheumatoid arthritis and scleroderma, and most women who have delivered babies with neonatal lupus. Antibodies to SSA (RO) and SSB (LA) are observed with the highest frequency in Sjögren's syndrome, although these antibodies are also found in a significant percentage of patients Performed: referred-A with SLE. turn around: 3-5 days

86217 SJÖGREN'S ANTIBODIES (SS-B) SS-B Ab Specimen Container: 86235 Immunoassay < 1.0 AI Negative Gel barrier (gold or tiger top)

Clinical Use: 1.0 (0.5) mL serum Sjögren's Antibody (SS-B) is detected in approximeatly 15% of patients with Sjögren's syndrome. Sjögren's Antibody (SS-B) is present only if Sjögren's Antibody (SS-A) is also detected. Antibodies to SSA (RO) and SSB (LA) are observed with the highest frequency in Sjögren's syndrome, although these antibodies are also found in a significant percentage of patients with SLE. Performed: referred-A turn around: 3-5 days

86917 SJÖGREN'S SYNDROME ANTIBODIES SS-A(Ro), SS-B(La) For both SS-A, SS-B Abs Specimen Container: 86235 (x2) EIA < 1.0 AI Negative Gel barrier (gold or tiger top)

Clinical Use: 2.0 (1.0) mL serum Sjögren's Antibody (SS-B) is detected in approximeatly 15% of patients with Sjögren's syndrome. Sjögren's Antibody (SS-B) is present only if Sjögren's Antibody (SS-A) is also detected. Antibodies to SSA (RO) and SSB (LA) The presence of both antibodies (SS-A and SS-B) strengthen the diagnosis of Sjögren''s syndrome and conveys prognostic Performed: referred-A information. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: 3-5 days

86239 Sm/RNP ANTIBODY < 1.0 AI Negative Specimen Container: 86235 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Smith (Sm)/U1-RNP Anibody is detected in patients with mixed 1.0 (0.5) mL serum connective tissue disease (having features of systemic lupus erythematosus, polymyosititis). (SLE), scleroderma, Performed: referred-A polymyosititis). turn around: 3-5 days

86235 SMITH (SM) ANTIBODY < 1.0 AI Negative Specimen Container: 86235 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Smith Antibody (Sm) is highly specific for systemic lupus 1.0 (0.5) mL serum erythematosus (SLE). Smith Antibody is also detected in approximately 15% of patients with SLE. Smith Antibody is detected in more than half of young African-American Performed: referred-A women with SLE. turn around: 3-5 days

14295 SODIUM, SERUM 136 – 147 mEq/L Specimen Container: 84295 ISE/Diluted Gel barrier (gold or tiger top) Clinical Use: Sodium measurements are used in the diagnosis and treatment of 1.0 (0.5) mL serum aldosteronism (excessive secretion of the hormone aldosterone), diabetes insipidus, adrenal hypertension, Addison's disease, dehydration, inappropriate antidiuretic hormone secretion, or Performed: daily other disease involving electrolyte imbalance. turn around: next day

24300 SODIUM, 24 HR. URINE 40 – 220 mEq/24 HR Specimen Container: 84300 ISE/Diluted 24 hour Urine Collection container, no preservative 82570 Clinical Use: The excretion of sodium varies with dietary intake. There is a 10.0 (0.5) mL aliquot of a well mixed 24-hr urine diurnal variation of sodium excretion with excreation being greater during the daytime than during the night. Decreased levels are Record total volume and collection time on specimen seen in congestive heart failure, excessive sweating, diarrhea, container and requisition. pyloric obstruction, malabsorption and primary aldosteronism. Increased levels may be due to increased salt intake, failure of the adrenal glands, diabetic acidosis, salt losing renal disease Performed: mon, wed, fri diuretic therapy and water deprivation dehydration. turn around: 1-3 days

14300 SODIUM, URINE No reference ranges have been established Specimen Container: 84300 ISE/Diluted Urine container, leak-proof Clinical Use: Decreased levels are seen in congestive heart failure, excessive 10.0 (2.0) random urine sweating, diarrhea, pyloric obstruction, malabsorption and primary aldosteronism. Increased levels may be due to increased salt intake, failure of the adrenal glands, diabetic acidosis, salt losing renal disease diuretic therapy and water deprivation dehydration. Performed: mon, wed, fri diuretic therapy and water deprivation dehydration. turn around: 1-3 days

24301 SODIUM AND POTASSIUM, 24 HOUR URINE Sodium: 40 – 220 mEq/24 HR Specimen Container: 84300 ISE/Diluted Potassium: 25 – 120 mEq/ 24 HR 24 hour Urine Collection container, no preservative 84133 82570 Clinical Use: 10.0 (0.5) mL aliquot of a well mixed 24-hr urine See individual test Record total volume and collection time on specimen Performed: mon, wed, fri container and requisition. turn around: 1-3 days

84004 SOLUBLE LIVER ANTIGEN (SLA) AUTOANTIBODY 0.0-20.0 Units: Negative NICL Laboratories/2011 Specimen Container: 83520 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Enzyme-Linked Immunosorbent Assay 20.1-24.9 Units: Equivocal Gel barrier (gold or tiger top) ≥ 25.0 Units: Positive 2.0 (0.3) mL serum Clinical Use: Antibodies to soluble liver antigen (SLA) are found in approximately 30% of patients with autoimmune hepatitis type 1 (AIH-1), and are identical to antibodies recognizing liver-pancreas (LP) antigen. SLA antibodies have been found in some patients with clinical features of AIH-1 who are negative for conventional serologic markers of AIH-1 (ANA, smooth muscle antibodies). Unlike these conventional markers, the specificity of SLA Performed: referred-A antibodies for AIH-1 approaches 100%. turn around: 3-5 days

84239 SOLUBLE TRANSFERRIN RECEP Accompanies report Specimen Container: 84238 Immunoturbidimetric Gel barrier (gold or tiger top) Clinical Use: Evaluation of suspected iron deficiency in patients who may have 1.0 (0.5) mL serum inflammation, infection, or chronic disease and other conditions in which ferritin concentration does not correlate with iron status, including: Cystic fibrosis patients who frequently have inflammation or infections, and evaluating insulin-dependent diabetics who may have iron-deficiency resulting from gastric autoimmunity and Performed: referred-A atrophic gastritis. turn around: 3-5 days

84307 SOMATOSTATIN, PLASMA ≤ 30 pg/mL Specimen Container: 84307 Extraction EDTA (lavender top) Radioimmunoassay Clinical Use: Somatostatin is a neurohormone produced in the brain, 2.0 (0.6) mL plasma, FROZEN hypothalamus, and gastrointestinal tract. High concentrations Transfer plasma immediately to a plastic, screw-cap of somatostatin are associated with somatostatinomas. These vial and freeze. occur in the pancreas. Elevations are also seen in other gastrointestinal. endocrine secreting tumors, medullary thyroid Performed: referred-A carcinoma, and pheochromocytomas. turn around: 5- 7 days

11004 SPECIFIC GRAVITY 1.005 – 1.03 Specimen Container: 81003 Refractometric Urine contianer, leak-proof Clinical Use: Specific gravity is a measure of the dissolved substances present 10.0 (1.0) mL random urine in the urine. Specific gravity is one measure of the concentrating and diluting ability of the kidneys and hydration status of the Performed: daily patient. turn around: next day

83501 SPRUE ANTIBODY PANEL Accompanies Report: Specimen Container: 83516 (x3) Enzyme Immunoassay Gel barrier (gold or tiger top) 86255 Indirect Immunofluorescence Assay Clinical Use: See individual tests 2.0 (1.0) mL serum Test components: Gliadin Antibody (IgG, IgA), Reticulin IgG Screen with Reflex to Titer, Tissue Transglutaminase IgA Antibody

