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Fred Hutchinson Cancer Center Clinical

Laboratories 825 Eastlake Ave E
PO Box 19023
Seattle, WA 98109-1023

Fred Hutchinson Cancer Center Specialty

Laboratories 188 E Blaine St Ste 250
Seattle, WA 98102- 3983

Fred Hutchinson Cancer Center Clinical

Immunogenetics lab 188 E Blaine St Ste 250
Seattle, WA 98102- 3983

Fred Hutchinson Cancer Center Cellular Therapy

Laboratory 1100 Eastlake Ave E
Seattle, WA 98109-4487

Fred Hutchinson Cancer Center Lab at Evergreen

Health 12040 NE 128th St
Kirkland, WA 98034

Fred Hutchinson Cancer Center Peninsula

Laboratory 19917 7th Ave NE Suite 100
Poulsbo, WA 98370

Fred Hutchinson Cancer Center MRI at Valley

Street 1209 Valley St
Seattle, WA 98109

SPECIMEN COLLECTION & HANDLING MANUAL

34TH EDITION

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TABLE OF CONTENTS

Introduction

Lab Locations and Hours of Service

After Hours/Special Instructions
FRED HUTCHINSON CANCER CENTER/RESEARCH/AFFILIATED LABORATORY
LOCATIONS
Compliance Policies

Specimen Handling Guidelines

Patient instruction for Urine and Stool Collection

Alliance Lab Testing Menu and Turnaround

Times Critical Values
Alliance Lab Reference Ranges

Tests Listed by Laboratory/Departments

Cellular Therapy
CD34 Assay

Chemistry - Alliance Lab

Panels
Blood Gas, Arterial
Basic Metabolic
Panel
Comprehensive Metabolic
Panel Electrolytes
Hepatic Function Panel
Lipid Panel
Renal Function Panel
Renal/Hepatic Function Panel
TSH with Reflexive Free T4
Urinalysis

Single Tests
Alanine
Aminotransferase
Albumin
Alkaline Phosphatase
Ammonia
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Amylase

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Aspartate
Aminotransferase Urea
Nitrogen
Calcium
Cancer Antigen 19-9
Carcinoembryonic Antigen
Cerebral Spinal Fluid Glucose
Cerebral Spinal Fluid Protein
Chloride
Cholesterol
Bicarbonate, CO2
Cortisol
Creatine
Kinase
Creatinine
Direct
Bilirubin
Gamma Glutamyl
Transferase Glucose
HDL Cholesterol
Ionized Calcium, Whole Blood
Lactate Dehydrogenase
LDL Cholesterol
Lipase
Magnesium
Phosphorus
Potassium
Pregnancy,
Urine
Pregnancy,
Serum
Prostate Specific
Antigen Sodium
Emergency Bleed, Stool
Thyroid Stimulating
Hormone Thyroxine (Free
T4)
Total
Bilirubin
Total
Protein
Urine Total Protein, Quantitative
Urine Total Protein, Semi
Quantitative Triglycerides
Troponin I (High
Sensitivity) Uric Acid
Urine Creatinine/ Creatinine Clearance
Urine Protein/Urine Creatinine Ratio

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Clinical Immunogenetics
HLA Typing
Chimerism Testing
CIL Turnaround
Times

Coagulation - Alliance Lab

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D-Dimer
Fibrinogen
Partial Thromboplastin Time
Prothrombin Time

Cancer Genomics (fka Cytogenetics)

Cytogenetics Studies, Chromosome Analysis and
FISH Cytogenetics Studies, Genomic Array
Cytogenetics Studies, NGS Targeted RNA
Sequencing Cytogenetics Studies, Skin
Fibroblast Expansion Cytogenetics Turnaround
Times

Hematology - Alliance Lab

Cerebral Spinal Fluid Cell
Count Complete Blood
Count Erythrocyte
Sedimentation Rate
Hematocrit/Hemoglobin
Immature Platelet Fraction
Platelet Count
Reticulocyte Count

Molecular – Alliance Lab

COVID/FLU/RSV Respiratory Panel, Rapid
PCR SARS-CoV-2 (COVID-19) Qualitative
Rapid PCR

Pathology
Bone Marrow Aspirate/Biopsy
Bronchoalveolar Lavage
Endoscopy
Fine Needle
Aspirations Lip or Skin
Biopsy
Liver Biopsy; Liver
Lung Biopsy
Lymph Node Biopsy
ThinPrep® Pap Test
Collection Sinus Biopsy or
Aspirate Surgical
Specimens
Other Fluid Specimens
Surgical Specimens Collected at FHCC Ambulatory Clinic

Pharmacokinetics
Therapeutic Drug Monitoring and Busulfan
Testing Pharmacogenetic testing
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Point of Care Testing

Creatinine (POCT)

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Glucose (POCT)
Ionized Calcium, Whole Blood (POCT)
Potassium (POCT)
KOH Prep (POCT)

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Introduction*

This manual summarizes requirements for collecting and handling specimens

for testing in the Clinical Laboratories of the Fred Hutchinson Cancer Center. It has
been prepared and revised as part of our ongoing efforts to provide the best possible
patient care.

The directors, supervisors and technologists/technicians of the respective

laboratories, and the QA Senior Manager, Clinical Labs have written these procedures.
Revisions and supplements will be provided as needed.

We urge you to let us know of any errors, ambiguities, or other deficiencies in

this manual. Please contact the director or manager of the appropriate laboratory. You
may also contact Clinical Lab Administration at 606-1396.

Teresa Hyun, MD, PhD

Director of Clinical
Laboratories
Fred Hutchinson Cancer Center

Keith Loeb, MD, PhD

Laboratories Medical Director for Community
Sites Fred Hutchinson Cancer Center

Xueyan Chen, MD, PhD

Director of Specialty
Laboratories Fred Hutchinson
Cancer Center

Gana Balgansuren, MD, PhD

Director of Clinical Immunogenetics
Lab Fred Hutchinson Cancer Center

*Note: All contact numbers listed throughout this manual assume a 206-area code
unless otherwise specified.
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LAB LOCATIONS AND HOURS OF SERVICE

Laboratory Building Room Phone Pager Service Hours

Alliance Lab - SLU 1500 Blood M-F 6am – 6pm
Blood Draw Draw: Weekends & Holidays
606-1214 8am – 4:30pm
Reception:
606- 6201
Alliance Lab – 12040 NE EV-100 425-441-2640 M-F 8am – 5:30pm
EVG 128th St
Kirkland,
WA
98034
Alliance Lab - 19917 7th STE 100 360-842-5116 M-F 8am – 5:30pm
PEN Ave NE
Poulsbo,
WA
98370
Alliance Lab - SLU 1500 606-1088 M-F 6am – 10pm
Specimen Weekends & Holidays
Processing 7:30am – 5:30pm

Alliance Lab - SLU 1500 Main: 606- M-F 6am – 10pm

Testing 1088 Weekends & Holidays
Chem: 606- 8am – 6pm
1094
Coag: 606-1094
Heme: 606-
1084
Cellular Therapy 1100 E1-419 606-1200 Weekends & M-F 7am – 8pm
Lab Eastlake Holidays Weekends & Holidays
540-2851 9am – 5pm; leave a
message on voicemail;
on- call tech will respond
CIL 188 E STE 250 Lab Coordinator M-F 8:30am – 5pm
Blaine Office (LABCO):
606-7700
Cancer Genomics 188 E STE 250 Main Line: 206-340- M-F 8am-5pm
(fka Cytogenetics) Blaine 206-606-1390 7207 Weekends & Holidays
on call 9am-5pm

6th Floor Bldg 1 SLU 66097 606-6049 M-F 6:30am – 2:30pm

Satellite Lab After hours:
contact Alliance Lab
3rd Floor Bldg 2 SLU H3317 206-606-8700 M-F 8am – 3pm
Satellite Lab After hours:
Contact Alliance Lab

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4th Floor Bldg 2 SLU H4317 206-606-8731 M-F 8am – 3pm

Satellite Lab After hours:
Contact Alliance Lab

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Pathology SLU 7910 606-1355 Technologi Monday 9:00am –

st 573- 6:30pm Tues-Fri
0892 6:00am – 6:30pm Sat
6:00am –
2:30pm Sun and all other
Pathologis times contact Path
t: 606- Pathologi Technologist
1343 st 498- Pathology is on call:
7956 24 hours 7 days a
week, including
Weekends & Holidays
Pharmacokinetics 188 E STE 250 606-7389 Pager Tues – Sat 8am – 5pm
Blaine 994- Sundays, Mondays and
5942 Holidays: on call
Point of Care SLU Procedure POCT Clinic hours varies by
Testing Suite, Office: 206- POCT unit.
Imaging, 606-7635 POCT Office:
Infusion/AC
E/CTU, Monday – Friday
Apheresis, 6:30am to 6:30pm
GI Care
Neighborho
o d, Skin
Oncology,
Gynecolog
y
Transfusion SLU 1500 606-1095 M-F 7am – 10pm
Service Support Weekends and Holidays
7:30am – 5:30pm

After Hours/Special Instructions

Alliance Lab
Testing: Hematology, limited chemistry, coagulation, blood gas analysis, and urinalysis.
Routes tests not performed in the Alliance Laboratory to outside reference and research
labs. Provides transfusion service support.
Location: SLU Room 1-500, Phone 606-1088
Routine hours: M – F, 6am – 10pm; 8am – 6pm, weekends and holidays
After hours: patients are seen at UWMC.

Blood Draw: SLU Room 1-500, Telephone: 606-1214 or 606-

6201 Routine Hours: M – F 6am – 6pm
8am – 4:30pm weekends and holidays
After hours: Infusion until 10pm. After 10pm patients are seen at UWMC.

Alliance Lab Specimen Processing: SLU Room 1-500; Telephone: 606-

1088 Routine hours: M – F, 6:00am – 10pm; 7:30am – 5:30pm,
weekends and holidays After hours: patients are seen at UWMC.

Alliance Lab Evergreen:

After hours: samples routed directly from Evergreen clinic to Alliance Lab via Delivery Express

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Alliance Lab Peninsula:

After hours: samples routed directly from Peninsula clinic to Alliance Lab via Delivery Express

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Cellular Therapy:
CD34 Assay
Location: 1100 Eastlake E, Room E1-419, Telephone:
606-1200 Routine hours: M – F 7am – 8pm, Processing
7am – 5pm Weekends and holidays 9am – 5pm;
Processing 9am – 3pm After hours: Pager 206-540-2851
After hours specimen handling: Redraw a fresh specimen in the morning.

Clinical Immunogenetics Lab:

HLA Typing and Chimerism Testing
Location: 188 E Blaine STE 250, Telephone (Lab Coordinator Office): 606-7700
Routine hours: M – F 8:30am – 5pm (see specific tests for cutoff times for specimen receipt)
After hours specimen handling: Draw sample and keep at room temperature. Deliver to CIL at 8am
on the next business day.

Cancer Genomics (fka Cytogenetics) Lab:

Chromosome analysis, FISH, Genomic Array, TRS, and Fibroblast Expansion
Location: 188 E Blaine, STE 250, Telephone: 206-606-1390 main
line Routine hours: M – F 8am – 5pm
After hours: on call 9am – 5pm weekend and holidays, Pager 206-340-7207
After hours specimen handling: Draw venous blood or marrow in tubes containing an
appropriate anticoagulant (sodium heparin for chromosome analysis and FISH; EDTA or
NaHep for Genomic Array, TRS). Store skin biopsies for fibroblast expansion in media. Store
all at room temperature until delivery to the lab during day shift or on-call hours. DO NOT
HOLD SPECIMENS OVER THE WEEKEND - contact pager: 206-340-7207.

Pathology:
Histology and Morphology
Location: SLU Room G7-910, Telephone: 606-1355
Routine hours: Monday 9am – 6:30pm; Tuesday – Friday 6:00am – 6:30pm
Saturday: 6am – 2:30pm
Sunday and all other times, contact the on-call Pathology Technologist at 206-573-0892.
There is an on-call pathologist & Histology tech 24 hours/ 7 days a week including holidays and
weekends. After hours: In advance of the procedure, notify the Fred Hutchinson Cancer Center
Pathology on-call technologist at the cell number 206-573-0892. When the specimen is
available, notify the on-call technologist
at 206-573-0892

Pharmacokinetics:
Performs Therapeutic Drug Monitoring, Busulfan Testing and Pharmacogenetics Testing
Location: 188 E Blaine, STE 250, Telephone: 606-7389
Routine hours: Tuesday – Saturday 8am – 5pm. On-call Sundays, Mondays, and Holidays.
After hours: Contact pager 206-994-5942

Microbiology Specimens:

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Sent by Specimen Processing to UWMC Microbiology; NW177; 598-6471

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Virology Specimens (except COVID-19):

Sent by Specimen Processing to UW Virology lab at 1616 Eastlake; 685-8037

COVID-19 Specimens:
Sent by Specimen Processing to UW Virology COVID Lab at 1601 Lind Ave SW, Renton, WA;
685-6656, Option 4

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FRED HUTCHINSON CANCER CENTER / RESEARCH / AFFILIATED LABORATORIES

LOCATIONS RESOURCE GUIDE

Lab Name Type of Lab Lab Location Phone Number

Bloodworks Northwest Transfusion Medicine 921 Terry 292-6525
Seattle
WA
Transfusion Support Transfusion Support CE2-128 606-1014
Office- Fred Hutchinson
Cancer Center
UW Laboratory Client Clinical Labs UW Montlake 520-4600
Support Services commserv@[Link]
UW Hematopathology Flow Cytometry & G7-800 606-7060
Molecular Studies

For information on Seattle Children’s Laboratories visit

[Link] professionals/access-services/diagnostic-
services/laboratories/
For information on UW Laboratories visit [Link]
For information and contact info on Fred Hutchinson Cancer Center Laboratories visit
[Link]

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FRED HUTCHINSON CANCER CENTER

Policies

Medical Necessity Information

When ordering tests, only those that are medically necessary for diagnosis and
treatment of the patient should be ordered. The ordering physician or
practitioner must provide an ICD code (International Classification of Diseases—
current Revision) or narrative description for each test ordered. Medicare does
not pay for screening tests, except for certain specifically approved tests.
While ordering custom panels or organ/disease related panels might be
convenient, tests that are not medically necessary might be included. Lab
requisitions include all tests included in each panel. Any test in a panel may be
ordered as an individual test to avoid ordering tests that are not medically
necessary.

