Components

QLS#	NAME	METHOD	REFERENCE RANGE	UNITS
133	Sodium	ISE	< 2 years: Call Client Services < 19 years: 138 - 148 >= 19 years: 136 - 145	mmol/L
134	Potassium	ISE	< 2 years: Call Client Services < 19 years: 3 - 4.3 >= 19 years: 3.5 - 5.1	mmol/L
135	Chloride	ISE	< 2 years: Call Client Services < 19 years: 99 - 108 >= 19 years: 98 - 107	mmol/L
117G	Glucose	KS	< 2 days: 40 - 60 < 2 years: 50 - 80 < 15 years: 60 - 100 >= 15 years: 74 - 106	mg/dL
112	Creatinine	S	view ref range	mg/dL
103	Calcium (Total)	S	< 2 years: 7.6 - 11 < 19 years: 8.4 - 10.5 >= 19 years: 8.7 - 10.4	mg/dL
131	Total Protein	S	< 2 years: Call Client Services < 19 years: 5.9 - 8.1 >= 19 years: 6.4 - 8.4	g/dL
101	Albumin	S	< 2 years: Call Client Services < 19 years: 3.3 - 4.4 >= 19 years: 3.5 - 5	g/dL
102	Alkaline Phosphatase	KS	view ref range	U/L
107	Aspartate Transaminase (AST)	KS	view ref range	U/L
106	Alanine Transaminase (ALT)	KS	view ref range	U/L
129	Bilirubin Total	S	< 2 years: Call Client Services < 19 years: 0.3 - 1.2 >= 19 years: < 1.4	mg/dL
136	BUN	KS	< 2 years: Call Client Services < 19 years: 5 - 11 >= 19 years: 5 - 15	mg/dL

Specimen Requirements

	TYPE	VOLUME	TEMPERATURE	INSTRUCTIONS
PRIMARY
1	Serum Foil Wrapped	2 (1) mL	Ambient - 24 Hour(s), Refrigerated - 72 Hour(s), Frozen - 2 Month(s)	See COLLECTIONS INSTRUCTIONS.
ALTERNATE
	Plasma Heparin Foil Wrap	2 (1) mL	Ambient - 24 Hour(s), Refrigerated - 72 Hour(s), Frozen - 2 Month(s)	Lithium heparinized plasma shipped refrigerated.

Collection Instruction

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

Reported: Same day

CPT Code: 80053