Performed: referred-A turn around: 3-5 days

86226 SSDNA IgG ANTIBODY < 69 U/mL Negative Specimen Container: 86226 Enzyme Immunoassay 69-229 U/mL Moderate Positive Gel barrier (gold or tiger top) > 229 U/mL Positive 1.0 (0.5) mL serum Clinical Use: Autoantibodies to ssDNA recognize the purine and pyrimidine bases of DNA. These antibodies are found in SLE and may NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE be present in patients with ANA-negative SLE. However, high titers are not risk of lupus nephritis and may be found in drug induced specific for SLE or for lupus, rheumatoid arthritis, and Performed: referred-A chronic active hepatitis. turn around: 3-5 days

47085 STREP SCREEN No Beta hemolytic Streptococcus isolated Specimen Container: 87081 Culture Culture transport swab (pink cap) Clinical Use: Group A Streptococcus is one of the most important causes of Throat swab acute upper respiratory tract infection. Early diagnosis and treatment of Group A Strep pharyngitis has been shown to reduce the severity of symptoms and further complications such as Performed: daily rheumatic fever and glomerulonephritis. turn around: 2-3 days

80250 STREPTOMYCIN LEVEL Accompanies report Specimen Container: 80299 High Performance Liquid Chromatography No additive (red top) Clinical Use: Therapeutic drug monitoring to optimize dose and avoid toxicity. 1.0 (0.5) mL FROZEN serum Transfer serum to a plastic, screw-cap vial, freeze

Performed: referred-A Do not use gel barrier tubes. turn around: 7-10 days

86270 STRIATED MUSCLE ANTIBODY WITH REFLEX TO TITER < 1:10 Specimen Container: 86255 Immunofluorescence Assay Gel barrier (gold or tiger top) Clinical Use: Anti-skeletal muscle antibody tiers of >1:80 have been reported to 1.0 (0.5) mL serum be present in the serum of 30% of patients with myasthenia gravis, 95% of patients with myastenia gravis and thymoma, and 25% of Performed: referred-A patients with thymomia. turn around: 5-7 days

80312 SULFA DRUGS Sulfa Drugs, Therapeutic Specimen Container: 80299 Colorimetric 0.5-10.0 mg/dL Sulfanilamide No additive (red top) Potentially toxic value: >20 mg/dL 3.0 mL serum Clinical Use: Therapeutic drug monitoring to optimize dose and to avoid Please specify on the request form particular Performed: referred-A toxicity. medications. turn around: 5-7 days

85805 SYNOVIAL FLUID ANALYSIS Accompanies report Specimen Container: 82945 Manual EDTA (lavender top) and 83872 Microscopic Examination Clinical Use: No additive (red top) 84999 An abnormal mucin clot test may occur in a wide variety of 89060 Test components: inflammatory conditions including septic arthritis, gouty arthritis, 3.0 (2.0) mL synovial fluid submitted in an EDTA Includes Glucose, Mucin Clot testing, Fat Globules and Crystal Analysis and rheumatoid arthritis. Monosodium Urate crystals (MSU) may (lavender top) tube be found in cases of gout and Calicium Pyrophosate Dihydrate and 3.0 (2.0) mL synovial fluid submitted in a No (CPPD) crystals may be found in pseudo-gout. Synovial Glucose additive (in conjunction with plasma glucose) aids in the diagnosis of (red top) tube synovial inflammation or infection. Performed: referred-A Transport refrigerated turn around: 3-5 days

14481 T3 (TRIIODOTHYRONINE), FREE 2.3 – 4.2 pg/mL Specimen Container: 84481 Chemilluminescence Gel barrier (gold or tiger top) Clinical Use: Free T-3 is used to diagnosis and monitor the treatment of 1.0 (0.5) mL serum hyperthyroidism. Free T-3 assays can differentiate most cases of nonthyroidal illness from TSH-dependent hyperthyroidism. Performed: daily NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE turn around: next day

84482 T3 (TRIIODOTHYRONINE), REVERSE 11-32 ng/dL Specimen Container: 84482 Radioimmunoassay Gel barrier (gold or tiger top) Clinical Use: Reverse T-3 (rT3) has limited application. They assay may be 1.0 (0.4) mL serum useful in the diagnosis of nonthyroidal illness (NTI). Patients with NTI have low T3 concentrations and increased concentrations of rT3. RT3 may be useful in neonates to distinguish euthyroid sick syndrome from central hypothyroidism.

14480 T3 (TRIIODOTHYRONINE), TOTAL 0.6 - 1.81 ng/mL Specimen Container: 84480 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Total T3 measurements are used to diagnose and 1.0 (0.5) mL serum monitor treatment of hyperthyroidism and are essential for recognizing T3 toxicosis. Performed: daily turn around: next day

14479 T3-UPTAKE 0.75 – 1.23 units Specimen Container: 84479 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: T3 Uptake is decreased in pregnancy, estrogen administration, 1.0 (0.5) mL serum hyperproteinemia, and acute intermittent porphyria. It is increased in androgen administration,stress, and acute liver disease. This assay is a measure of available thyroid hormone binding sites Performed: daily and should be interpreted with thyroxine levels. turn around: next day

14439 T4 (THYROXINE), FREE 0.6 - 1.55 ng/dL Specimen Container: 84439 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Test is for diagnosis of hypothyroidism and hyperthyroidism. 1.0 (0.5) mL serum Performed: daily turn around: next day

14436 T4 (THYROXINE), TOTAL 4.5 - 10.9 ug/dL Specimen Container: 84436 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Test is for diagnosis of hypothyroidism and hyperthyroidism. 1.0 (0.5) mL serum Performed: daily turn around: next day

80197 TACROLIMUS (FK506) (PROGRAF) Trough: 5.0-20.0 ng/mL Specimen Container: 80197 Liquid Chromatography/Tandem Mass Spectrometry Toxicity may occur at a level as low as 20.0 ng/mL. EDTA (lavender top)

Clinical Use: 2.0 (1.0) mL whole blood Tacrolimus (FK 506) is an immunosuppresive drug used in organ transplantation to prevent graft rejection. Therapeutic drug Optimal time to draw specimen: 1/2-1 hour before Performed: referred-A monitoring is useful to optimize dose and avoid toxicity. next oral dose. turn around: 3-5 days

86327 TEICHOIC ACID Ab SCREEN w/REFLEX TO TITER Negative in normal individuals Specimen Container: 86331 Immunodiffusion Gel barrier (gold or tiger top) Clinical Use: Teichoic acid antibodies have been detected in patients with 1.0 (0.5) mL serum Performed: referred-A staphylococcus aureus, osteomyelitis as well as endocarditis. turn around: 3-5 days

14403 TESTOSTERONE, TOTAL Female: 14 – 76 ng/dL Specimen Container: 84403 Chemiluminescence Male: 241 – 827 ng/dL Gel barrier (gold or tiger top)

1.0 (0.5) mL serum NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: This test is useful in the differential diagnosis of male hypogonadism, premature or delayed puberty, and female Performed: daily hirsitism and virilization. turn around: next day

84404 TESTOSTERONE, FREE & TOTAL Accompanies report Specimen Container: 84402 Liquid Chromatography Tandem Mass Spectrometry (LC/MS/MS) No additive (red top) 84403 Tracer Equilibrium Dialysis Clinical Use: Calculation Test is helpful in assessing testicular function in males and 1.0 (0.5) mL serum In managing hirsutism and virilization in females. Transfer serum to a plastic, screw-cap vial.