Order Authorization
All tests collected by Fred Hutchinson Cancer Center are ordered through CPOE
(computerized order entry) by authorized providers with granted EPIC Access. Verbal test
orders are not accepted by any Fred Hutchinson Cancer Center Laboratories.

Reflexive Testing
Some of our tests can be ordered as reflex tests or panels in which additional
testing is done automatically in response to particular results from the initial
testing. These tests or panels are included on the lab requisition and indicate
when reflexive testing will be done.

Repeat Testing
Whenever there is a question about the validity of a test result, a repeat will be
performed at no additional charges if there is specimen available.

Reporting
Results that have been entered into the Pathology LIS (Epic Beaker), the Alliance
Lab LIS (SunQuest, also used by CIL for Chimerism) or LabWare LIMS
(Pharmacokinetics, Cytogenetics, Clinical Immunogenetics Lab (CIL), Cellular
Therapy) are available for viewing in Epic. Reports not available in Epic are faxed
or printed to Health Information Management (HIM) and the patient care areas.

Referral to Another Lab

Testing not provided by the Fred Hutchinson Cancer Center or Affiliate
Laboratories will be referred to another qualified laboratory licensed to perform
high complexity testing in the specialty/ subspecialty as defined by the Clinical
Laboratory Improvement Amendment (CLIA).
Fred Hutchinson Cancer Center has established a reference laboratory policy in
cooperation with UW Department of Laboratory Medicine and Pathology to ensure
appropriate and adequate organizational oversight, to safeguard the Fred
Hutchinson Cancer Center conflict of
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interest policies and to ensure standard processes for laboratory testing outside
the Fred Hutchinson Cancer Center and UW Medicine Organizations.
The Laboratory Director for the UW Medicine Department of Laboratory Medicine
has designated the division directors, in consultation with laboratory medicine
residents, institutional medical staff or physician clients (where appropriate), as
primarily responsible for the selection of the reference laboratory locations and
clinical oversight of the referral testing process.
UW Department of Laboratory Medicine and Pathology oversight is established by the
assignment of specific division directors to each test referred to other laboratories. The
appropriate division director assignment is based on clinical expertise and experience in
the general classification of the assay.
Assignments are adjusted as needed and are reviewed annually.
The UW Department of Laboratory Medicine and Pathology Resident (LMR) must approve
requests for non-defined reference laboratory tests and select an appropriate reference
lab.
The final reports will include the name of the laboratory performing the test.

Procedure for Requesting Reference Lab Testing

1. Providers requesting reference lab tests must complete a physician’s order to
be filed in the patient’s medical record.
2. Requests for reference lab testing should be submitted to the Alliance Laboratory
which will coordinate the administrative functions necessary for UW LMR approval
of the test(s) and specimen collection. In general, reference laboratory test
requests should be submitted to the Alliance Lab in writing on a Fred Hutchinson
Cancer Center Clinical Laboratory test request form. The Alliance Lab may be
phoned in advance if advance administrative coordination is necessary (see
below).
3. In general, a minimum of 24 hours advance notice is required by the Alliance
Laboratory staff to allow administrative coordination, minimize patient waiting, and
ensure appropriate specimen collection. Ordering providers or their staff should
notify the Alliance Laboratory for reference laboratory testing need by submitting in
advance a test request form or by calling 606-1088.
4. The UW LMR may need to speak directly with the ordering provider and require
time to determine if clinical testing is available and to select an appropriate lab for
testing. Alliance Lab staff will provide the ordering provider name and contact
information upon LMR request.
5. Denial of testing: UW LMR denial of testing is most often the result of either
clinical testing that is unavailable or the test is offered only on a research basis.
The ordering provider will be notified of the denial by either the UW LMR or Alliance
Laboratory staff.
6. Inquiries about establishing new laboratory testing opportunities at the Fred
Hutchinson Cancer Center or UW Department of Laboratory Medicine and
Pathology or at other reference laboratories should be directed to the Fred
Hutchinson Cancer Center Clinical Laboratory Medical Director or the Fred
Hutchinson Cancer Center Director of Clinical Laboratories.

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Fred Hutchinson Cancer Center

SPECIMEN HANDLING GUIDELINES

I. Labeling the Specimen

Specimens may be labeled with a Sunquest-generated label, an Epic label, or a hand-
written label. The following information must appear on the specimen label:
1. Patient name: last name, first name, middle initial, or middle name
2. Patient Medical Record Number (MRN)
3. Patient Date of Birth*
4. Specimen source when applicable, i.e., throat, urine

*Bloodworks Northwest does not accept the date of birth as a specimen identifier.

Note: Specimens collected for blood bank testing require two staff members
to verbally verify the spelling of the patient’s name, the MRN, and
date of birth.
Both staff members will initial the specimen tube and handwrite on the
label the date and time the specimen was collected
Note: Label to be attached in the presence of the patient.
Note: Specimens (including secondary containers) will be labeled at all times
while being processed by Fred Hutch Clinical Laboratories.
II. Requisition
For those lab tests requiring a requisition form, a CPOE requisition will be generated.
The following information is included on the requisition:
1. Patient last name, first name, middle initial, or middle name
2. Patient date of birth
3. Patient Medical Record Number (MRN)
4. Patient location
5. Specimen and site, if applicable
6. Date sample collected/to be collected
7. Time sample collected/to be collected
8. The location where the specimen is to be collected (Alliance Lab,
Apheresis, or Infusion Room)
9. Test(s) required
10. Physician name and billing ID number (UPN)
11. ICD code or descriptive diagnosis
12. Please provide any other pertinent clinical information/history that is available
13. Where applicable, a sample drawn from a donor or family
member should include the patient name and the donor’s
relationship to the patient.
Verify that the information on the requisition matches the information on the
specimen that it accompanies.
III. Specimens Processed in the Fred Hutchinson Cancer Center Labs
Orders defined in Sunquest will interface with the lab system from Epic. Specialty labs
will receive requisitions printed from Epic and will continue to log in specimens in
LabWare.
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IV. Packaging and Transport of Specimens Not Processed in the Fred Hutchinson
Cancer Center Labs
Specimens sent to testing laboratories at FHCRC and the Fred Hutchinson Cancer
Center Clinic shall be packaged into sealed biohazard marked zip-lock bags. Test
request forms accompanying these specimens should be placed in the pouch on
the outside of the bag.
Specimens transported via the Fred Hutchinson Cancer Center Clinic tube
system will be double-bagged in sealed zip-lock biohazard marked bags.
Specimens transported outside of the Fred Hutchinson Cancer Center Clinic must
be packaged into containers with hard sides (i.e., Styrofoam, plastic with screw
top lid, cardboard box with appropriate Styrofoam specimen holder, etc.) and
securely closed with packaging tape. Shipping containers will contain absorbent
material. A biohazard sticker must be affixed to the outside of the shipping
container. A sticker stating “diagnostic specimens” must be affixed to the outside
of the shipping container. Complete a commodities tracking/routing slip
appropriate for the destination of the specimen (UWMC, Seattle Children’s, SLU,
etc.)
V. Criteria for Rejection of Specimens
It is within the discretion of the receiving laboratory to determine if a specimen
has been compromised, justifying the rejection of the specimen. Below are specific
reasons that may apply.

A. Mislabeled specimens and requisitions

Specimens submitted to the Alliance laboratories must adhere to all collecting,
labeling, packaging, transporting, and storing guidelines outlined in this manual.
Misidentified or unlabeled specimens or requisitions will not be accepted.
Mislabeled specimens are defined as:
 Specimens that are not labeled
 Specimens labeled on the container lid only.
 Specimens labeled with a patient name and/or
identification number different from that on the
accompanying lab requisition form.
 Specimens were drawn from the correct patient but labeled with
the wrong name and identification number or date of birth.
 Specimens with matching specimen and requisition labels but
drawn from the wrong patient.
 Specimens not labeled with two patient identifiers.
The laboratory receiving the specimen will immediately notify the ordering
location of the error and request a new specimen.
If extenuating circumstances exist that prevent re-collection of the specimen and
the patient care provider requests that the test be performed on a specimen
meeting the definition of a mislabeled specimen, the lab will follow the Mislabeled
Laboratory Specimens and Requisitions LAPP Gen.01. This LAPP can be found on
PolicyStat.

B. Hemolysis of the blood sample

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Hemolysis results from the destruction of RBCs and the liberation of hemoglobin
into the fluid portion of the specimen. This will not be known until the sample has
been separated. Severe hemolysis will affect certain tests (such as Potassium and
Lactate Dehydrogenase), and the

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sample will have to be redrawn.

(Continued)

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Hemolysis can be caused by:

 mixing additive tubes too vigorously or using rough
handling during transport
 drawing blood from a vein that has a hematoma.
 pulling back the plunger on a syringe too quickly
 using a needle with too small of a bore for the venipuncture
 using too large a tube when using a small diameter butterfly needle
 frothing of the blood caused by an improper fit of the needle on a syringe.
 forcing the blood from a syringe into an evacuated tube

C. Specimen clotted.
Inadequate mixing of the Vacutainer™ tubes as soon as possible after the
phlebotomy will result in the blood not mixing with the anti-coagulant. By
gently inverting the Vacutainer™ tube 5-10 times, the blood will mix, and
clotting will not occur.

D. Insufficient Specimen Quantity or Quantity Not Sufficient (QNS)

Blood-testing volumes are reviewed annually for appropriateness, and every effort
is made to minimize these volumes. Please check the test to see what the
minimum requirements are for that procedure. Specimens with insufficient
volumes for testing will have to be redrawn.
VI. Collection Guide
A. Contamination
Non-additive tubes are drawn before additive tubes to avoid contamination with the
additive.

B. Additive-Containing Tubes
Even for tubes with additives, there is a recommended "order of draw" to avoid
cross- contamination that can result in erroneous test values. Additive-Containing
tubes should be drawn as follows:
1. Blue top tubes (Na Citrate)
2. Green top tubes (Heparin)
3. Purple top tubes (EDTA)
Note: Gently invert tubes 5-10 times to mix the blood with the additive.

C. Order of Draw
The recommended "order of draw" when collecting several specimens from a
single venipuncture and using an evacuated tube system is as follows:

1. Syringe for blood cultures

2. Glass Red Top
3. PORTEX 3ml ABG heparinized syringe
4. 🞿Blue Top or Black Top
5. Royal Blue Top No Additive
6. Gold or Red Gray Tiger Top or Orange Top
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7. Plastic Red Top Tube

8. Lime Green Top
9. Green Top
10. Lavender (Purple) Top
11. Royal Blue Top with EDTA
12. Copper Top (Rarecyte BCT)
13. Gray Top
14. Yellow Top
15. QuantiFERON Kit– (1. Grey 2. Lavender 3. Green 4. Yellow)
16. Specialty Tubes – Unless otherwise noted.

Research is drawn with clinical samples following the correct order of draw.

🞿 If blood cultures are not drawn and the 1st tube to be drawn is the Blue Top,
a Discard Tube or a glass Red Top tube for testing MUST be drawn first to
eliminate possible thromboplastin contamination from the site of the
venipuncture. Note that plastic red top tubes contain a clot activator. You
must use the translucent red top tube with no clot activator as a discard
tube. Laboratory staff is able to assist with determining the correct tube for
discard.

D. Minimizing unnecessarily large blood draw volumes

Blood losses from phlebotomy, particularly in pediatric patients and those with many
venipunctures, may be a cause of iatrogenic anemia and increased transfusion needs.
Adverse consequences of excess venipunctures include complications during collection for
patients and health care workers, hazards from subsequent transfusions, contending with
increased amounts of hazardous waste, and greater cost.
Wherever possible, efforts should be made to reduce blood collection volumes in the
following manner:
1. Combining tests with similar specimen tube type and processing and
storage and transport requirements.
2. Reducing the number of blood collection tubes to produce the
minimum volume needed for laboratory testing.
Minimal specimen requirements for tests performed at the Fred Hutchinson Cancer Center
Cellular Therapy, Clinical Immunogenetics, Cytogenetics, Pathology, Pharmacokinetics,
Alliance Laboratory (including IMTX and GI Oncology) and POCT are specified in this
manual: see entry for each test.
Minimal specimen collection requirements for tests performed at UW Department
of Laboratory Medicine and Pathology labs can be located in the UW Laboratory
online test guide [Link]

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Fred Hutchinson Cancer Center

GUIDELINES FOR TIMED URINE AND STOOL COLLECTIONS

The staff member providing the timed urine/stool container(s) is responsible for
labeling the container(s) before giving them to the patient.

The following information must appear on the specimen label:

1. Patient name: Last name, first name and middle initial

2. Patient Medical Record Number (MRN)
3. Patient Date of Birth
4. Date and Time the specimen was collected

Provide the patient with the Timed Urine Collection or Timed Stool Collection
instruction form, or the Stool Collection form (not timed).

Patient Instructions for timed urine

collection Patient Instructions for timed stool
collection Patient Instructions for stool
collection (not timed)

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Timed Urine Collection

The best diagnostic results are based on a complete 24-hour urine collection, so it is important for
you to follow this procedure carefully.

1. Start the collection at any time that is convenient for you.

2. To start, empty your bladder and discard the urine. Record the start time on this form.
3. Using the urine “hat” or urinal, save all urine from this point on in the container provided. If
you need another container, the Alliance Lab staff, your team nurse, or nurse case manager
will provide one for you.
4. At exactly 24 hours after your start time, empty your bladder and add this urine to the container.
Record this time on this form. Do not put any additional urine into the container.
5. Store the container in the refrigerator during the collection period.
6. If any urine is spilled or discarded during the 24-hour period, stop the collection. Discard the
urine and discard the container in the trash. (**Note: If your container has HCL added, please bring
the collection container to the Alliance Lab to discard). In order to begin collection again, request
another collection container from the Alliance Lab or your team/clinical nurse.
7. Deliver the container along with this form to the Alliance Lab (1st floor-Specimen Window) as
soon as possible (preferably the same day).