Performed: referred-A turn around: 5-7 days

86649 TETANUS & DIPH TOXOID IgG Diptheria Toxoid IgG Antibodies: >.099 IU/mL Specimen Container: 86774 Enzyme Immunoassay Tetanus Toxoid IgG Antibodies: >.150 IU/mL Gel barrier (gold or tiger top) 86648

Clinical Use: 2.0 (1.0) mL serum Performed: referred-A Used to evaluate Diptheria and Tetanus immunization efficacy. turn around: 3-5 days

80295 TETRACYCLINE LEVEL, BA Accompanies report Specimen Container: 80299 Bioassay No additive (red top) Clinical Use: Therapeutic drug monitoring to optimize dose and to avoid 1.0 (0.5) mL serum toxicity. Transfer serum to a plastic, screw-cap vial.

Specimens collected just before or within 15 minutes of the next antibiotic dose represent the trough levels

Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or Performed: Monday-Friday Morning 90 minutes after oral intake represent the peak level. turn around: 4 Days

12137 THEOPHYLLINE 10 - 20 mcg/mL Specimen Container: 80198 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Theophylline is used in the treatment of bronchial asthma, as 1.0 (0.5) mL serum well as in the treatment of chronic obstructive pulmonary disease and episodes of prolonged apnea in preterm infants. Theophylline levels are monitored to assure adequate therapeutic levels are Performed: daily achieved and to avoid toxicity. turn around: next day

68142 THIN PREP PAP No atypical or abnormal cells detected Specimen Container: 88142 Papanicolaou Staining/Bethesda System of Reporting ThinPrep® PAP Vial Clinical Use: The liquid based Thinprep Pap Smear is intended for the use of Endocervical specimen screening for the presence of atypical cells, dysplasia or cervical ThinPrep® PAP Vial must be used with plastic spatula, cancer, as well as all cytologic categories as defined by The plus endocervical brush or broom device. Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses. Patient's name must be written on the specimen container. Transport at room temperature. Performed: mon-fri turn around: 7-10 days

67623 THIN PREP PAP W/HIGH RISK HPV Pap: No atypical or abnormal cells detected Specimen Container: 88142 Hybrid Capture HPV: Not detected ThinPrep® PAP Vial 87621 Papanicolaou Staining/Bethesda System of Reporting Clinical Use: Endocervical specimen The liquid based Thinprep Pap Smear is intended for the use of ThinPrep® PAP Vial must be used with plastic spatula, screening for the presence of atypical cells, dysplasia or cervical plus endocervical brush or broom device. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE cancer, as well as all cytologic categories as defined by The Bethesda System for Reporting Cervical/Vaginal Cytologic Patient's name must be written on the specimen Diagnoses. HPV is the causative agent of cervical dysplasia container. Transport at room temperature. and cervical carcinoma. This assay only detects high-risk HPV Performed: mon-fri types, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. turn around: 7-10 days

67625 THIN PREP W/LOW & HIGH RISK HPV 88142 Hybrid Capture Papanicolaou Staining/Bethesda System of Reporting

Performed: Monday-Saturday All Shifts turn around: Same Day

68143 THIN PREP W/REFLEX HIGH RISK HPV Pap: No atypical or abnormal cells detected. 88142 Hybrid Capture HPV: Not detected Papanicolaou Staining/Bethesda System of Reporting

Performed: Monday-Saturday All Shifts turn around: Same Day

84430 THIOCYANATE Therapeutic information Specimen Container: 84430 Colorimetric Unexposed nonsmokers: 1.0-4.0 mcg/mL No additive (red top) Unexposed smokers: 3.0-12.0 mcg/mL 3.0 (1.5) mL serum Clinical Use: Transfer serum to a plastic, screw-cap vial. Sodium nitroprusside is a potent hypotensive agent. It is used in the treatment of malignant hypertension and as an adjunct in the control of blood pressure in surgery. The major metabolite is thiocyanate which is largely excreted by the kidneys. Thiocyanate levels should be monitored in any patient receiving therapy longer than 48 hours, or who has renal or hepatic impairment. Thiocyanate is also a metabolite of acetonitrite, acrylonitrite, amygdalin and cyanide. Thiocyanate is higher in smokers vs. Performed: referred-A non-smokers. turn around: 5-7 days

80221 THIORIDAZINE+MESORIDAZINE Accompanies report Specimen Container: 84022 Gas Chromatography No additive (red top) Clinical Use: Thioridazine is a phenothiazine for treating psychosis. Monitoring 2.0 (0.7) mL serum its level is important to optimize therapy, to avoid toxicity, and to Transfer serum to a plastic, screw-cap vial. assure compliance. Performed: referred-A Do not use gel barrier tubes turn around: 5-7 days

84435 THYROGLOBULIN, FINE NEEDLE ASPIRATE Accompanies report Specimen Container: 84432 Immunoassay Sterile container, leak-proof Clinical Use: Clinically enlarged cervical lymph nodes with a history of 1.0 (0.8) mL aspirate, FROZEN thyroid cancer are usually assessed by fine-needle aspiration or biopsy (FNAB), followed by a cytology. Thyroglobulin (Tg) is 1.0 (0.8) mL node washings, FROZEN frequently elevated in malignant FNAB needle wash specimens Performed: referred-A and its use may possibly augment or replace cytology. turn around: 5-7 days

84231 THYROGLOBULIN Also includes Anti-Thyroglobulin Antibodies 2.0-35.0 ng/mL Specimen Container: 84432 Immunoassay Samples containing Thyroglobulin Antibodies could interfere in Gel barrier (gold or tiger top) the determination of Thyroglobulin. Please interpret results with caution. NICL Laboratories/2011 2.0 (0.8) mL serum TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE

Clinical Use: Thyroglobulin is elevated in three types of thyroid disorders: goiter and thyroid hyperfunction, inflammation or physical injury to the thyroid, and differential thyroid tumors. Thyroglobulin is useful in the management but not diagnosis of differentiated thyroid Performed: referred-A carcinomas. turn around: 3-5 days

16800 THYROGLOBULIN ANTIBODIES 0 - 60 U/mL Specimen Container: 86800 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Measurement of thyroglobulin antibodies is useful in the diagnosis 1.0 (0.5) mL serum and management of a variety of thyroid disorders including Performed: mon-wed, fri Hashimoto's thyroiditis, Graves Disease and certain types of goiter. turn around: 1-3 days

26594 THYROID ANTIBODY PANEL Anti-Thyroglobulin: 0 - 60 U/mL Specimen Container: 86800 Chemiluminescence Anti-Thyroid Peroxidase: 0 - 60 U/mL Gel barrier (gold or tiger top) 86376

Test Components: Clinical Use: 2.0 (1.0) mL serum Anti-Thyroglobulin Measurement of thyroglobulin and thyroid peroxidase antibodies Anti-Thyroid Peroxidase (Anti-TPO) is useful in the diagnosis and management of a variety of thyroid disorders, including autoimmune thyroiditis, Hashimoto's thyroiditis, Performed: mon-wed, fri Graves' disease, turn around: 1-3 days

16376 THYROID PEROXIDASE ANTIBODIES 0 - 60 U/mL Specimen Container: 86376 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Assists in the diagnosis of thyroid diseases such as endemic 1.0 (0.5) mL serum goiter, Graves Disease, autoimmune thyroiditis, Addison's Disease, insulin-dependent diabetes mellitus, Hashimoto's Disease, and Performed: mon-wed, fri polyendocrine auto-immunopathies. turn around: 1-3 days

20079 THYROID PROFILE III Free T-4: 0.6 - 1.55 ng/dL Specimen Container: 84443 Chemiluminescence TSH, Sensitive: 0.35 - 5.5 uIU/mL Gel barrier (gold or tiger top) 84439

Test components: Clinical Use: 2.0 (1.0) mL serum Free T-4, TSH, Sensitive For differential diagnosis of primary, secondary and tertiary hypothyroidism. Also useful in screening for hyperthyroidism. Performed: daily turn around: next day

84444 THYROID STIMULATING IMMUNOGLOBULIN (TSI) Accompanies report Specimen Container: 84445 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Graves' disease is a classic form of hyperthyroid disease, affecting 1.0 (0.2) mL serum approximately 0.4% of the population in the United States. It is caused by IgG immunoglobulins, collectively known as thyroid stimulating immunoglobulins (TSI). Patients who are candidates for antithyroid drug therapy may not respond to this treatment when TSI levels are markedly elevated. The determination of TSI can also assist in predicting hyperthyroidism in neonates, due to placental transmission of the immunoglobulins from a mother with Performed; referred-A hyperthyroidism. turn around: 5-7 days

84443 THYROXINE BINDING GLOBULIN (TBG) Accompanies report Specimen Container: 84442 Chemiluminescence Assay Gel barrier (gold or tiger top) Clinical Use: Thyroxine-binding globulin (TBG) is used to differentiate 1.0 (0.5) mL serum quantitative TBG derangements from thyroid dysfunction. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE The measurement of TBG can also be used to establish the presence of TBG deficiency or excess, suggested by abnormal total T4 and T3 concentrations in the presence Performed: referred-A of normal free levels of these hormones. turn around: next day

87168 TICK ID FOR LYME DISEASE Accompanies report Specimen Container: 87168 Microscopic Examination Sterile container, leak-proof Clinical Use: Arthropods/insects may be vectors of disease and may cause Tick, insect, larva, etc. infestations of skin, hair, and mucous membranes. Diagnosis of a disease or infestation may be achieved by recovery and Place specimen in 70% Alcohol as soon as possible. identification of the intact arthropod/insect. Submit in a screw-capped container, ensuring that the Performed: referred-A cap is as tight as possible to prevent leakage in transit. turn around: 7-10 days

83510 TISSUE TRANSGLUTAMINASE ANTIBODY (IgA, IgG) Accompanies report Specimen Container: 83516 (x2) Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Tissue Transglutaminase Antibody, IgA, is useful in diagnosing 1.0 (0.5) mL serum gluten-sensitive enteropathies, such as celiac sprue disease and an associated skin condition, dermatitis herpetiformis. The IgG test is useful in patients who are IgA-deficient. The IgG test also provides support for gluten-sensitive enteropathies beyond the IgA test.

Performed: referred-A turn around: 3-5 days

83547 TISSUE TRANSGLUTAMINASE IgG Ab Specimen Container: 83516 Enzyme Immunoassay < 7 U/mL Negative Gel barrier (gold or tiger top) 7-10 U/mL Equivocal > 10 U/mL Positive 1.0 (0.5) mL serum

Clinical Use: Tissue Transglutaminase Antibody, IgG, is useful in diagnosing gluten-sensitive enteropathies, such as celiac sprue disease and Performed: referred-A an associated skin condition, dermatitis herpetiformis, in turn around: 3-5 days

14841 TOBRAMYCIN (NEBCIN), PEAK 5.0 - 10.0 mg/L Specimen Container: 80200 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Tobramycin is an aminoglycoside antibiotic, used in the treatment 1.0 (0.5) mL serum of gram-negative bacterial infections, especially Pseudomonas, Proteus, Klebsiella, & Staphylococcus. Tobramycin is potentially Peak: Collect 30 minutes after end of IV infusion or nephrotoxic and ototoxic and serial monitoring of peak and trough 60-90 minutes after IM dose. serum levels may provide the clinician with information to maintain Performed: daily safe and therapeutic levels. turn around: next day

14842 TOBRAMYCIN, RANDOM 0.5 – 10 mcg/mL Specimen Container: 80200 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Tobramycin is an aminoglycoside antibiotic, used in the 1.0 (0.5) mL serum treatment of gram-negative bacterial infections, especially Pseudomonas, Proteus, Klebsiella, & Staphylococcus. Tobramycin is potentially nephrotoxic and ototoxic and serial monitoring of peak and trough serum levels may provide the clinician with information Performed: daily to maintain safe and therapeutic levels. turn around: next day

14840 TOBRAMYCIN (NEBCIN), TROUGH 0.5 - 2.0 mg/L Specimen Container: 80200 NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Tobramycin is an aminoglycoside antibiotic, used in the 1.0 (0.5) mL serum treatment of gram-negative bacterial infections, especially Pseudomonas, Proteus, Klebsiella, & Trough: Collect just before next dose. Staphylococcus. Tobramycin is potentially nephrotoxic and ototoxic and serial monitoring of peak and trough serum levels may provide the clinician with information Performed: daily to maintain safe and therapeutic levels. turn around: next day

80201 TOPIRAMATE (TOPAMAX) Accompanies report Specimen Container: 80201 Fluorescence polarizaton Immunoassay No additive (red top) Clinical Use: Topiramate is an antidepressant used as an adjunctive 1.0 (0.5) mL serum treatment of partial-onset epilepsy and Lennox-Gastaut Transfer serum to a plastic, screw-cap vial syndrome in children. Therapeutic drug monitoring is useful Performed: referred-A to optimize dose and avoid toxicity. turn around: 3-5 days

86682 TOXACARA ANTIBODY, ELISA * Accompanies report Specimen Container: 86682 Enzyme-Linked Immunosorbent Assay No additive (red top) Clinical Use: This ELISA procedure uses the excretory-secretory (ES) antigen 1.0 (0.2) mL serum of T. canis larvae to minimize cross-reactivity with antigens of Transfer serum to a plastic, screw-cap vial Ascaris spp. and of other parasites. Results must be interpreted with caution, as broad variations in antibody response occur and levels may remain elevated for years after infection. Generally, antibody levels are higher in patients with visceral larva migrans than in patients with ocular larva migrans or asymptomatic infection. Although a negative result (<1.00) usually rules out infection with Toxocara spp.,testing of serial samples in parallel may be useful in Performed: referred-A following patients with suspected toxocariasis. turn around: 7-10 days

86173 TOXOPLASMA IgG ANTIBODY Accompanies report Specimen Container: 86777 Immunoassay Gel barrier (gold or tiger top) Clinical Use: Toxoplasma gondii is endemic in cats and is excreted by 1.0 (0.2) mL serum them in their feces. Humans are easily exposed to cyst forms, and the majority develop antibody without any clinical disease. A self-limiting lymphadenitis is the most common clinical presentation in symptomatic infection. Congenital toxoplasmosis and infections Performed: referred-A in AIDS patients are more serious. turn around: 3-5 days

14466 TRANSFERRIN 203 – 362 mg/dL Specimen Container: 84466 Absorbance of complexes of antigen/antibody reaction Gel barrier (gold or tiger top) Clinical Use: Transferrin concentration relects the total iron-binding capacity 1.0 (0.5) mL serum Performed: mon, wed, fri (TIBC) and is used as an indicator of iron metabolism. turn around: 1-3 days

14476 TRIFLUOPERAZINE (STELAZINE ) Accompanies report Specimen Container: 84022 HPLC No additive (red top) Clinical Use: Trifluoperazine is a phenothiazine for treating 5.0 (2.2) mL serum psychosis. Monitoring its level is important to optimize Transfer serum to a plastic, screw-cap vial therapy, to avoid toxicity, and to assure compliance. Performed: referred-A Do not use gel barrier tube. turn around: 5-7 days