If you have been asked to collect urine for the following tests, please note the restrictions listed below:

Bence Jones  No Restrictions. No additive required. REFRIGERATE DURING COLLECTION.

Quantitation
Catecholamines  15 mL HCL must be added to container prior to collection. Please see Alliance Lab staff.
(Epinephrine, REFRIGERATE DURING COLLECTION.
Norepinephrine, (** Note: HCL can cause burns and irritations. Avoid contact with skin or eyes.)
Dopamine  Discontinue one week prior to and during collection: mythyldopa (Aldomet), &
Metanephrine) related antihypertensives, tetracyclines, quinidine, and quinine.
 A blood Creatinine level is required within 48 hours of the conclusion of the
Creatinine urine collection. Please check in with the lab to see if you need blood drawn
Clearance for this test.
 No Restrictions. No additive required. REFRIGERATE DURING COLLECTION.
Creatinine, Protein,  No Restrictions. No additive required. REFRIGERATE DURING COLLECTION.
Protein
Electrophoresis
 10 g of boric acid must be added to container at start of collection.
Cortisol
REFRIGERATE DURING COLLECTION.
 5g sodium carbonate (NOT sodium bicarbonate) must be added to container prior
Prophyrins
to collection. Please see Alliance Lab staff. REFRIGERATE DURING
Quantitation
COLLECTION.
(includes
 Protect from light. Keep collection container in brown paper bag.
porphobilinogen)
 Blood specimen and stool collection may be required as well. Please check with
your Team Nurse or Nurse Case Manager to determine if these are necessary.
 15 mL HCL must be added to container prior to collection. Please see Alliance Lab staff.
VMA REFRIGERATE DURING COLLECTION.
(** Note: HCL can cause burns and irritations. Avoid contact with skin or eyes.)
 15 mL HCL must be added to container prior to collection. Please see Alliance Lab staff.
5HIAA REFRIGERATE DURING COLLECTION.
(5- (** Note: HCL can cause burns and irritations. Avoid contact with skin or eyes.)
Hydroxyindolacetic  Discontinue two days before and during collection: acetanilide, aspirin, avocados,
Acid) bananas, chlorpromazine, cough medicines, eggplant, methamphetamines, nicotine,
nortriptyline, nuts, phenothiazine, pineapple, and plums.

Patient Name: Start Date: / / Start Time:

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Stop Date: / / Stop Time:

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Timed Stool Collection for Fecal Fat

The best diagnostic results are based on a complete 36 to 72-hour collection.

Therefore, it is important for you to follow this procedure carefully.

1. You must be off any mineral oil compound for three days prior to start
of your stool collection.

2. Start the collection at any time that is convenient for you.

3. Collect stool into collection “hat” and transfer to the specimen container
provided.

4. Do not fill the container more than half full. You may request another
collection container from the Alliance Lab staff.

5. Keep the specimen container refrigerated during the collection time period.

6. Seal the lid securely and deliver the container(s) along with this form to the
Alliance Lab as soon as possible (preferably the same day).

Note:
 Store the container in the refrigerator during the collection period.

 DO NOT DISCARD ANY STOOL SPECIMEN DURING THE COLLECTION

TIME FRAME.

Patient Name:

Patient Medical Record Number:

Patient Date of Birth:

Date Started: / / Time Started:

Date Completed: / / Time Completed:

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Alliance Laboratory
Stool Collection Instructions
You have been asked by the medical team to obtain a stool specimen. We ask that you collect the
specimen according to the following instructions.
 NOTE: Antacids, barium bismuth, anti-diarrhea medication or oily laxatives should not be used
prior to collection.
 Containers should be labeled prior to collection with the patient’s name and either
the date of birth or the MRN (the U number).

1. Stool sample containers and a collection device (hat shaped white plastic)
have been provided to you.
2. The stool sample should not be contaminated with urine or toilet paper.
3. Collect stool in the white plastic container (the hat) that is provided:
a. Lift the toilet seat.
b. Place the device over the toilet bowl.
c. Place the toilet seat down.
d. Pass the stool into the white plastic (hat) container without it being
contaminated with urine.
4. Once stool is in the hat, use a wooden stick (or pour) to remove portions of the
stool and place it into the containers provided, collecting any mucus or blood with
the specimen. Depending on the tests ordered by your provider, you may receive
one or all of the containers below:
a. For C. difficile and/or virology tests, place a portion of the stool sample into
separate sterile clear containers without additive.
b. For bacterial culture, place stool into the Para-Pak C&S Orange Cap container
to the fill line, tighten the cap, and shake firmly to ensure that the specimen
is adequately mixed.
c. For Ova and Parasite Exam, place stool into the Para-Pak EcoFix Green Cap
container to the fill line, tighten the cap, and shake firmly to ensure that the
specimen is adequately mixed.
5. Verify the containers are labeled correctly with your name and another identifier.
6. Place the containers into the biohazard bag and seal the bag.
7. Remove gloves and wash hands.
Note: The specimen should be delivered to the Alliance Laboratory drop-off window within
24 hours after collection. Samples collected in preservative should be kept at room
temperature. Samples collected without preservative should be refrigerated.

Monday – Friday: 6am – 6pm

Lab Hours: Saturday & Sunday: 8am – 4:30pm
Holidays: 8am – 4:30pm

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ALLIANCE LAB

This table provides additional information for tests performed in the Fred Hutchinson
Cancer Center Alliance Laboratory SLU and Community Sites. Note: several tests that were
formerly listed in these tables have been removed from this list because they are performed
elsewhere (UWMC, HMC).
Additional information is available on the UWMC Online Test Guide:
[Link]

Turnaround times are 60 minutes from the time the sample is received in the initial Alliance Lab
location except as noted under Comments. Turnaround times for Community Site testing
performed at SLU is less than 8 hours. Turnaround time is defined as the time from specimen
receipt to result reporting. Not included in the turnaround time are specimen transport
time, blood draw waiting time, and blood draw time. These may also delay results.

CHEMISTRY PANELS

TEST
DESCRIPTION TESTS INCLUDED
MNEMONIC COMMENTS

BMP Basic Metabolic Panel Na, K, Cl, CO2, Glu, BUN, Creat, Ca,
calculated glomerular filtration rate
LYT Electrolytes Na, K, Cl, CO2

LIPID Lipid Panel Chol, HDL, Trigs, LDL

HFPA Hepatic Function Panel ALT, AST, ALK, Albumin, Bili T/D, Total
protein

Albumin, Ca, CO2, Cl, Creat, Glu,

RENFP Renal Function Panel Phosphorus, Na, K, BUN, calculated
glomerular filtration rate
Albumin, Na, K, CL, CO2, Glu, BUN,
RENFHF Renal/Hepatic Function Creat, Bili T/D, Ca, Phos, ALK, AST,
Panel ALT, calculated glomerular filtration
rate,

Na, K, Cl, CO2, Glu, BUN, Creat, Ca,

Comprehensive
COMP Total Protein, Albumin, ALT, AST,
Metabolic Panel
ALK, T Bili, calculated glomerular
filtration rate

90
TSHRF4 TSH with Reflexive Free T4 TSH, Free T4 minutes
TAT

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CHEMISTRY INDIVIDUAL TESTS

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

ALB Albumin Albumin

ALK Alkaline Phosphatase Alkaline Phosphatase

AY Amylase Amylase

AST AST AST

BIL Bilirubin, Total Bilirubin, Total

BILT/D Bilirubin, Total/Direct Bilirubin, Total/Direct

BUN BUN BUN

CA Calcium, Total Calcium, Total

CA199 CA 19.9 CA 19.9 90 minutes TAT

CEA Carcinoembryonic Antigen Carcinoembryonic antigen 90 minutes TAT

CHOL Cholesterol, Total Cholesterol, Total

CK Creatine Kinase Creatine Kinase

CREG Creatinine Creatinine, calculated

glomerular filtration rate

CRT Cortisol Cortisol

GGT GGT GGT

GLU Glucose Glucose

GLUF Glucose, Fasting Glucose, Fasting

HDL HDL cholesterol HDL cholesterol

K Potassium Potassium

LD LD LD
Calculation must be run
LDL LDL cholesterol with Lipid Panel
LPASE Lipase Lipase

MG Magnesium Magnesium

NA Sodium Sodium

P Phosphorus Phosphorus

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Positive or
PGSTAT Qualitative Serum Pregnancy negative
pregnancy test
PLNH3 Ammonia, Plasma Ammonia

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ALLIANCE LAB - CHEMISTRY INDIVIDUAL TESTS (cont.)

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

PSA Prostate Specific Antigen Prostate Specific Antigen, Total 90 minutes TAT
1 occult
blood card
assessing
current
concern of GI
ESB Stool Occult Blood Stool occult blood
bleeding,
SFOBG is IA
testing for
cancer
screening, test
is
transferred
to HMC
T4FR Thyroxine, Free Free T4 90 minutes TAT

TP Total Protein Total Protein

TRIG Triglycerides Triglycerides

TROPIG Troponin I (High Troponin I (High Sensitivity)

Sensitivity)
TSH Thyroid Stimulating Thyroid Stimulating Hormone 90 minutes TAT
Hormone
URIC Uric Acid Uric Acid
Must arrive in
the Main Lab
Calcium, Ionized, Whole for testing to
WIC Calcium, Ionized
Blood begin within
10 minutes of
collection

HEMATOLOGY

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

CBC HCT, HB, WBC, RBC, Platelet &

Hemogram
RBC indices
HCT, HB, WBC, RBC, Platelet,
CBANC Hemogram and
RBC indices & Abs Neutrophil
Abs Neutrophil Count
count

CBD HCT, HB, WBC, RBC, Platelets &

CBC w/ Diff/Smear Eval
RBC indices w/ Diff
CPLTG Citrated Platelet Count Platelets

ESR Erythrocyte 90 minutes TAT

Sedimentation Rate
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HBHCT Hemoglobin and Hemoglobin, Hematocrit

Hematocrit
IPF Immature Platelet Fraction Immature Platelet Fraction

PLTG Platelet Platelet

RETIC Reticulocyte Reticulocyte

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ALLIANCE LAB - COAGULATION

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

PRO Prothrombin Time Prothrombin Time

Activated Partial Activated Partial
PTT
Thromboplastin Thromboplastin Time
Time
FIBCL Fibrinogen Fibrinogen

DDI D-Dimer D-Dimer

ALLIANCE LAB – MOLECULAR

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

For
symptomatic
clinical
patients only.
Testing for
COVID/FLU/RSV Qualitative COVID, FLU A, FLU
FABRCV research,
Respiratory Panel, Rapid B, and RSV by Cepheid PCR
NWH and OVL,
PCR
and
asymptomatic
testing –
consider
NCVQLT,
FLURSV, &
REVSQF.
Requires pre-
approval from
SARS-CoV-2 (COVID-19) Qualitative COVID by Cepheid Fred
NCVRPD
Qualitative Rapid PCR PCR Hutchinson
Cancer Center
Infection
Prevention

URINES

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

Urine dipstick tests, microscopic

UAWK Urinalysis, workup
performed if macroscopic
abnormal
UAC Urinalysis, complete Urine dipstick tests, microscopic
Serum
UCLEAR Creatinine clearance Urine creatinine creatinine
level
required

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UTP Protein Urine total protein

Positive or
UPG Urine Pregnancy negative
pregnancy
test

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Protein/Creatinine Urine Protein, Urine Creatinine 24hr

UPCRAT
Ratio, Timed Urine & Calculated Ratio urine
collectio
n
Protein/Creatinine Urine Protein, Urine Creatinine Random
UPCRTR
Ratio, Random Urine & Calculated Ratio urine
collection

CEREBRAL SPINAL FLUID

TEST
DESCRIPTION TESTS INCLUDED COMMENTS
MNEMONIC

Testing is
performed
immediately
CCCNT Cell Count WBC, RBC upon receipt
but may take
up to 2
hours for
results to be
released.
CGLU Glucose Glucose

CTP Total Protein Total Protein

Review may
take several
days, slides
are prepared
CCFUGE CSF Cell evaluation by
upon receipt
Hematopathologist
and
transferred to
UW
Hematopathol
og y.

BLOOD GASES

TEST
DESCRIPTION TESTS INCLUDED STAT TAT COMMENTS
MNEMONIC

COOX
performed at
HMC (Not
collected at
pH, pCO2, pO2, SLU due to
AG Arterial blood gas 30 minutes
HCO3 short stability
time), sample
must be
received in the
SLU Main Lab
within 10
minutes of
collection.

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COOX
performed at
HMC (Not
pH, pCO2, pO2, collected at
VG Venous blood gas 30 minutes
HCO3 SLU due to
short stability
time), sample
must be
received in the
SLU Main Lab

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within 10
minutes of
collection.

FR

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Laboratory Critical Results

Serum or Plasma Less than Greater than Units

Na 120 160 mEq/L
K 3.0 6.0 mEq/L
HCO3/CO2 10 40 mEq/L
Glucose 55 500 mg/dl
Ca 6.0 13.0 mg/dl
Phosphate 1.0 none mg/dl
Mg 1.2 4.7 mg/dl
Troponin I (High N/A 0.39 ng/mL
Sensitivity)
CSF glucose 20 N/A mg/dl

Whole Blood Less than Greater than Units

Ionized Calcium 0.78 1.58 mmol/L

Arterial Blood Gases Less than Greater than Units

pH 7.20 7.58
pCO2 9 65 mmHg
pO2 40 N/A mmHg
HCO3 10 40 mEq/L

Hematology Less than Greater than Units

*Absolute neutrophils 0.5 N/A x 103 /uL
Hematocrit 20 none %
Hemoglobin 6.0 none g/dL
Platelet 20 1000 x 103 /uL
Hemoglobin 6.0 none mg/dl

Coagulation Less than Greater than Units

Prothrombin Time N/A 5 INR
aPTT N/A 120 Sec
Fibrinogen 100 N/A mg/dL

*Critical ANC: The first time that a patient is seen, the critical value applies, and this
count must be called to the appropriate individual on the 3 rd, 4th, 5th, 6th, 7th floor or
Apheresis.
 All patients are monitored, and careful attention paid to previous counts. If there is
a clinically significant fall in platelets, as determined by a Medical Laboratory
Scientist/Technician trained in Hematology, the appropriate nurse is called.