14478 TRIGLYCERIDES 10 – 150 mg/dL Specimen Container: 84478 Enzyamatic color/Glycerol Phosphate Oxidase Gel barrier (gold or tiger top) NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Clinical Use: Serum triglyceride analysis has proven useful in the diagnosis 1.0 (0.5) mL serum and treatment of patients with diabetes mellitus, nephrosis, liver obstruction, other diseases involving lipid metabolism, and various Performed: daily endocrine disorders. turn around: next day

82493 TRILEPTAL (OXCARBAZEPINE) Accompanies report Specimen Container: 83789 Liquid Chromatography Tandem Mass Spectrometry (LC/MS/MS) No additive (red top) Clinical Use: Oxcarbazepine (trileptal) is an anti-convulsant used for treating 1.0 (0.3) mL serum generalized tonic-clonic and partial seizures. It can be Transfer serum to a plastic, screw-cap vial administered alone or as an adjunct to other anti-convulsants. Performed: referred-A Do not use gel barrier tube. turn around: 3-5 days

84914 TRIPLE SCREEN-MATERNAL AFP Accompanies report Specimen Container: 82105 Calculation Gel barrier (gold or tiger top) 82677 Immunoassay Clinical Use: 84702 Maternal serum alpha-fetoprotein (MSAFP) is used for prenatal 1.0 (0.5) mL serum The Maternal Serum Screen in pregnant women screening of open neural tube defects (ONTD). Maternal serum should be performed between 14.0 and 22.9 weeks Triple and Quad Screens are used for prenatal screening for Because the Maternal Serum Screen test results are gestational age, although the optimal period is Down syndrome (Trisomy 21), Trisomy 18 (Edwards' syndrome), influenced by certain patient characteristics, the 15.0-16.9 weeks. and open neural tube defects (ONTD). following data must be provided with the specimen in order to permit accurate interpretation of results: Date of collection, patient's (maternal) date of birth, patient's estimated date of delivery, patient's weight, patient's race, patient's diabetic status (is patient insulin dependent before pregnancy), number of Performed: referred-A fetuses, and whether this is a repeat sample. turn around: 3-5 days

14484 TROPONIN I, SERUM 0 - 1 ng/mL Specimen Container: 84484 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Troponin is part of a protein complex which regulates the 1.0 (0.5) mL serum contraction of striated muscle. In acute coronary syndromes (ACS), it can be detected in blood at 4-8 hours following the onset of chest pain, reaches a peak concentration at 12-16 hours, and remains elevated for 5-9 days. Troponin I has been used as a reliable marker in the diagnosis of perioperative myocardial Performed: daily infarction in patients undergoing cardiac surgery. turn around: next day

83503 TRYPTASE, SERUM 2-10 ng/mL Specimen Container: 83520 Fluorescence Enzyme Immunoassay No additive (red top) Clinical Use: Tryptase concentrations are increased with immediate 1.0 (0.3) mL serum hypersensitivity (anaphylaxis), acute allergen challenge, Transfer serum to a plastic, screw-cap vial and mastocytosis. Performed: referred-A Do not use gel barrier tubes turn around: 5-7 days

84904 TSH RECEPTOR ANTIBODIES Healthy, nonthyroidal disease: Specimen Container: 82397 Immunoassay < or = 1.22 IU/L Gel barrier (gold or tiger top) Thyroid disease without Graves' disease: < or = 1.58 IU/L 1.0 (0.5) mL serum Untreated Graves' disease: > 1.75 IU/L

Clinical Use: Hyperthyroidism in Graves' disease is caused by autoantibodies to the TSH receptor (TSHR), and measurement of these TSHR antibodies can be useful in disease diagnosis and management. NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE The majority of TSH receptor antibodies mimic the action of TSH, because they are not controlled by the negative feeback system, the stimulation of the thyroid often leads to the clinical thyrotoxic Performed: referred-A state of Graves' disease. turn around: 3-5 days

84447 TSH, 3RD GENERATION Accompanies report Specimen Container: 84443 Immunoassay Gel barrier (gold or tiger top) Clinical Use: For differential diagnosis of primary, secondary, and tertiary 1.0 (0.5) mL serum hypothyroidism. Also useful in screening for hyperthyroidism. This assay allows adjustment of exogenous thyroxine dosage in hypothyroid patients and in patients on suppressive thyroxine Performed: referred-A therapy for thyroid neoplasia. turn around: 3-5 days

14443 TSH, SENSITIVE 0.35 – 5.5 uIU/mL Specimen Container: 84443 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: For differential diagnosis of primary, secondary, and tertiary 1.0 (0.5) mL serum Performed: daily hypothyroidism. Also useful in screening for hyperthyroidism. turn around: next day

24545 UREA CLEARANCE, 24 HR URINE 40 - 100 mL/min Specimen Container: 84545 Spectrophotometric 24 hour urine container, no preservative Clinical Significance and Test Components: Urea is the end-product of protein metabolism. Urinary urea Gel barrier (gold or tiger top) Urea Nitrogen, blood (BUN), Urea Nitrogen, 24-hr urine nitrogen reflects the amount of protein destruction. Especially in severely ill patients, the uriniary Urea Nitrogen is useful in 10.0 (1.0) mL aliquot of a well mixed 24 hour urine assessing the necessary protein replenishment. and 1.0 (0.5) mL serum.

Record patient's height, weight and total urine Performed: mon, wed, fri volume on test requisition. turn around: 1-3 days

24540 UREA NITROGEN, URINE 12 - 20 g/24 hr Specimen Container: 84540 Spectrophotometric 24 hour urine container, no preservative Clinical Significance Urea is the end-product of protein metabolism. Urinary urea 10.0 (1.0) mL aliquot of a well mixed 24 hour urine nitrogen reflects the amount of protein destruction. Especially in severely ill patients, the uriniary Urea Nitrogen is useful in Record total urine volume on test requisition. Performed: mon, wed, fri assessing the necessary protein replenishment. turn around: 1-3 days

14550 URIC ACID, SERUM Female: Specimen Container: 84550 Spectrophotometric 0-6 days: 1.0 - 9.0 mg/dL Gel barrier (gold or tiger top) 6 days – 12 years: 2.0 - 7.5 mg/dL > 12 years: 1.7 - 5.7 mg/dL 1.0 (0.5) mL serum. Male: 0-6 days: 1.0 - 9.0 mg/dL 6 days – 12 years: 2.0 - 7.5 mg/dL > 12 years: 3.3 - 7.2 mg/dL

Clinical Use: Serum uric acid measurements are useful in the diagnosis and treatment of numerous renal and metabolic disorders, including renal failure, gout, starvation or other wasting conditions, and Performed: daily in-patients leukemia, psoriasis, receiving cytotoxic drugs. turn around: next day

84560 URIC ACID, 24 HR URINE Male: 120-820 mg/24 h Specimen Container: 84560 Spectrophotometric Female: 65-630 mg/24 h 24 hour urine container, no preservative

Clinical Use: 10.0 (1.0) mL aliquot of a well mixed 24 hour urine NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Urine uric acid may supplement serum uric acid testing when trying to identify conditions in which there is alteration of uric Do not acidify the urine. acid production or excretion, e. g., gout, leukemia, renal disease. The amount of uric acid excreted may be useful in treating Record total urine volume on test requisition. asymptomatic hyperuricemia. Measurement of urine uric acid is Performed: referred-A important in the investigation of urolithiasis. turn around: 3-5 days

14551 URIC ACID, URINE RANDOM Reference ranges not established Specimen Container: 84560 Spectrophotometric Sterile urine container, leak-proof, no preservative Clinical Use: Uric acid measurements are used in the diagnosis and treatment 10.0 (1.0) ml random urine of numerous renal and metabolic disorders, including renal failure, gout, leukemia, psoriasis, starvation, or other wasting conditions, Performed: mon, wed, fri and of patients receiving cytotoxic drugs. turn around: 1-3 days

21000 URINALYSIS WITH MICROSCOPIC Accompanies report Specimen Container: 81000 Siemens Atlas Automated Dipstick Sterile urine container, leak-proof Microscopic Clinical Use: Test results from a routine urinalysis may provide information 10.0 (3.0) mL random urine regarding the status of carbohydrate metabolism, kidney and liver Performed: daily function, acid-base balance and urinary tract infection. turn around: next day

21001 U/A WITHOUT MICROSCOPIC Accompanies report Specimen Container: 81000 Siemens Atlas Automated Dipstick Sterile urine container, leak-proof Clinical Use: Test results from a routine urinalysis may provide information 10.0 (3.0) mL random urine regarding the status of carbohydrate metabolism, kidney and liver Performed: daily function, acid-base balance and urinary tract infection. turn around: next day

21002 URINALYSIS WITH REFLEX URINE CULTURE Accompanies report Specimen Container: 81000 Siemens Atlas Automated Dipstick with microscopic Sterile urine container, leak-proof Clinical Use: If urinalysis reports leukocyte esterase results greater than small, Test results from a routine urinalysis may provide information 10.0 (3.0) mL clean-catch random urine, refrigerated microscopic analysis reports WBC results more than 2-5 on males and 5-10 on females, regarding the status of carbohydrate metabolism, kidney and liver or a positive nitrite, a urine culture will be performed. Additional charges/CPT codes may apply. function, acid-base balance and urinary tract infection.

Performed: daily turn around: 1-3 days

12663 VALPROIC ACID (DEPAKENE) 50-100 mg/L Specimen Container: 80164 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Valproic Acid is used as an anticonvulsant to treat certain types 1.0 (0.5) mL serum. of seizures, to prevent migraine headaches, and to treat various psychiatric illnesses, bipolar disorder and aggression. Therapeutic drug such as monitoring is useful to optimize dose and avoid Performed: daily toxicity. turn around: next day

14851 VANCOMYCIN (VANCOCIN), PEAK 30.0-40.0 mg/L Specimen Container: 80202 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Vancomycin is an antibiotic used in the treatment of serious 1.0 (0.5) mL serum. bacterial infections, especially methicillin-resistant staphylococci. Vancomycin is also used in the treatment of penicillin-allergic Collect peak specimen 1 hour after completion patients who cannot receive or have failed to respond to other of the drug infusion. drugs, including the penicillins and/or cephalosporins and for Performed: daily infections caused by vancomycin-susceptible organisms. turn around: next day

NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE 14852 VANCOMYCIN, RANDOM 5.0-40.0 mg/L Specimen Container: 80202 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Vancomycin is an antibiotic used in the treatment of serious 1.0 (0.5) mL serum. bacterial infections, especially methicillin-resistant staphylococci. Vancomycin is also used in the treatment of penicillin-allergic patients who cannot receive or have failed to respond to other drugs, including the penicillins and/or cephalosporins and for Performed: daily infections caused by vancomycin-susceptible organisms. turn around: next day

14850 VANCOMYCIN (VANCOCIN), TROUGH 5.0-10.0 mg/L Specimen Container: 80202 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Vancomycin is an antibiotic used in the treatment of serious 1.0 (0.5) mL serum. bacterial infections, especially methicillin-resistant staphylococci. Vancomycin is also used in the treatment of penicillin-allergic Collect specimen just prior to next dose. patients who cannot receive or have failed to respond to other drugs, including the penicillins and/or cephalosporins and for Performed: daily infections caused by vancomycin-susceptible organisms. turn around: next day

16787 VARICELLA ZOSTER ANTIBODY PANEL Reference Range: Index Value Specimen Container: 86787 Immunoassay Negative ≤0.90 Gel barrier (gold or tiger top) Equivocal 0.91-1.09 Postive ≥1.10 1.0 (0.5) mL serum.

This is a qualitative test, no quantitative interpretation should be made, based on these values.

Clinical Use: Varicella Zoster Virus (VZV) causes chickenpox and, when reactivated potentially decades later, causes shingles. 20% of adults will develop shingles, a rash or blister of the skin that may cause severe pain. Varicella Zoster IgG, EIA reliably measures immunity, due to previous infection, but is unsuitable Performed: mon, wed, fri for detection of postvaccination immune status. turn around: 1-3 days

87290 VARICELLA/HERPES-ZOSTER VIRUS Ag Accompanies report Specimen Container: 87290 Direct Immunofluorescence Assay VCM Collection Kit B Clinical Use: Do not use if media is yellow. Varicella Zoster Virus (VZV) causes chickenpox and, when reactivated potentially decades later, causes shingles. 20% of adults will develop shingles, a rash or blister of the skin that Performed: referred-A may cause severe pain. 3.0 mL vesicle fluid/scraping or eye swab, turn around: 7-10 days

86315 VARICELLA-ZOSTER ANTIBODIES IgG & IgM Accompanies report Specimen Container: 86787 (x2) Enzyme Immunoassay Gel barrier (gold or tiger top) Clinical Use: Varicella Zoster Virus (VZV) causes chickenpox and, when 1.0 (0.5) mL serum. reactivated potentially decades later, causes shingles. 20% of adults will develop shingles, a rash or blister of the skin that may cause severe pain. Varicella Zoster IgG, EIA reliably measures immunity, due to previous infection, but is unsuitable Performed: referred-A for detection of postvaccination immune status. turn around: 3-5 days

86592 VDRL, SERUM Nonreactive Specimen Container: 86592 Slide Micro Flocculation Gel barrier (gold or tiger top) Clinical Use: The serum VDRL test is an aid in the diagnosis of syphilis. The 1.0 (0.5) mL serum. predictive value of a reactive VDRL is increased when combined NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE with a treponemal-specific test such as FTA or TP-PA. VDRL Performed: referred-A can also be used to monitor treatment. turn around: 3-5 days

80307 VERAPAMIL, QUANT Accompanies report Specimen Container: 80202 Gas Chromatography No additive (red top) Clinical Use: Therapeutic drug monitoring is useful in optimizing dose and 1.0 (0.3) mL serum to avoid toxicity. Transfer serum to a plastic, screw-cap vial

Performed: referred-A Do not use gel barrier tubes turn around: 7-10 days

84589 VISCOSITY, SERUM 1.5 - 1.9 Relative to Water Specimen Container: 85810 Kinematic Viscometer Gel barrier (gold or tiger top) Clinical Use: High serum viscosity may be most commonly observed in 1.0 (0.5) mL serum. patients with Waldenstrom's macroglobulinemia and multiple macroglobulinemia and multiple myeloma. Patients with high Performed: referred-A viscosity may have capillary occlusion, stasis hypoxia and acidosis. turn around: 3-5 days

84590 VITAMIN A, SERUM 1-6 years: 20-43 mcg/dL Specimen Container: 84590 High Performance Liquid Chromatography 7-12 years: 26-49 mcg/dL Gel barrier (gold or tiger top) 13-19 years: 26-72 mcg/dL Adults: 38-98 mcg/dL 1.0 (0.5) mL serum. Centrifuge serum specimen within 1 hour of collection. Clinical Use: Transfer serum to plastic, screw-cap vial. Vitamin A is critical for vision, growth, and many cell functions. High concentrations of Vitamin A are seen with renal failure, Wrap tube in aluminum foil to protect from light. but this is not associated with toxicity and excessive ingestion. High concentrations are associated with bone fractures. Low Overnight fasting is preferred. concentrations of Vitamin A are consistent with fat malabsorption Performed: referred-A and are rarely due to inadequate diet. turn around: 5-7 days