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ALLIANCE LAB REFERENCE RANGES

HEMATOLOGY

RBC Units: mil/uL Hemoglobin Units: g/dL

Female Male Female Male
Age Range Age Range Age Range Age Range
0 – 3d 4.00 – 6.60 – 3d 4.00 – 6.60 – 3d 14.5 – 22.5 – 3d 14.5 – 22.5
3d – 1w 3.90 – 6.30 3d – 1w 3.90 – 6.30 3d – 1w 13.5 – 21.5 3d – 1w 13.5 – 21.5
1w – 2w 3.60 – 6.20 1w – 2w 3.60 – 6.20 1w – 2w 12.5 – 20.5 1w – 2w 12.5 – 20.5
2w – 1m 3.00 – 5.40 2w – 1m 3.00 – 5.40 2w – 1m 10.0 – 18.0 2w – 1m 10.0 – 18.0
1m – 2m 2.70 – 4.90 1m – 2m 2.70 – 4.90 1m – 2m 9.0 – 14.0 1m – 2m 9.0 – 14.0
2m – 6m 3.10 – 4.50 2m – 6m 3.10 – 4.50 2m – 6m 9.5 – 13.5 2m – 6m 9.5 – 13.5
6m – 2y 3.70 – 5.30 6m – 2y 3.70 – 5.30 6m – 2y 10.5 – 13.5 6m – 2y 10.5 – 13.5
2y – 5y 3.90 – 5.30 – 6y 3.90 – 5.30 – 6y 11.5 – 13.5 – 6y 11.5 – 13.5
6y – 12y 4.00 – 5.20 – 12y 4.00 – 5.20 – 12y 11.5 – 15.5 – 12y 11.5 – 15.5
12y – 18y 4.10 – 5.10 12y – 18y 4.50 – 5.30 12y – 18y 12.0 – 16.0 12y – 18y 13.0 – 16.0
18y – 3.80 – 5.00 18y – 4.40 – 5.60 18y – 11.5 – 15.5 18y – 13.0 – 18.0

MCV Units: fL MCH Units: pg Hematocrit Units: %

Female/Male Female/Male Female Male
Age Range Age Range Age Range Age Range
0 – 3d 95 – 121 – 3d 31.0 – 37.0 – 3d 45 – 67 – 3d 45 – 67
3d – 1w 88 – 126 3d – 1m 28.0 – 37.0 3d – 1w 42 – 66 3d – 1w 42 – 66
1w – 2w 86 – 124 1m – 2m 26.0 – 34.0 1w – 2w 39 – 63 1w – 2w 39 – 63
2w – 1m 85 – 123 2m – 6m 25.0 – 35.0 2w – 1m 31 – 55 2w – 1m 31 – 55
1m – 2m 77 - 115 6m – 2y 23.0 – 31.0 1m – 2m 28 – 42 1m – 2m 28 – 42
2m – 6m 74 - 108 – 6y 24.0 – 30.0 2m – 6m 29 - 41 2m – 6m 29 – 41
6m – 2y 70 - 86 – 12y 25.0 – 33.0 6m – 2y 33 – 39 6m – 2y 33 – 39
2y – 6y 75 - 87 12y – 18y 25.0 – 35.0 – 6y 34 – 40 – 6y 34 – 40
6y – 12y 77 - 95 18y – 27.3 – 33.6 – 12y 35 – 45 – 12y 35 – 45
12y - 81 - 98 12y – 18y 37 – 46 12y – 18y 37 – 49
18y – 36 – 45 18y – 38 – 50

MCHC Units: g/dL RDW-CV Units: % Retic PCT Units: % Retic ABS Units: bil/uL
Female/Mal
Female/Male Female/Male Female/Male e
Age Range Age Range Age Range Age Range
0 – 3d 29.0 – 37.0 – 1w 11.0 – 18.0 6m - 0.5 - 2.5 15y - 25 - 125
3d – 2w 28.0 – 37.0 1w – 1m 11.0 – 17.0
2w – 2m 29.0 – 37.0 1m – 6m 11.0 – 16.5
2m – 2y 30.0 – 36.0 6m – 11.6 – 14.4

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2y 32.2 – 36.5

– Platelet Units: Units: mm/hr

Count thou/uL IPF PCT Units: % Erythrocyte Sedimentation Rate (ESR)
Female/Male Female/Male Female Male
0- 1.20 -–8.6
3d 250 - 450 Age Range Age Range
3d – 9d 200 - 400 ≤50y 0 -20 ≤50y 0 - 15
Units: thou/uL
9d – 1m 250 - 450 IPF ABS ≥50y 0 - 30 ≥50y 0 - 20
1m – 6m 300 - 750 Female/Male
6m – 2y 250 - 600 0- 3.6 -20.0
2y – 8y 250 - 550
8y – 12y 200 - 450
12y – 150-400

MPV Units: fL
Female Male
Age Range Age Range
9.4 - 12.3 9.4 - 12.4

Units:
WBC thou/uL
Female/Male
Age Range
0 – 1d 9.0 – 30.0
1d – 1w 5.0 – 21.0
1w – 1m 5.0 – 19.5
1m – 1y 6.0 – 17.5
1y – 2y 5.0 – 15.5
2y – 4y 6.0 – 15.5
4y – 6y 5.0 – 13.5
6y – 10y 4.5 – 13.5
10y – 14y 5.0 – 11.0
14y – 4.3 – 10.0

Absolutes
Units: Units: Units:
Neutrophils thou/uL % Monocytes thou/uL % Basophils thou/uL %
Female Female
Female/Male
Female/Male /Male Female/Male /Male
Age Range Age Range Age Range
0 – 1d 3.00 – 12.00 33 – 70 0 – 1m 0.00 – 1.10 0-10 0 – 1w 0 – 0.10 0–1

1d – 1w 2.00 – 6.00 15 – 50 1m – 1y 0.00 – 0.90 0-10 1w – 6m 0 – 0.05 0–1

1w – 1y 1.50 – 5.00 15 – 45 1y – 0.00 – 0.80 0-10 6m – 0 – 0.20 0-1

1y – 4y 1.50 – 7.00 15 – 70

4y – 10y 1.80 – 7.00 25 – 70

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10y – 12y 1.50 – 7.00 30 – 70

Female/Male
12y – 1.80 - 7.00 40 – 75

Units: Units: Immature Units:

Lymphocytes thou/uL % Eosinophils thou/uL % Grans thou/uL %
Female/Male Female/Male

Age Range
0.00 - 0.40 0-4
0 – 24hr
0.00 - 0.50 0-4
1d – 1w
0.00 - 0.30 0-4
1w – 1y
0.00 - 0.50 0-4
1y -

Age Range

CSF Cell CSF

Count Units: cell/uL Differential Units: %
Female/Male
Cell Range
Red Blood
Cell 0
Mononuclear
Cell 0-5

COAGULATION

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Female/Male
Cell Range

Neutrophils 2±4

Lymphocytes 60 ± 20
Monocytes 30 ± 15

TEST Reference Range Units

Prothrombin time (PT) 10.7-15.6 Seconds
INR 0.8 - 1.3
Activated Partial Thromboplastin Time (APTT) 22-35 Seconds
Fibrinogen 150-400 mg/dL
D-Dimer 0-0.59 µg/mL FEU

CHEMISTRY

Analyte Reference Range Units

Na (Sodium) 135-145 mEq/L
K (Potassium) 3.6-5.2 mEq/L
Cl (Chloride) 98-108 mEq/L
CO2 (Bicarbonate) 22-32 mEq/L
Ion Gap 4-12

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Creatine Kinase Male 62-325 U/L

Female 43-274
Creatinine Female >18yrs 0.38-1.02 mg/dL
Male >18 yrs. 0.51-1.18
Male or Female <18 yrs. 0.20-
1.10
BUN 8-21 mg/dL
Glucose 62-125 mg/dL
Ca (Calcium) 8.9-10.2 mg/dL
P (Phosphorus) 2.5-4.5
mg/dL
Child <12 years: 4.5-6.0
Albumin 3.5-5.2 g/dL
Mg (Magnesium) 1.8-2.4 mg/dL
Total Bilirubin 0.2-1.3 mg/dL
Direct Bilirubin 0.0-0.3 mg/dL
AST 9-38 U/L
ALT Male Age 0-49 10-
64 U/L
Age > 50 10-48
Female 7-33
CK (total) Male: 62-325 Female: 43-274 U/L
GGT 0-55 U/L
LD <210 U/L
Total Protein 6.0-8.2 g/dL
Uric Acid Male 3.9-7.6
mg/dL
Female 2.6-6.8
Cholesterol Desirable <200
Borderline 200-239 mg/dL
High >239
HDL-Cholesterol >39
Desirable >59 mg/dL
Acceptable 40-59
Low <40
Triglyceride Desirable <150
Borderline 150-199 mg/dL
High 200-499
Very High >499
Ammonia 1-13d M/F: 110-180
14-29d M/F: 95-155
µg/dL
1m-11y M/F: 35-85
12-150y M/F: 0-65
Amylase 27-106 U/L
Lipase <70 U/L
Ionized Calcium (Whole > 1 year 1.18-1.38 mmol/L
Blood) < 1 year 1.16-1.45
Prostate Specific Antigen Male: 0.00-5.00 ng/mL
CEA 0.0-5.0 ng/mL
Troponin I (High <0.04 Normal
Sensitivity) 0.04 - 0.39 Elevated above the ng/mL
99th percentile of a healthy
population

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CSF Glucose 40-80 mg/dL

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CSF Protein 15-45 mg/dL

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ALLIANCE LAB REFERENCE RANGES

ALKALINE PHOSPHATASE

AGE MALE FEMALE UNITS

75 52-227 49-199 U/L
65 36-161 38-172 U/L
55 37-159 31-132 U/L
45 39-139 34-121 U/L
35 36-122 25-112 U/L
25 35-109 25-100 U/L
18 42-136 26-98 U/L
14 72-400 43-226 U/L
12 119-426 89-285 U/L
10 115-324 132-366 U/L
0 115-324 111-281 U/L

BLOOD GASES

Blood gas, Arterial (Adult) Reference Range Units

pH 7.35-7.45
pCO2 33-48 mmHg
1-39y: 80-104
pO2 40-59y: 70-95 mmHg
60-150y: 63-87
Bicarbonate 22-26 mEq/L
O2 Saturation 95-99 %

Blood gas, Venous (Adult) Reference Range Units

pH 7.32-7.40
pCO2 42-50 mmHg
pO2 35-40 mmHg
Bicarbonate 23-27 mEq/L
O2 Saturation 70-75 %

MOLECULAR

Qualitative COVID/FLU/RSV Reference Range Units

by Cepheid PCR
SARS-CoV-2 (COVID-19) Negative
FLU A Negative
FLU B Negative
RSV Negative

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ALLIANCE LAB REFERENCE RANGES

URINALYSIS

Test (Dipstick) Reference Range

pH 5.0-8.0
Specific Gravity 1.002-1.027
Protein negative
Glucose negative
Ketone negative
Bilirubin negative
Blood negative
Nitrite negative
Urobilinogen 0.1-1.9 Ehrlich units
Leucocyte esterase negative

Test (Microscopic) Reference Range

WBC/hpf 0-5
RBC/hpf 0-2
Casts/lpf 0
Crystals/lpf 0
Bacteria/hpf 0
Squamous epithelial cells/lpf 0-5 (neg)
Renal/transitional epithelial <3 (neg)
cells/hpf

Analyte Reference Range Units

0-14 (random specimen) mg/dL

Urine Total Protein
0.050-0.080 (24-hour specimen) g/24ho
ur
Child 0-9 years 700 - 1800
mg/
Urine Creatinine Male > 9 years 1000 - 2000
24
Female > 9 Years 700 - 1800
hours
Newborn 40-60 mL/
Creatinine Clearance Male 75-120 min/m2
Female 65-105 mL/min
mL/min

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CD34 ASSAY

Lab Cellular Therapy, 1100 Eastlake Avenue E, E1-419

Request Form Fred Hutchinson Cancer Center CTL Test
Requisition/Billing form – for Peripheral Blood Leukocytes (PBL)
For Fred Hutchinson Cancer Center Ambulatory Clinic, CPOE requisition will be
generated for those lab tests requiring a requisition form.
Phone 606-1200
Availability M – F Lab Hours 7am –
8pm Processing Hours 7am – 5pm
Weekends & Holidays Lab Hours 9am – 5pm
Processing Hours 9am – 3pm
Turnaround Time Three hours after sample received or lab start-up
Specimen Peripheral Blood
Volume 2 - 4 mL
Pediatric Volume 2 - 4 mL
Container EDTA (2.0 mL purple top)
Collection Routine venipuncture or line
draw Special Handling Room temperature, label as
STAT Causes for Rejection
Misidentified specimens and requisitions, specimen
QNS, improperly stored specimen, specimen clotted.
Reference Ranges No normal values established for mobilized specimens.
After Hours Draw a fresh specimen in the morning (no after-hours
specimen handling).