84425 VITAMIN B1, (THIAMINE), PLASMA 9-44 nmol/L Specimen Container: 84425 High Performance Liquid Chromatography EDTA (lavender top) Clinical Use: Vitamin B1 is required for branched-chain amino acid and 3.0 (1.1) mL plasma, FROZEN carbohydrate metabolism. Vitamin B1 deficiency is most often Transfer plasma to a plastic, screw-cap vial and freeze. due to alcoholism or chronic illness. In the early stage, patients with Vitamin B1 deficiency exhibit anorexia, irritability, apathy, Wrap tube in aluminum foil to protect from light. and generalized weakness. Prolonged deficiency causes Performed: referred-A beriberi. turn around: 5-7 days

84252 VITAMIN B2 Accompanies report Specimen Container: 84252 Fluorometric EDTA (lavender top) High Performance Liquid Chromatography Clinical Use: Vitamin B2 is involved in metabolism of fats, carbohydrates, and 3.0 (1.1) mL plasma, FROZEN protein. The clinical manifestations of deficiency are nonspecific. Transfer plasma to a plastic, screw-cap vial and freeze. Clinical manifestations include mucocutaneous lesions of the mouth and skin, corneal vascularization, anemia, and personality Wrap tube in aluminum foil to protect from light. Performed: referred-A changes. turn around:7-10 days

84207 VITAMIN B6, PLASMA Accompanies report Specimen Container: 84207 High Performance Liquid Chromatography EDTA (lavender top) Clinical Use: Test is used to determine vitamin B6 deficiency or overdosage, 3.0 (1.1) mL plasma, FROZEN for monitoring treatment, and to evaluate wellness and health. Transfer plasma to a plastic, screw-cap vial and freeze.

Draw blood into light-protected lavender top tube, NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE following an overnight fast. Patient must be restricted from alcohol and vitamins for 24 hours prior to draw.

Performed: referred-A Wrap tube in aluminum foil to protect from light. turn around: 7-10 days

12607 VITAMIN B12 211 - 911 pg/mL Specimen Container: 82180 Chemiluminescence Gel barrier (gold or tiger top) Clinical Use: Vitamin B12 is decreased in pernicious anemia, total or partial 2.0 (1.0) mL FROZEN serum. gastrectomy, malabsorption, and certain congenital biochemical Transfer serum to a plastic screw-cap vial, freeze. disorders. Its deficiency causes neurological disturbances and increases the serum level of homcysteine which is a cardio- Wrap tube in aluminum foil to protect from light. Performed: daily vascular risk factor. turn around: next day

82180 VITAMIN C Accompanies report Specimen Container: 83921 Capillary Electrophoresis Gel barrier (gold or tiger top) Clinical Use: Vitamin C is an antioxidant involved in connective tissue 2.0 (1.0) mL serum. metabolism, drug-metabolizing systems, and mixed function oxidase systems to list a few. Vitamin C deficiency causes scurvy; manifestations include impaired formation of mature connective tissue, bleeding into the skin, weakness, fatigue and depression.

Performed: referred-A turn around: 7-10 days

12306 VITAMIN D, 25-OH 19.1 - 57.6 ng/mL Specimen Container: 82306 Enzyme Immunoassay/EIA Gel barrier (gold or tiger top) Clinical Use: The role of vitamin D in bone and mineral metabolism was 2.0 (1.0) mL serum. recognized from its first identification as a factor that could cure rickets. However, Vitamin D is now recognized as a prohormone Performed: mon, wed, fri which has multiple roles in maintaining optimal health. turn around: 1-3 days

82306 VITAMIN D, 25 HYDROXY w/D2 D3 Accompanies report Specimen Container: 82308 Liquid Chromatography/Tandem Mass Spectrometry Gel barrier (gold or tiger top) Clinical Use: This test is used to measure the bio-active form of Vitamin D. 1.0 (0.5) mL serum. This test is also used in the differential diagnosis of hypocalcemia Transfer serum to a plastic, screw-cap vial. and to monitor patients with renal osteodystrophy or chronic renal Performed: referred-A failure. Overnight fasting specimen preferred. turn around: 3-5 days

84446 VITAMIN E Accompanies report: Specimen Container: 84446 High Performance Liquid Chromatography Gel barrier (gold or tiger top) Clinical Use: Deficiency of vitamin E may cause extensive neuropathy in 1.0 (0.5) mL serum. young children and, in addition, is suspect as a possible cause of motor and sensory neuropathy in older children and in adults. One likely cause of vitamin E deficiency is intestinal malabsorption, resulting from bowel disease, pancreatic disease, or chronic cholestasis. Other causes of malabsorption of vitamin E include Performed: referred-A celiac disease, cystic fibrosis, and intestinal lymphangiectasia. turn around: 5-7 days

84597 VITAMIN K 80-1160 pg/mL Specimen Container: 84597 High Performance Liquid Chromatography EDTA (lavender top) Clinical Use: NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE Vitamin K is a required cofactor for the synthesis of factors 2, 7, 9 3.0 (1.5) mL plasma, FROZEN and 10, and proteins C and S. Deficiencies of vitamin K lead to Transfer plasma to a plastic, screw-cap vial and freeze. bleeding. Warfarin acts as an anticoagulant because it is a vitamin Performed: referred-A K antagonist. Wrap tube in aluminum foil to protect from light. turn around: 7-10 days

84585 VMA (VANILLYLMANDELIC ACID), 24 HOUR URINE Age (years) mg/24 hours Specimen Container: 84585 High Performance Liquid Chromatography 3-8: 2.3 or less 24 hour urine collection container, with 25 mL 6N HCL 9-12: 3.4 or less 13-17: 3.9 or less 10.0 (5.0) mL aliquot of a well mixed 24-hr urine Adults: 6.0 or less Patient should avoid alcohol, coffee, tea, tobacco Clinical Use: (including use of nicotine patch), bananas, citrus fruits, Vanillylmandelic acid (VMA) is the major urinary product resulting and strenuous exercise before collection. from the metabolic degradation of catecholamine, norepinephrine and epinephrine. Elevated concentrations of VMA are commonly It is preferable for the patient to be off medications found in cases of catecholamine secreting tumors such as for 3 days before specimen collection. However, pheochromocytoma, neuroblastoma, and ganglioneuroma. Drugs common antihypertensives (diuretics, ACE inhibitors, which can interfere with testing, due to physiologic response: calcium channel blockers, alpha and beta blockers) clonidine, L-dopa, methocarbamol, monoamine oxidase inhibitors, cause minimal or no interference. Performed: referred-A reserprine, salicylates. turn around: 5-7 days

VMA (VANILLYLMANDELIC ACID), RANDOM URINE 84587 w/CREATININE Accompanies report Specimen Container: 84585 High Performance Liquid Chromatography Sterile urine container, leak-proof 82570 Clinical Use: Urinary VMA is useful in diagnosing neuroblastoma, one of the 10.0 (0.5) mL random urine most common tumors in the pediatric population. Patient should avoid alcohol, coffee, tea, tobacco (including use of nicotine patch), bananas, citrus fruits, and strenuous exercise before collection.