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BLOOD GAS, ARTERIAL

Related Terms Arterial blood gas, Blood gas, ABG, Gases

Panel includes Measured parameters include pH, pCO2 and pO2;
Calculated parameters include HCO3, base excess,
and oxygen saturation.
Lab Alliance Lab, Room G1-500
Request Form Fred
Hutchinson Cancer Center Clinical Lab Request: fill out completely, including
ICD codes.
Pulmonary Function Testing (PFT) staff will print a CPOE requisition to
accompany the specimen.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Arterial Blood
Volume 3mL; minimum volume is 300 µL (0.3mL) in a tuberculin syringe.
Pediatric Volume See Capillary Blood Gases
Container Blood should be drawn into gas-tight plastic syringe
using 1000- units sodium or lithium heparin. Other anticoagulants are not
acceptable.
Patient Preparation
Acknowledging that patients requiring blood gas analysis may be unstable, the
patient should be as physiologically stable as possible when the arterial blood
specimen is collected. Ideally, a patient’s ventilation should be stable during
specimen collection. Therefore, a patient breathing spontaneously should be at
rest at least 5 minutes or, if possible, for as long as it takes for the ventilation
pattern to become stable.
Collection
Collect samples in airtight plastic syringe. Completely wet the inside of the barrel
of the syringe. The sodium heparin acts as an anticoagulant. Place a needle on
the syringe and expel the sodium heparin to fill the dead space of the syringe
and needle. Draw samples anaerobically, without introducing air bubbles in the
syringe, and cap the syringe. If bubbles develop during sample collection,
remove them immediately.

(Continued)

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(Blood Gas, Arterial, continued)

Special Instructions
Requisition must indicate time drawn, type of sample (arterial, venous, or
capillary), FiO2 and ventillary support type, and patient temperature. Notifying
the lab of a pending sample is helpful. Deliver to the lab immediately following
collection.
Causes for Rejection
Large air bubbles will cause all values to be erroneous. The magnitude of error
will be determined by the size of the air bubble, sample and sample air bubble
interface, length of time bubble was in contact with sample before analysis and
the gradient between sample gas tensions and room air gas tensions. Small
bubbles, if immediately expelled, will generally not cause any significant error.
Samples with large (more than 0.2 mL) bubbles should be discarded and a new,
anaerobic sample obtained. Needle attached, sample clotted, specimen received
more than 1 hour after collection.

Reference Ranges/Critical Values

Reference Range Critical Values

pH 7.35 – 7.45 <7.20 or >7.58
pCO2 33 – 48 mm Hg <9 or >65 mm Hg
pO2 80 – 104 mm Hg <40 mm Hg
(<20 mm Hg venous)
HCO3 24-31 mEq/L <10 or >40mEq/L
O2 Saturation 95-99%

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BASIC METABOLIC PANEL

Related Terms BMP

Panel includes Sodium, potassium, chloride, carbon dioxide,
glucose, urea nitrogen (BUN), creatinine, calcium, calculated
glomerular
filtration rate.
Ion Gap is calculated: Gap = Na – (Cl + CO2)
Glomerular filtration rate (GFR) is calculated by the Modification of
Diet in Renal Disease (MDRD) Study equation, which is reasonably
accurate in non- hospitalized patients with chronic kidney disease but
tends to underestimate GFR in other populations. It is inaccurate in
patients with rapidly changing renal function. See NEJM 2006; 354:2473.

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 2 mL
Pediatric Volume Pediatric capillary collection: 500 µL (0.5 mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection See individual tests.
Reference Range See individual tests.
Critical Values See individual tests.

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COMPREHENSIVE METABOLIC PANEL

Related Terms COMP

Panel includes Sodium, potassium, chloride, carbon dioxide, calculation for
Ion Gap, glucose, urea nitrogen (BUN), calcium, creatinine,
alanine aminotransferase (ALT), alkaline phosphatase (ALP),
aspartate aminotransferase (AST), bilirubin (total), total
protein, albumin, calculated glomerular filtration rate

Ion Gap = Na – (Cl + CO2)

Glomerular filtration rate (GFR) is calculated by the Modification of
Diet in Renal Disease (MDRD) Study equation, which is reasonably
accurate in non- hospitalized patients with chronic kidney disease but
tends to underestimate GFR in other populations. It is inaccurate in
patients with rapidly changing renal function. See NEJM 2006; 354:2473

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order
activation in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection:
500 µL serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST tube
Collection Routine venipuncture or line draw
Causes for Rejection See individual tests.
Reference Ranges See individual tests.
Critical Values See individual tests

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ELECTROLYTES

Related Terms Lutes

Panel includes Sodium, potassium, chloride,
CO2 Ion Gap is calculated: Gap = Na – (Cl + CO2)
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 2 mL
Pediatric Volume Pediatric capillary collection:
500 µL (0.5 mL) serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST tube
Collection Routine venipuncture or line draw
Causes for Rejection See individual tests.

Reference Ranges See individual tests.

Critical Values See individual tests.

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HEPATIC FUNCTION PANEL

Related Terms Liver Panel, Liver Studies, Hepatic

Function, LFT, Liver Function Tests, Hepatic Profile
Panel includes Alanine aminotransferase (ALT), alkaline phosphatase (ALP),
aspartate aminotransferase (AST), bilirubin (total & direct), total protein, albumin.
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection:
500 µL (0.5 mL) serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST tube
Collection Routine venipuncture or line draw
Causes for See individual tests.
Rejection
Reference Ranges See individual tests.
Critical Values See individual tests.

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LIPID PANEL

Related Terms Lipid Profile

Panel includes Cholesterol, triglycerides, HDL cholesterol, calculated LDL
cholesterol, non-HDL Cholesterol, Cholesterol/HLC Ratio
LDL = Chol – (Trig/5) – HDL
Non-HDL Cholesterol = Cholesterol –
HDL Cholesterol/HDL Ratio =
Cholesterol/HDL
Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection; 500µL (0.5mL)
serum collected in microtube or “bullet” tube.
Container 5mL lime top PST, green top, red top, gold top SST or orange
top RST tube
Collection Routine venipuncture or line draw
Causes for See individual tests.
Rejection
Reference Ranges See individual tests.
Critical Values See individual tests.

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RENAL FUNCTION PANEL

Panel includes Sodium, potassium, chloride, carbon dioxide, calculation for

Ion Gap, glucose, urea nitrogen (BUN), creatinine, calcium, phosphorus, albumin,
calculated glomerular filtration rate

Ion Gap is calculated: Gap = Na – (Cl + CO2)

Glomerular filtration rate (GFR) is calculated by the Modification of
Diet in Renal Disease (MDRD) Study equation, which is reasonably
accurate in non- hospitalized patients with chronic kidney disease
but tends to underestimate GFR in other populations. It is
inaccurate in patients with rapidly changing renal function. See NEJM
2006; 354:2473.

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606 -1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability Stat or Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL (0.5 mL)
serum collected in microtube or “bullet” tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST tube
Collection Routine venipuncture or line draw
Causes for See individual tests.
Rejection
Reference Ranges See individual tests.
Critical Values See individual tests.

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RENAL/HEPATIC FUNCTION PANEL

Panel includes Sodium, potassium, chloride, carbon dioxide, calculation for

Ion Gap, glucose, urea nitrogen (BUN), creatinine, calcium, phosphorus, albumin,
total protein, albumin, total/direct bilirubin, alkaline phosphatase (ALK),
aspartate aminotransferase (AST), alanine aminotransferase (ALT), phosphate,
calculated glomerular filtration rate

Ion Gap = Na – (Cl + CO2)

Glomerular filtration rate (GFR) is calculated by the Modification of
Diet in Renal Disease (MDRD) Study equation, which is reasonably
accurate in non- hospitalized patients with chronic kidney disease
but tends to underestimate GFR in other populations. It is
inaccurate in patients with rapidly changing renal function. See NEJM
2006; 354:2437

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability Stat or Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL (0.5 mL)
serum collected in microtube or “bullet” tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST tube
Collection Routine venipuncture or line draw
Causes for See individual tests.
Rejection
Reference Ranges See individual tests.
Critical Values See individual tests.

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TSH WITH REFLEXIVE FREE T4

Related Terms TSHRF4

Panel includes TSH, Free T4
Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Serum
Volume 2.0 mL, minimum 0.8 mL
Container 5 mL orange top tube preferred or gold top, SST, or red top tube SST.
Collection Routine venipuncture or line draw
Causes for See individual tests.
Rejection
Reference Range See individual tests.

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URINALYSIS

Related Terms UA
Panel includes Color, appearance, bilirubin, leukocyte esterase, nitrite,
specific gravity, pH, protein, glucose, ketones, blood, and microscopic analysis if
ordered or indicated by chemistries.
Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Random Urine
Volume 12 mL can be done on <12 mL in extenuating
instances such as infants.
Container Sterile plastic urine container, approved BD collection kit
with cup, red/yellow tube, and gray tube at community sites
Collection Freshly voided clean-catch random urine or catheterized
specimen. Storage Instructions Fresh urine cups must be examined within 2 hours
of collection, appropriately collected BD urine collection kits are stable for 24-72
hours depending on tests ordered.
Causes for Rejection Specimens contaminated with feces, less than 1 mL of
urine or specimens in fresh urine cups >2 hours old.
Reference Ranges Urinalysis macroscopic:
color straw-dark yellow; appearance clear-hazy; pH 5-8; specific gravity 1.005-
1.030; protein negative; glucose negative; ketones negative; bilirubin negative;
blood negative: nitrite negative; urobilinogen 0.1-1 Ehrlich units; leucocyte
esterase: negative.
Urinalysis microscopic: RBC 0-2/hpf; WBC 0-5/hpf; casts negative.

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ALANINE AMINOTRANSFERASE (ALT)

Related Terms ALT, SGPT

Test included in these panels:
 Comprehensive Metabolic Panel
 Hepatic Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2 mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST; NO EDTA samples
Collection Routine venipuncture or line draw
Special Handling Samples must be separated from red cells as soon as
possible after collection. Erythrocytes contain 3x – 5x more ALT than does
serum.
Causes for Rejection
Hemolysis, lipemia, bilirubin, misidentified specimens and requisitions,
specimen QNS
Reference Ranges
Age Male Female
0 - 49 10 - 64 U/L 7-33U/L
> 50 10 - 48 U/L 7-33U/L

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ALBUMIN

Test is included in these panels:

 Hepatic Function Panel
 Renal Function Panel
 Renal/Hepatic Function Panel
 Comprehensive Metabolic Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200 µL (0.2 mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, lipemia or bilirubin, misidentified specimens and requisitions,
specimen QNS.
Reference Ranges 3.5 – 5.2 g/dL

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ALKALINE PHOSPHATASE (ALK)

Related Terms ALK, Alk Phos, ALP, Phosphatase, Alkaline

Test included in these panels:
 Hepatic Function Panel
 Renal/Hepatic Function Panel
 Comprehensive Metabolic Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200 µL (0.2mL)
serum collected in microtube or “bullet” tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST; NO EDTA or oxalate samples
Collection Routine venipuncture or line draw
Causes for Rejection
Hemolysis, misidentified specimens and requisitions,
specimen QNS, serum not separated from cells within 2 hours after collection.

(Continued)

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Alkaline Phosphatase, continued

Reference Ranges

Age Male Female

75 years 52-227 U/L 49-199 U/L
65 years 36-161 U/L 38-172 U/L
55 years 37-159 U/L 31-132 U/L
45 years 39-139 U/L 34-121 U/L
35 years 36-122 U/L 25-112 U/L
25 years 35-109 U/L 25-100 U/L
18 years 42-136 U/L 26-98 U/L
14 years 72-400 U/L 43-226 U/L
12 years 119-426 U/L 89-285 U/L
10 years 115-324 U/L 132-366 U/L
0 years 115-324 U/L 111-281 U/L

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ASPARTATE AMINOTRANSFERASE (AST)

Related Terms AST, GOT, Serum Glutamic Oxaloacetic Transaminase, SGOT

Test included in these panels:
 Hepatic Function Panel
 Renal/Hepatic Function Panel
 Comprehensive Metabolic Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Special Handling The concentration of AST in red cells is roughly 15x
that of normal serum, therefore, hemolysis should be avoided.
Causes for Rejection
Hemolysis, misidentified specimens and requisitions, specimen QNS
Reference Ranges 9-38 U/L

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AMMONIA, PLASMA

Related Terms Ammonia, PLNH3

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma ON ICE
Volume 2 mL plasma, minimum 0.2mL plasma. Ideal to have tube
completely filled.
Pediatric Volume Same as above
Container Lime or Green top refrigerated or
on ice Collection Routine venipuncture or line draw
Causes for Rejection
Samples older than 3 hours old at 2-4 degrees C or 24 hours
at -20 C, QNS, Hemolysis, misidentified specimens
Reference Ranges
Female Male
Age Range Age Range
1d-13d 110-180 1d-13d 110-180
14d-29d 95-155 14d-29d 95-155
1m-11y 35-85 1m-11y 35-85
12y- 0-65 12y- 0-65

AMYLASE
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Related Terms Amylase

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Preferred – lithium heparin plasma, Acceptable – serum.
Volume 0.5 mL
Pediatric Volume 200uL (0.2mL) collected in microtube.
Container 5 mL lime top (lithium heparin) PST, lithium heparin green
top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, misidentified specimens and requisitions, specimen
QNS
Reference Ranges 27-106 U/L

UREA NITROGEN

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Related Terms Blood Urea Nitrogen, BUN

Test included in these panels:
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for rejection
Gross hemolysis, misidentified specimens and requisitions, specimen
QNS
Reference Ranges 8 – 21 mg/dL

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CALCIUM

Related Terms Ca++

Test included in these panels:
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for rejection
Gross hemolysis, specimen QNS, misidentified specimens and
requisitions
Reference Range 8.9 – 10.2 mg/dL
Critical Values <6.0 mg/dL or >13.0 mg/dL

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CA 19-9

Related Terms Cancer Antigen 19-9, Carbohydrate Antigen 19-9

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Serum or plasma
Volume 2.0 mL, minimum 0.8 mL
Container 5 mL orange top tube preferred or gold top, SST, red top
tube SST, or lime top PST.
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, lipemia or bilirubin, misidentified specimens
and requisitions, specimen QNS
Reference Ranges 0 – 54 U/mL

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CARCINOEMBRYONIC ANTIGEN

Related Terms CEA

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Serum
Volume 2.0 mL, minimum 0.8
Container 5 mL orange top tube preferred: or gold top or SST or red top tube SST.
Collection Routine venipuncture or line draw
Interfering Substances
Gross hemolysis, lipemia or bilirubin, misidentified specimens
and requisitions, specimen QNS
Reference Ranges 0.0-5.0 ng/mL

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CEREBRAL SPINAL FLUID GLUCOSE

Related Terms CSF glucose

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Cerebral spinal fluid
Volume 1 mL
Minimum Volume 0.4 mL
Container Plastic tube with tight-fitting lid, orange top tube
Collection Lumbar Puncture
Causes for Rejection
Insufficient quantity, misidentified specimens, and requisitions.
Reference Ranges 40-80 mg/dL
Critical Values Less than 20 mg/dL

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Contents
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CEREBRAL SPINAL FLUID PROTEIN

Related Terms CSF protein

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Cerebral spinal fluid
Volume 1 mL
Minimum Volume 0.4 mL
Container Plastic tube with tight-fitting lid
Collection Lumbar Puncture
Causes for Rejection
Insufficient quantity, misidentified specimens, and requisitions.
Reference Ranges 15-45 mg/dL

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Contents
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CHLORIDE

Related Terms Cl-

Test included in these panels:
 Electrolytes
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Special Handling Centrifuge the specimen to separate serum from
red cells within 2 hours of collection. Store refrigerated at 2–8°C.
Causes for Rejection
Gross hemolysis, misidentified specimens, and
requisitions, specimen QNS.
Reference Ranges 98 – 108 mEq/L

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Contents
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CHOLESTEROL

Test included in this panel: Lipid panel.

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL(0.5mL)
serum collected in microtube or “bullet tube.”
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection
Misidentified specimens and requisitions, specimen
QNS, improperly stored specimen, gross hemolysis.
Reference Ranges Desirable <200
mg/dL Acceptable 200-239 mg/dL
High >239 mg/dL

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Contents
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CO2 (BICARBONATE)

Related Terms TCO2, Total CO2, CO2, HCO3-

Test included in these panels:
 Electrolytes
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST;
NO EDTA, oxalate, or citrate
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, misidentified specimens
and requisitions, specimen QNS.
Reference Ranges 22 – 32 mEq/L
Critical Values <10 mEq/L or >40 mEq/L

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Contents
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CORTISOL

Related Terms ACTH Stimulation Test, Cortrosyn Stimulation Test,

Cosyntropin, Hydrocortisone
Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Serum or plasma
Volume 2.0 mL, minimum 0.8 mL
Container 5 mL lime top PST preferred or gold top, SST, red top tube
SST, or orange top tube.
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, lipemia or bilirubin, misidentified specimens
and requisitions, specimen QNS
Reference Ranges 7am – 9am: 5.0 – 22.6 µg/dL, PM: approximately half of the AM values

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CREATINE KINASE

Related terms CK, CK-Total, CPK

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric volume Pediatric capillary collection: 200μL (0.2mL) serum
collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST; NO EDTA, citrate, or oxalate.
Collection Routine venipuncture or line draw
Special handling Separated serum or plasma should not remain at room
temp longer than 4 hours. If assays are not completed
within 4 hours, serum or plasma should be stored at 2°C to
8°C for up to one week.
Cause for rejection Misidentified specimens and requisitions, specimen QNS
Reference Ranges
Male Female

62-325 U/L 43-274 U/L

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CREATININE

Test included in these panels:

 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Test includes Creatinine, calculated glomerular filtration rate.

Glomerular filtration rate (GFR) is calculated by the Modification of
Diet in Renal Disease (MDRD) Study equation, which is reasonably
accurate in non- hospitalized patients with chronic kidney disease
but tends to underestimate GFR in other populations. It is
inaccurate in patients with rapidly changing renal function. See NEJM
2006; 354:2473

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Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form FHCC Clinical Lab Request: fill out completely, including ICD
codes. CPOE orders will be interfaced to Sunquest upon
order activation in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric volume Pediatric capillary collection: 200µL (0.2mL) serum
collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection Hemolysis, misidentified specimens and requisitions, specimen QNS

Reference Range

Female Male

Age Range Age Range

>=18 yrs. 0.38-1.02 >=18 yrs. 0.51-1.18

DIRECT BILIRUBIN

Related Terms Conjugated Bilirubin

Test included in these panels:
 Hepatic Function Panel
 Renal/Hepatic Function Panel

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Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Special Handling Protect specimen from light. Direct exposure can
decrease direct bilirubin values in specimens by 50% in one hour.
Causes for Rejection
Hemolysis, misidentified specimens and requisitions, specimen QNS.
Reference Ranges 0.0 – 0.3 mg/dL

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GAMMA GLUTAMYL TRANSFERASE

Related Terms GGT

Test included in this panel:
 Comprehensive Metabolic Panel with HSCT subgroup

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL (0.5mL)
serum collected in microtube or “bullet tube.”
Container 5 ml lime top PST, green top, red top, gold top SST or orange
top RST. No EDTA, citrate, oxalate, or fluoride.
Collection Routine venipuncture or line draw
Interfering Substances
Some anti-epileptic drugs (phenytoin, barbiturates), as well as heavy alcohol
consumption before specimen collection may result in falsely elevated GGT
values.
Causes for Rejection
Misidentified specimens and requisitions, specimen
QNS, improperly stored specimen, gross hemolysis

Reference Ranges 0 – 55 U/L

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GLUCOSE

Related Terms Blood sugar, sugar

Test included in these panels:
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST. EDTA or fluoride acceptable.
Collection Routine venipuncture or line draw;
do not draw specimen from an arm receiving intravenous transfusion.
Specimen Handling Separate plasma or serum from cells as soon as
possible to minimize loss of glucose through glycolysis.
Causes for Rejection
Hemolysis, misidentified specimens and requisitions, specimen QNS

Reference Ranges Glucose, fasting: 62–125 mg/dL.

Critical Values <55 mg/dL or >500 mg/dL

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HDL CHOLESTEROL

Related Terms HDL

Test included in this panel Lipid Panel
Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL (0.5mL)
serum collected in microtube or “bullet tube.”
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST. No citrate or oxalate.
Collection Routine venipuncture or line draw
Causes for Rejection
Misidentified specimens and requisitions, specimen
QNS, improperly stored specimen.
Reference Ranges >39
Desirable >59 mg/dL
Acceptable 40-59 mg/dL
Low <40 mg/dL

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Contents
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IONIZED CALCIUM, WHOLE BLOOD

Test includes Ionized Calcium

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT
Specimen Whole Blood
Volume 1 mL
Pediatric Volume 0.5 mL
Container Blood should be drawn into a balanced heparinized syringe
such as the 2 mL Radiometer Pico TM or 3 mL Smiths Portex Pro-Vent syringes.
Other tubes or anticoagulants are not acceptable.
Collection Routine venipuncture or line draw
Storage Instructions
DO NOT OPEN SYRINGE. Samples must remain sealed
between the time of collection and sampling for testing. Return syringe to testing
lab STAT. Samples at room temperature MUST be tested within 10 mins after
blood draw.
Causes for Rejection
Misidentified specimens and requisitions, samples other than a heparinized
syringe, specimen QNS, any syringe that has been opened and exposed to air,
gross hemolysis, sample too old. Reference Ranges > 1 year 1.18 mmol/L - 1.38
mmol/L
< 1 year 1.16 mmol/L - 1.45 mmol/L
Critical Values < 0.78 mmol/L or > 1.58 mmol/L

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Contents
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LACTATE DEHYDROGENASE

Related Terms LD, LDH

Lab Alliance Lab, Room G 1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container Orange top RST, gold top SST, or red top
Collection Routine venipuncture or line draw
Causes for Rejection Lime PST, green top, citrate tube and oxalate tube.
Reference Range <210 U/L

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LDL CHOLESTEROLRELATED TERMS LDL

Test Included in this panel: Lipid Panel

This test is a calculation, and it cannot be ordered as an individual test.
Refer to Lipid Panel
2
𝑇𝐶 𝐻𝐷𝐿 𝑇𝐺 [𝑇𝐺 × 𝑛𝑜𝑛−𝐻𝐷𝐿−𝐶] 𝑇𝐺
LDL-C =0.948 −
0.97 8.5
–( +2140 16,100 - ) – 9.44
1 6

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order
activation in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL (0.5mL) serum
collected in microtube or “bullet tube.”
Container 5 mL lime top PST, green top, red top, gold top SST or orange top RST.
Collection Routine venipuncture or line draw
Special Handling Serum or plasma must be separated from cells within 2 hours.
Causes for Rejection
Misidentified specimens and requisitions, specimen
QNS, improperly stored specimen, gross hemolysis.
Reference Ranges <130

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LIPASE

Related Terms Lipase

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center
Clinical Lab Request: fill out completely, including ICD
codes.
CPOE orders will be interfaced to Sunquest upon order
activation in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Preferred – lithium heparin plasma, Acceptable – serum.
Volume 0.5 mL
Pediatric Volume 200uL (0.2mL) collected in microtube.
Container 5 mL lime top (lithium heparin) PST, lithium heparin green
top, red top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection Gross hemolysis, misidentified specimens and requisitions,
specimen QNS.
Reference Ranges <70 U/L

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MAGNESIUM

Related Terms Mg++

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST. No EDTA, citrate or oxalate.
Collection Routine venipuncture or line draw
Note Erythrocytes contain 3x the magnesium concentration of serum.
Special Handling Draw without venous stasis.
Causes for Rejection
Hemolysis, misidentified specimens, and
requisitions, specimen QNS.
Reference Ranges 1.8 – 2.4 mg/dL
Critical Values <1.2 or >4.7 mg/dL

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Contents
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PHOSPHORUS

Related Terms Phos, PO4, Inorganic phosphorus

Test included in these panels:
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST. No EDTA, citrate or oxalate.
Collection Routine venipuncture or line draw
Special Handling Hemolysis must be avoided, as phosphate may be
split off from labile esters in the erythrocytes.
Causes for Rejection
Hemolysis, misidentified specimens, and
requisitions, specimen QNS.
Reference Ranges Adult 2.5 – 4.5
mg/dL Child <12 years 4.5 – 6.0
mg/dL
Critical Values < 1.0 mg/dL

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POTASSIUM

Related Terms K+, K, Serum Potassium

Test included in these panels:
 Electrolytes
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or orange
top RST Collection Routine venipuncture or line draw do not draw specimen from
an arm receiving intravenous transfusion. Avoid hemolysis, as it can lead to
falsely elevated K+ levels.
Causes for Rejection
Hemolysis, misidentified specimens, and
requisitions, specimen QNS.
Reference Ranges 3.6 – 5.2 mEq/L
Critical Values <3.0 mEq/L or >6.0 mEq/L

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Contents
94 | P a g 34th Edition
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URINE PREGNANCY TEST

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Random Urine, first morning specimen preferred for best results.
Volume 10 mL
Container Plastic urine container
Collection Freshly voided random urine.
Storage Instructions Specimen can be refrigerated (2-8°C).
Causes for Rejection Specimens contaminated with feces, less than 1 mL of
urine or specimens in fresh urine cups >2 hours old, yellow/red or gray top
urine collection kit tubes. Reporting Qualitative results, positive or negative
Reference Ranges Negative, positive results will be called to the ordering provider.

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Contents
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SERUM PREGNANCY TEST (QUALITATIVE)

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in
Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Serum
Volume 5 mL
Container 4ml orange top RST, gold top SST, red top tube
Not acceptable: lime or green top tube
Collection Routine venipuncture or line draw
Causes for Rejection
Collected in tube with anticoagulant, QNS,
misidentified specimens and requisitions.
Reporting Qualitative results, positive or negative
Reference Ranges Negative, positive results will be called to the ordering provider.

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Contents
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PROSTATE SPECIFIC ANTIGEN

Related Terms PSA, PSA monitor, PSA screen, ultrasensitive PSA

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson
Cancer Center Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Serum
Volume 2.0 mL, minimum 0.8
Container 5 mL orange top tube preferred: or gold top SST, red
top tube, SST.
Collection Routine venipuncture or line draw
Interfering Substances
Gross hemolysis, lipemia, or bilirubin; misidentified specimens and requisitions;
specimen QNS
Reference Ranges 0.00-4.00 ng/mL

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Contents
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SODIUM

Related Terms Na+

Test included in these panels:
 Electrolytes
 Basic Metabolic Panel
 Comprehensive Metabolic Panel
 Renal Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or
orange top RST
Collection Routine venipuncture or line draw; do not draw
specimen from an arm receiving intravenous transfusion.
Causes for Rejection
Gross hemolysis, misidentified specimens, and
requisitions, specimen QNS.
Reference Ranges 135 – 145 mEq/L
Critical Values <120 mEq/L or >160 mEq/L

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Contents
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EMERGENCY BLEED, STOOL

Related Terms Fecal Occult Blood, FOBT, Stool (GI Bleeding Screen), ESB
Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson Cancer Center Clinical Lab Request:

fill out completely, including ICD codes;
include date and time of specimen collection.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Stool sample must be applied to the card prior to being sent to
the lab. The lab will not accept stool samples in specimen containers. Do not send
stool directly to lab. Note: The Alliance Lab does not supply cards, these are
stocked by our Storeroom team in each clinic space. Connect with the Storeroom
to acquire more cards.
Causes for Rejection
Misidentified specimens and requisitions, specimen QNS, improperly prepared
card, card stored outside of room temperature
Reference Range Negative [NRN]

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THYROID STIMULATING HORMONE

Related Terms Sensitive TSH, TSH, TSH-Sensitive, Thyrotropin

Test included in these panels:
 TSH with Reflexive Free T4

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson
Cancer Center Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Serum
Volume 2.0 mL, minimum 0.8 mL
Container 5 mL orange top tube preferred or gold top, SST, or red
top tube SST.
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, lipemia or bilirubin, misidentified specimens and
requisitions, specimen QNS, wrong tube type
Reference Ranges 0.400 – 5.000 µIU/mL

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Contents
100 | P a g 34th Edition
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THYROXINE (FREE)

Related Terms FT4, Free T4, Free Thyroxine, T4-Free, thyroid function
Test included in these panels:
 TSH with Reflexive Free T4