It is preferable for the patient to be off medications for 3 days before specimen collection. However, common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) Performed: referred-A cause minimal or no interference. turn around: 5-7 days

85310 VON WILLEBRAND COMP PANEL Accompanies report Specimen Container: 85247 Various 3.2% Sodium heparin (light blue top) 85240 85245 Test components: 8.0 (4.0) ml FROZEN plasma 85246 aPTT, Factor VIII Activity, (Clotting), von Willebrand Factor Antigen, 85730 Ristocetin Cofactor, von Willebrand Antigen, Multimeric Analysis Clinical Use: Platelet Poor Plasma Collection Instructions: VWD is perhaps the most common bleeding disorder known, but 1) Draw one red top tube to remove tissue fluid the diagnosis can only be assured by performing a multiplicity of contamination. tests to confirm the diagnosis, and to be able to distinguish Type I, 2) Draw 4 light blue top tubes, filled to the appropriate Type II, and Type III disease types, which require different level. (Do not overfill or underfill) treatments programs. Therefore it is essential to measure FVIII 3) Invert gently 6 times to mix, process immediately. activity along with VWF Antigen, functional VWF Activity by 4) Centrifuge for 15 minutes at 2500 x g Ristocetin Cofactor, and measure Multimeric analysis of von 5) Using a plastic pipette, remove plasma, taking care Willebrand protein to characterize intermediate and high weight to avoid the wbc/platelet buffy layer, and place into forms. a plastic vial. 6) Centrifuge a second time for 15 minutes and transfer platelet-poor plasma into 4 separate plastic, screw-cap vials. Label tubes appropriately. Performed: referred-A 7) Freeze immediately. turn around: 5-7 days

15048 WBC (WHITE BLOOD CELLS) Accompanies report Specimen Container: 85048 Sysmex, Combined Impedence EDTA (lavender top) Flow Cytometry Clinical Use: The WBC count is used to determineNICL Laboratories/2011the presence of an infection 5.0 (3.0) mL whole blood TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE or leukemia. It is also used to help monitor the bodies response to various treatments and to monitor bone marrow function. Conditions or medications that weaken the immune system, such as HIV infection, chemotherapy, or radiation therapy cause a decrease in white blood cells.

25059 WBC FOR CLOZARIL Accompanies report Specimen Container: 85048 Sysmex, Combined Impedence EDTA (lavender top) Flow Cytometry Clinical Use: The FDA requires blood testing for patients taking clozapine. 5.0 (3.0) mL whole blood WBC and ANC values must be monitored per established protocol. Peformed: daily turn around: next day

25025 WBC WITH DIFFERENTIAL Accompanies report Specimen Container: 85048 Sysmex, Combined Impedence EDTA (lavender top) Flow Cytometry Clinical Use: The WBC count is used to determine the presence of an infection 5.0 (3.0) mL whole blood or leukemia. It is also used to help monitor the bodies response to various treatments and to monitor bone marrow function. Conditions or medications that weaken the immune system, such as HIV infection, chemotherapy, or radiation therapy cause a Peformed: daily decrease in white blood cells. turn around: next day

45048 WBCS, STOOL None seen Specimen Container: 89055 Microscopic Examination Sterile container, leak-proof Clinical Use: White blood cells in the stool may be caused by inflammation of 1.0 g random stool specimen, refrigerated Peformed: daily the intestines, such as ulcerative colitis, or a bacterial infection. turn around: next day

86790 WEST NILE VIRUS Ab PANEL Accompanies report Specimen Container: 86788 Enzyme-Linked Immunosorbent Assay Gel barrier (gold or tiger top) 86789 Clinical Use: The West Nile Virus (WNV) is a single-stranded RNA virus of the 2.0 (0.7) mL serum. Flaviviridae family. Like other arboviruses (e.g., St. Louis Transfer serum to a plastic, screw-cap vial Encephalitis, Dengue Fever, and Yellow Fever), its main route of transmission to humans is through mosquitoes (primarily culex species) that have acquired the virus from infected birds. A single elevated WNV result, including IgM that may persist for many months, could represent past infection with WNV or infection with another flavivirus including Dengue and St. Louis Encephalitis. Diagnosis of suspected WNV infection is confirmed by isolation of WNV or detection of WNV antigen or nucleic acid sequences in clinical samples or detection of WNV-soecific IgM in blood or CSF, confirmed with detection of WNV-specific neutralizing Performed: referred-A antibody in the same or a subsequent sample. turn around: 3.-5 days

86317 WESTERN BLOT, HIV-1 AB Negative Specimen Container: 86689 Western Blot Gel barrier (gold or tiger top) Clinical Use: HIV-1 is the virus that causes Acquired Immunodeficiency 1.0 (0.5) mL serum. Syndrome (AIDS). Western blot with an EIA-positivity has Transfer serum to a plastic, screw-cap vial combined specificity of greater that 99.9%. Western blot results may be indeterminate with early HIV-1 infection, in patients with Performed: referred-A autoimmune disease, and in women who are pregnant. turn around: 3.-5 days

84631 ZINC Accompanies report Specimen Container: 84630 Atomic Spectroscopy EDTA Trace Element (royal blue top) Clinical Use: Zinc is an essential element involved in a myriad of enzyme 2.0 (0.7) plasma NICL Laboratories/2011 TEST CODE TEST DESCRIPTION REFERENCE RANGE SPECIMEN REQUIREMENTS CPT CODE systems, including wound healing, immune function, and fetal Transfer plasma to a plastic, screw-cap vial development. Zinc measurements are used to detect and monitor industrial, dietary, and accidental exposure to zinc. Also, zinc measurements may be used to evaluate health and Performed: referred-A to monitor response to treatment. turn around: 5-7days

84202 ZINC PROTOPORPHYRIN (ZPP) Accompanies report Specimen Container: 84202 Fluorometric EDTA (lavender top) Clinical Use: Zinc protoporphyrin (ZPP) accumulates in erythrocytes as 2.0 (1.0) mL whole blood Performed: referred-A a result of chronic lead absorption or iron deficiency anemia. turn around:3-5 days

82541 ZIPRASIDONE (GEODON)(ZELDOX) Accompanies report Specimen Container: 82542 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Therapeutic drug monitoring of antipsychotic drug to optimize 1.0 (0.4) mL serum dose and avoid toxicity Transfer serum to a plastic- screw-cap vial

Performed: referred-A Do not use gel barrier tube. turn around: 7-10 days

82499 ZOLOFT (SERTRALINE) Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Sertraline is an antidepressant used in the treatment of mental 3.0 (1.2) mL serum depression. Monitoring its level is important to optimize therapy, Transfer serum to a plastic- screw-cap vial to avoid toxicity, and to assure compliance. Performed: referred-A Do not use gel barrier tube. turn around: 7-10 days

80322 ZOLPIDEM (AMBIEN), BLOOD Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Therapeutic drug monitoring to optimize dose and to avoid toxicity. 3.0 (1.2) mL serum Transfer serum to a plastic- screw-cap vial

Performed: referred-A Do not use gel barrier tube. turn around: 7-10 days

82498 ZONISAMIDE (ZONEGRAN) Accompanies report Specimen Container: 80299 Liquid Chromatography/Tandem Mass Spectrometry No additive (red top) Clinical Use: Zonisamide is an anticonvulsant, commonly used as an adjunct 3.0 (1.2) mL serum together with other conventional anticonvulsants. As multiple Transfer serum to a plastic- screw-cap vial drugs are administered, it is important to monitor its level to optimize therapeutic effects, to assure compliance, and to avoid Do not use gel barrier tube.

Performed: referred-A Draw sample 1/2 to 1 hour before next dose. turn around: 7-10 days

NICL Laboratories/2011

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NICL Laboratories/2011 86606 (x3)

86160 (x2)

NICL Laboratories/2011 87798 (x2)

86753 (x2)

83902 (x2) NICL Laboratories/2011 83896 (x3)

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NICL Laboratories/2011 83516 (x3) 86225 (x2)

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NICL Laboratories/2011 NICL Laboratories/2011 NICL Laboratories/2011 86160 (x3)

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83914 (x70)

NICL Laboratories/2011 83892 (x3) 83914 (x8)

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NICL Laboratories/2011 NICL Laboratories/2011 NICL Laboratories/2011 86790 (x2)

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