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson
Cancer Center Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Serum or plasma
Volume 2.0 mL, minimum 0.8 mL
Container 5 mL orange top tube preferred or gold top, SST, red
top tube SST, or lime top PST.
Collection Routine venipuncture or line draw
Causes for Rejection
Gross hemolysis, lipemia or bilirubin, misidentified specimens and
requisitions, specimen QNS
Reference Ranges 0.6 – 1.2 ng/dL

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TOTAL BILIRUBIN

Related Terms Bilirubin

Test included in these panels:
 Comprehensive Metabolic Panel
 Hepatic Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200 µL
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or
orange top RST
Collection Routine venipuncture or line draw
Special Handling Protect specimen from light; direct exposure can
decrease bilirubin values in specimens by 50% in 1 hour.
Causes for Rejection
Hemolysis, misidentified specimens, and
requisitions, specimen QNS.
Reference Ranges 0.2 – 1.3 mg/dL

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TOTAL PROTEIN

Related Terms Protein

Test included in these panels:
 Comprehensive Metabolic Screen
 Hepatic Function Panel
 Renal/Hepatic Function Panel

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or serum. Plasma samples will exhibit slightly
higher total protein levels due to the presence of fibrinogen. Heparin is the
recommended anticoagulant for plasma samples.
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200 µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or
orange top RST
Collection Routine venipuncture or line draw
Interfering Substances
Gross hemolysis, lipemia, or bilirubin
Causes for Rejection
Misidentified specimens and requisitions, specimen QNS.
Reference Ranges 6.0 – 8.2 g/dL

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URINE TOTAL PROTEIN, QUANTITATIVE

Related Terms Urine protein, Urine total protein

Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson
Cancer Center Clinical Lab Request: write UPCRAT in the OTHER
REQUEST section. Fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen 24-hour urine collection, random specimen also acceptable
Volume 1 mL
Minimum Volume 0.4 mL
Container 24-hour urine collection container, or plastic urine cup
w/ tight- fitting lid
Causes for Rejection
Insufficient quantity, misidentified
specimens and requisitions.
Reference Ranges 0-14 mg/dL (random
specimen) 0.05-0.08 g/24 hours (24-hour
collection)

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URINE TOTAL PROTEIN, SEMI QUANTITATVE

Related Terms Urine protein, Urine total protein

Lab
Satellite Labs, South Lake Union
Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request: write
UTPQL in the OTHER
REQUEST section. Fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in Epic.
Phone
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Random urine specimen
Volume 1 mL
Minimum Volume 0.4 mL
Container Plastic urine cup w/ tight-fitting lid
Causes for Rejection
Insufficient quantity, misidentified
specimens and requisitions, 24-hour urine
specimens
Reference Ranges No reference range.

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TRIGLYCERIDES

Related Terms Trigs

Test included in this panel Lipid panel

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson
Cancer Center Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability Routine
Specimen Plasma or Serum
Volume 1 mL
Pediatric Volume Pediatric capillary collection: 500µL (0.5mL)
serum collected in microtube or “bullet tube.”
Container 5 mL lime top PST, green top, red top, gold top SST or
orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection
Misidentified specimens and requisitions,
specimen QNS, improperly stored specimen,
hemolysis, not fasting for at least 12 hours.
Reference Ranges Desirable <150
mg/dL Borderline 150-199 mg/dL
High 200-499 mg/dL
Very High >500 mg/dL

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TROPONIN I (HIGH SENSITIVITY)

Related Terms High Sensitivity Troponin I, hsTnI, TROPIG, Troponin-I, Troponin I

Test included in these panels TROPIG
Lab Alliance Lab, Room G1-500
Request Form Fred Hutchinson
Cancer Center Clinical Lab. Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT
Specimen Serum
Volume 4 mL
Pediatric Volume 2 full GOLD MICROTAINER
Container 4 mL blood in GOLD SST or RED TOP tube
Collection Routine venipuncture or line draw
Causes for Rejection
Collection in LIME GREEN PST or GREEN TOP tube, misidentified specimens and
requisitions, specimen QNS, sample type other than serum, sample not
separated from the cells, sample not stored at the appropriate temperature,
sample too old (>4 hours at room temperature, >48 hours refrigerated)
Reference Ranges <0.04 ng/mL
Critical Values ≥0.4 ng/mL

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URIC ACID

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088
EVG 425-441-2640
PEN 360-842-5116
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Plasma or Serum
Volume 0.5 mL
Pediatric Volume Pediatric capillary collection: 200µL (0.2mL)
serum collected in microtube or "bullet" tube.
Container 5 mL lime top PST, green top, red top, gold top SST or
orange top RSTNO EDTA
Collection Routine venipuncture or line draw
Causes for Rejection
Misidentified specimens and requisitions, specimen QNS.
Reference Ranges

Male Female
3.9 – 7.6 mg/dL 2.6-6.8 mg/dL

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URINE CREATININE
CREATININE CLEARANCE

Test included in:

 Urine Creatinine
 Creatinine clearance
 Urine Protein/Creatinine ratio

Lab Alliance Lab, Room G1-500

Request Form Fred Hutchinson
Cancer Center Clinical Lab Request: fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service

hours Availability STAT or routine
Specimen: Urine for Urine Creatinine
Aliquot of 4, 12 or 24-hour urine and a serum creatinine
level within 48 hours of urine collection for a Creatinine
Clearance
Volume 0.5 mL min.
Container Clean, leakproof container.
Collection No preservative needed, but if needed for other
analytes, only Thymol or Toluene should be used.
Creatinine Clearance Patient Preparation
 Hydrate the patient by administering a minimum of 600
ml water. Withhold tea, coffee, and drugs on the day of
collection.
 Have the patient void and discard that specimen. Note
the time and begin the urine collection period.
 Save all urine from this time on.
(Continued)

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Urine Creatinine, Creatinine Clearance, continued

 Collect a 4, 12, or 24-hour specimen and record exact times of

starting and completion of collection. A precisely timed specimen
is required. At the end of the collection period, the patient is to
empty their bladder and add
the urine to the collection container. Do not add any additional
urine to the container after the collection period.
 Refrigerate the sample during collection.

Causes for Rejection

Incomplete collections for timed periods.
Reference Ranges
Urine Creatinine Child 0-9 yrs. 700-1800 mg/24 hrs
Male > 9 yrs. 1000-2000 mg/24
hrs Female > 9 yrs. 700-1800 mg/24
hrs

Creatinine Clearance Newborn 40 –60 mL/min/m2

Male 75-120 mL/min
Female 65-105 mL/min

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URINE PROTEIN/URINE CREATININE RATIO

Related Terms Urine Total Protein, Urine Creatinine

Test included Urine Total Protein, Urine Creatinine, calculated ratio.
Lab Alliance Lab, Room G1-500
Request Form Fred
Hutchinson Cancer Center Clinical Lab Request; write UPCRAT in the OTHER
REQUEST section. Fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 206-606-1088

Testing Frequency Throughout service hours

Availability STAT or routine
Specimen Random urine sample
Volume 1.0 mL
Container Urine specimen cup
Causes for Rejection
Misidentified specimens and requisitions, specimen QNS.

Calculation Urine Protein value =

Ratio Urine Creatinine value

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HLA TYPING

Related Terms Histocompatibility Testing, HLA testing, Serology, PRA

testing Lab Clinical Immunogenetics Lab, 188 E. Blaine, Suite 250
Request Form Epic generated HLA Typing requisition and Epic generated
Progress Notes for Fred Hutchinson Cancer Center ambulatory clinics.
Fill out completely, including name, second identifier, sample source and
collection date and time.
Sample Label Label and request must have the sample name and a
second identifier.
Phone (206)606-7700 Lab Coordinator’s
Office FAX (206)606-1169
Availability M – F 8:30am – 5pm. Please call the Lab Coordinator’s
Office and CIL will complete progress notes with sample type and volume needed
for testing.
Specimens must arrive in CIL before 5pm or they will not be received until the
next business day (See After Hours instructions).
Turnaround Time See ‘CIL Turn Around Time Chart ‘
Specimen Peripheral Blood. CIL requests saliva and buccal samples
in some clinical cases. CIL will send a kit and instructions when a buccal or saliva
is required.
Volume/ Container Adults: 10 mL blood in red top tube and 30 mL blood in green
top tubes (sodium heparin)
Pediatrics: minimum of 2mL blood in red top and 2 mL
blood in green top (sodium heparin) depending on age
(lithium heparin and ACD are acceptable if sodium heparin is not
available)
Collection Peripheral Blood: Routine venipuncture or line draw
Saliva and Buccal samples: call CIL for collection kits and instructions.
Special Handling Room temperature, deliver to CIL immediately.
Causes for Rejection
Misidentified specimens and requisitions, unlabeled specimens,
specimen QNS, improperly stored specimen or broken
tubes, specimens received without requisitions, specimens of questionable
integrity.
After hours Draw sample and keep specimen at room
temperature. Deliver to CIL at 8am on the next business day.

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CHIMERISM TESTING

Related Terms AMP-FLP (Amplified Fragment Length Polymorphism,

Engraftment and Monitoring), STR (Short Tandem Repeat); VNTR (Variable
Number Tandem Repeat).
Lab Clinical Immunogenetics Lab, 188 E. Blaine, Suite 250, Room 2120
Request Form Label and request must have two patient or donor identifiers.

All samples must be accompanied by a paper requisition.

Collection Center Lab Request Forms

Fred Hutchinson Cancer
Center’s Ambulatory Epic generated requisition form.
Clinics and UW
Medicine
Mailed-in Specimens
Long Term Follow Up/ Multiple Lab
(LTFU, Peds LTFU, Mini-
Requisition
Transplant, etc.)
Multiple Lab Requisition (for blood
specimens)
Seattle Children’s Ambulatory Offsite
Hospital Laboratory Requisition
(for bone marrow
specimens)

Phone (206)606-1139 or (206)606-7700, FAX 606-1169

Availability M – F 8:30am – 5pm. Specimens must arrive in CIL before
5pm or they will not be received until the next business day (See After Hours
instructions).
Turnaround Time See ‘CIL Turnaround Time Chart’
Specimen Peripheral Blood, Bone Marrow or
Sorted Cell subsets, biopsy samples, hair follicles.
Volume Adults: For peripheral blood 10mL; for bone
marrow 1-2mL Pediatric: Minimum of 5mL
peripheal blood
Container Sodium Heparin (green top) – 20 units/mL of blood or bone marrow
Collection Routine venipuncture, line draw or bone marrow aspiration
Special Handling Room temperature, deliver to CIL immediately.
Causes for Rejection
Misidentified specimens and requisitions, unlabeled specimens,
Specimens without a second identifier, QNS specimens,
specimens received without requisitions, specimens of questionable integrity.
After Hours Draw sample and keep at room
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temperature. Deliver to CIL at 8am on the next business

day.

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CIL TURNAROUND TIMES

FOR HLA ADMIT WORKUPS AND CHIMERISM TESTING

HLA Typing

Specimen Rec’d Results available in EPIC or faxed to ordering

Patient/Donor Status
by 2:30 pm**: provider by EOD*:

STAT Monday-Friday Within 3 working days

Urgent Clinical Monday-Friday Within 5 working days

Non-Urgent Monday-Friday Within 10 working days

Clinical/Research
*Turnaround time starts when sample, requisition and order are received by CIL.
**After 2:30 PM, specimens will be processed the next business day.

Chimerism Testing

Results available in EPIC or faxed to the source of test request and current attending in 1-3
days of sample receipt.

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D-DIMER

Related Terms DDI

Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 4.5 mL
Pediatric volume 2.7 mL
Container Blue top 3.2 % (sodium citrate) tube
Collection If multiple tests are being drawn, draw coagulation
studies second.
If only a fibrinogen is being drawn, draw 1-2 mL into another Vacutainer®,
discard, and then collect the fibrinogen tube. This procedure avoids
contamination of the specimen with tissue thromboplastin. When it is necessary
to obtain blood from indwelling arterial or venous catheters, the heparinized fluid
infusion should be stopped, and the first 15 mL blood obtained through the
indwelling catheter should not be utilized for any coagulation studies. The
appropriate volume of blood for the needed coagulation studies should be
withdrawn from the catheter and the heparin infusion resumed after obtaining the
sample. Samples obtained from a catheter should be so indicated. It should be
understood that all coagulation specimens should be obtained without heparin
contamination. All coagulation tests are, to some extent, sensitive to heparin
contamination. Transport to the laboratory as soon as possible.
Specimen MUST be processed by Lab within 24 hrs of blood collection.
Causes for Rejection Specimen clotted, hemolyzed, contaminated with
heparin, specimen received more than 2 hours after collection, tubes
under-filled or overfilled, misidentified specimens and requisitions.
Reference Ranges 0-0.59 ug/mL FEU
Critical Values none
After Hours For preparation to send to UW: Centrifuge for 10
minutes. Remove plasma and re-spin plasma for 10 minutes. Decant and freeze.
Send frozen on dry ice.

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FIBRINOGEN

Related Terms FIBCL

Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 4.5 mL
Pediatric volume 2.7 mL
Container Blue top 3.2 % (sodium citrate) tube
Collection If multiple tests are being drawn, draw coagulation
studies second.
If only a fibrinogen is being drawn, draw 1-2 mL into another Vacutainer®,
discard, and then collect the fibrinogen tube. This procedure avoids
contamination of the specimen with tissue thromboplastin. When it is necessary
to obtain blood from indwelling arterial or venous catheters, the heparinized fluid
infusion should be stopped, and the first 15 mL blood obtained through the
indwelling catheter should not be utilized for any coagulation studies. The
appropriate volume of blood for the needed coagulation studies should be
withdrawn from the catheter and the heparin infusion resumed after obtaining the
sample. Samples obtained from a catheter should be so indicated. It should be
understood that all coagulation specimens should be obtained without heparin
contamination. All coagulation tests are, to some extent, sensitive to heparin
contamination. Transport to the laboratory as soon as possible.
Specimen MUST be processed by Lab within 24 hrs of blood collection.
(Continued)

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Fibrinogen, continued

Causes for Rejection Specimen clotted, hemolyzed, contaminated with

heparin, specimen received more than 2 hours after collection, tubes
under-filled or overfilled, misidentified specimens and requisitions.
Reference Ranges 150 – 400 mg/dL
Critical Values <100 mg/dL, possible effect, hemorrhage
After Hours Centrifuge for 10 minutes. Remove plasma and re-spin
plasma for 10 minutes. Decant and freeze. Send frozen on dry ice.

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PARTIAL THROMBOPLASTIN TIME

Related Terms Activated Partial Thromboplastin Time, aPTT, PTT.

Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 4.5 mL
Pediatric Volume 2.7 mL
Container Blue top (3.2 % sodium citrate) tube
Collection Routine venipuncture or line draw. If multiple tests are
being drawn, draw coagulation studies second. If only a partial thromboplastin
time (PTT) is being drawn, draw 1-2 mL into another Vacutainer®, discard, and
then collect the PTT. This collection procedure avoids contamination of the
specimen with tissue thromboplastins or heparin. Must be processed within 6
hrs.
Note: For Heparin monitoring, MUST DRAW 5 mL BLUE TOP
and process in 1hr.
Causes for Rejection
Specimen clotted, gross hemolysis, received more than 2 hours after collection,
tubes under- filled or overfilled, misidentified specimens and requisitions.
Reference Ranges 22 – 35 seconds
Therapeutic Range 60 –100 seconds for patient on heparin therapy.
Critical Value >120 seconds
After Hours Centrifuge for 10 minutes. Remove plasma and re-spin
plasma for 10 minutes. Decant and freeze. Send frozen on dry ice.

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PROTHROMBIN TIME

Related Terms Protime, PT, PRO, ACCINR*

Test includes Prothrombin Time and International Normalization
Ratio (INR) (*ACCINR includes INR result, only)
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes.
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 4.5 mL
Pediatric Volume 2.7 mL
Container Blue top (3.2% sodium citrate) tube
Collection Routine venipuncture or line draw. If multiple tests are
being drawn, draw coagulation studies second. If only a Prothrombin Time is
being drawn, draw 1-2 mL into another Vacutainer®, discard, and then collect
the Prothrombin Time. This collection procedure avoids contamination of the
specimen with tissue thromboplastins or heparin.
Specimen MUST be processed by Lab within 24 hrs of blood collection.
Causes for Rejection
Specimen clotted, gross hemolysis, tubes under-filled or overfilled, misidentified
specimens and requisitions.
Reference Range INR 0.8 – 1.3
PRO 10.7 – 15.6 secs
Therapeutic Range INR 2.0 – 3.5; INR is applicable only to
patients on stable coumadin therapy.
Critical Values Non-anticoagulated patient, more than 44 seconds,
possible effect is hemorrhage.
Anticoagulated patient, more than three times normal mean, possible effect is
hemorrhage. Critical Prothrombin Time is the PT that generates >5.0 INR.
After Hours Centrifuge for 10 minutes. Remove plasma and re-spin
plasma for 10 minutes. Decant and freeze. Send frozen on dry ice.

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CANCER GENOMICS (FKA CYTOGENETICS) STUDIES

– CHROMOSOME ANALYSIS AND FISH
Related Terms Molecular Cytogenetics, Chromosome
Analysis, FISH (fluorescence in situ hybridization): Karyotype
Test includes Chromosome analysis or fluorescence in situ
hybridization (FISH)
Lab Cancer Genomics Lab, Blaine, BL-103
Request Form

Epic generated order OR

Downtime Blood and Other Samples Physicians Orders OR
 Long Term Follow Up (for mail-in specimens) OR
 VA requisitions
Fill out requisition completely, including date and time of draw, requesting
clinician, and ICD codes.
Patient label and request must have two matching patient/donor identifiers.

See [Link] for additional information

on ordering HDP testing.
Phone 206-606-1390 main line
Availability M – F 8am – 5pm
After hours: on call 9am – 5pm weekends and
holidays, Pager 206-340-7207
Turnaround Time See Cancer Genomics Turnaround Time Table
Specimen Bone Marrow, Peripheral Blood, or Flow Cytometry
Sorted White Cell subsets.
Cell Sorting: Contact the lab before order placed when
possible. Volume For bone marrow 1-2mL; peripheral blood
5mL Pediatric volume For blood, infants 1-2mL.
Container Sodium heparin (green top tube)
(Continued)

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Cancer Genomic Studies – Chromosome Analysis and FISH, continued

Collection Routine venipuncture, line draw, or bone marrow aspiration.

Special Handling Room temperature; deliver promptly to Cancer
Genomics Lab. For cell sorting contact the lab.
Causes for Rejection
Misidentified specimens and requisitions, frozen or heated
marrow or blood, severely clotted specimens, any specimen possibly exposed to
contaminating DNA or RNA, leaking specimens that pose a risk to technologists,
and specimens of questionable integrity.

After Hours Store specimens at room temperature until delivery to

lab during day shift or on-call hours.

DO NOT HOLD SPECIMENS OVER THE WEEKEND - CONTACT PAGER.

Pager: 206-340-7207
(On call weekends and holidays 9am – 5pm: Pager: 206-340-7207)

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CANCER GENOMICS (FKA CYTOGENETICS STUDIES

– GENOMIC ARRAY
Related Terms CGAT, Array CGH, SNP array, DNA Microarray
Test includes Genomic Array (CGAT)
Lab Cancer Genomics Lab, Blaine, BL-103
Request Form
Epic generated order OR

 Downtime Blood and Other Samples Physicians Orders OR

 Long Term Follow Up (for mail-in specimens) OR
 VA requisitions
Fill out requisition completely, including date and time of draw, requesting
clinician, and ICD codes.
Patient label and request must have two matching patient/donor identifiers.

See [Link] for additional

information on ordering HDP testing.

Phone 206-606-1390 main line

Availability M – F 8am – 5pm
After hours:
on call 9am – 5pm weekends and holidays, Pager: 206-340-7207
Turnaround Time See Cancer Genomics Turnaround Time Table
Specimen Bone Marrow, Peripheral Blood, Tissue (fresh, frozen, or
FFPE). DNA extracted from a CLIA-certified laboratory.
Volume For bone marrow 1-2mL; peripheral blood 3-5mL, tissue
(contact lab).
Container Marrow and Blood: Put in an EDTA (purple top) tube.
Sodium heparin (green top), Sodium citrate (blue top) and Acid citrate dextrose
(yellow top) are also acceptable. After marrow is put into tubes, the tubes must
be mixed well to prevent clotting. Tissue: contact lab
Collection Routine venipuncture, line draw or bone marrow
aspiration; surgical excision for tissue
Special Handling Deliver immediately to Cancer Genomics Lab at room
temperature; cool pack is desirable if CGAT is the only test needed. If not
delivered same day, refrigerate until

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delivery possible, though sample will not be immediately rejected if

stored/delivered at room temperature.

Causes for Rejection

Misidentified specimens and requisitions, frozen or heated marrow
or blood, severely clotted specimens, any specimen possibly exposed to
contaminating DNA or RNA, leaking specimens that pose a risk to technologists,
and specimens of questionable integrity.

After Hours Store specimens refrigerated or at 2-8°C until delivery to lab

during day shift or on-call hours.

DO NOT HOLD SPECIMENS OVER THE WEEKEND - CONTACT

PAGER. Pager: 206-340-7207

(On call weekends and holidays 9am – 5pm: Pager: 206-340-7207)

Cytogenetics Studies-Genomic Array, continued

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CANCER GENOMICS (FKA CYTOGENETICS) STUDIES

– NGS TARGETED RNA SEQUENCING

Related Terms Targeted RNA Sequencing (TRS);

FusionPlex Test includes Targeted RNA Sequencing (TRS);
FusionPlex Lab Cancer Genomics Lab, Blaine, BL-103
Request Form
Epic generated order OR
Downtime Blood and Other Samples Physicians Orders OR
 Long Term Follow Up (for mail-in specimens) OR
 VA requisitions
Fill out requisition completely, including date and time of draw, requesting
clinician, and ICD codes.
Patinet label and request must have two matching patient/donor identifiers.
See [Link] for
additional information on ordering HDP testing.
Phone 206-606-1390 main line
Availability M – F 8am – 5pm
After hours:
on call 9am – 5pm weekends and holidays, Pager: 206-340-7207
Turnaround Time See Cancer Genomics Turnaround Time Table
Specimen Bone Marrow, Peripheral Blood (fresh; <48 hrs).
Methanol/acetic acid pellet cytogenetic prep also
acceptable. RNA extracted from a CLIA- certified laboratory.
Volume For bone marrow 1-2mL; peripheral blood 3-5mL, fixed pellet
(contact lab)
Container Marrow and Blood: Put in an EDTA (purple top) tube. Sodium
heparin (green top) is also acceptable. After marrow is put
into tubes, the tubes must be mixed well to prevent clotting.
Fixed pellet: contact lab
Collection Routine venipuncture, line draw or bone marrow aspiration
Special Handling Deliver immediately to Cancer Genomics Lab. Keep
refrigerated if delivery delayed. Room temperature OK if
delivered within a few hours of draw.
Causes for Rejection Misidentified specimens and requisitions, frozen or heated
marrow or blood, severely clotted specimens, any specimen
possibly exposed to contaminating DNA or RNA, leaking
specimens that pose a risk to technologist, and specimens of
questionable integrity.
After Hours Store specimens refrigerated or at 2-8°C until delivery to lab
during day shift or on-call hours.
DO NOT HOLD SPECIMENS OVER THE WEEKEND - CONTACT
PAGER. Pager: 206-340-7207

(On call weekends and holidays 9am – 5pm: Pager: 206-340-7207)

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CANCER GENOMICS (FKA CYTOGENETICS) STUDIES

– SKIN FIBROBLAST EXPANSION FOR GERMLINE
TESTING
Related Terms
Test includes Fibroblast expansion
Lab Cancer Genomics Lab, Blaine, BL-103
Request Form Epic generated order.

Fill out requisition completely, including date and time of draw, requesting clinician, and
ICD codes. Patient label and request must have two matching patient/donor identifiers.

Phone 206-606-1390 main line

Availability M – F 8am – 5pm
After hours:
on call 9am – 5pm weekends and holidays, Pager: 206-340-7207
Turnaround Time N/A; Not a direct test result; genetic counselors are informed
when skin is expanded adequately for desired testing;
typically, 6-12 weeks
Specimen Skin punch biopsy.
Volume 2-4 mm square, collected sterile
Container Place in 1-3 ml of refrigerated, unexpired transport medium
supplied by Cancer Genomics lab.
Collection Routine skin punch biopsy
Special Handling Deliver immediately to Cancer Genomics Lab; keep
at room temperature
Causes for Rejection Misidentified specimens and requisitions, frozen or heated
specimens, any specimen possibly exposed to formaldehyde,
formalin, or alcohol, leaking specimens that pose a risk to
technologist, and specimens of questionable integrity.
After Hours Store specimens at room temperature until delivery to lab
during day shift or on-call hours.

DO NOT HOLD SPECIMENS OVER THE WEEKEND - CONTACT PAGER. PAGER:

206-340-7207

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TURNAROUND TIMES
CANCER GENOMICS (FKA CYTOGENETICS)

TURNAROUND TIMES Chromosome Analysis, FISH, CGAT, TRS

Test Type Results by:***

Chromosome Analysis and 5–10 working days with day 1 as day of receipt.
FISH Pretransplant and new diagnosis samples are
prioritized for day 5 completion or sooner. Samples
requiring mitogen stimulation and or cultures longer
than 24 hours may not be completed by day 5.
Genomic Array (CGAT) 5–10 working days with day 1 as day of receipt; up to
15 days for FFPE samples.
NGS Targeted RNA 15-20 working days with day 1 as day of receipt
Sequencing (TRS)
Please indicate special circumstances on requisition form and/or call 206-606-1390.

Unusual circumstances may cause a delay in availability of results. During times of

heavy workload, samples will be prioritized according to known clinical urgency. If
results are needed sooner than the above stated time, please indicate this on
requisition form and/or call 206-606- 1390.

*** Unexpected abnormal results are reported to the attending physician or primary provider.
All reports are uploaded to Epic. Reports are also faxed to patient locations without Epic access.

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CEREBRAL SPINAL FLUID CELL COUNT

Related Terms CSF cell count

Test Includes White blood cell count, red blood cell count, white blood
cell differential (includes all nucleated cells observed on concentrated smear).
Smears also sent to UWMC Hematopathology for microscopic examination.
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Cerebral spinal fluid
Volume 1 mL
Minimum Volume 0.5 mL
Container Sterile Tube; EDTA (lavender-top tube) if bloody
Collection Lumbar puncture
Causes for Rejection
Insufficient quantity, misidentified specimens
and requisitions
Reference Ranges 0 rbc/uL
0-5 mononuclear (lymphocytes and/or monocytes) cells/uL
Differential Neutrophils 2% +/- 4%
Lymphocytes 60% +/- 20%
Monocytes 30% +/- 15%

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COMPLETE BLOOD COUNT AND DIFFERENTIAL

Related Terms CBC, Complete CBC

Panels Available CBC (Hemogram) = WBC, RBC, Hgb, HCT, MCV, MCH,
MCHC & platelets

CBANC = CBC & Absolute Neutrophil

Count CBD = CBC & differential

Panels Include
Measured Parameters: Hemoglobin (Hgb), platelets (PLT), red
blood cells (RBC), white blood cells (WBC), and hematocrit (HCT).
Calculated Parameters: Mean corpuscular volume (MCV),
mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin
concentration (MCHC), red blood cell distribution width (RDW), and mean platelet
volume (MPV).
Auto Differential: Lymphocytes, Neutrophils, Monocytes,
Eosinophils, and Basophils expressed as Absolute Number and % of total WBC.
Manual Differential: Cells in auto diff plus metamyelocytes,
myelocytes, promyelocytes, blasts, plasma cells, hairy cells, unclassified cells
(description provided) and nRBCs.

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Daily
Availability STAT or routine
Specimen Blood
Volume 2 – 3 mL
Pediatric Volume One properly filled Microtainer (EDTA) tube for pediatric
capillary collection.
(Continued)

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Complete Blood Count and Differential, continued

Storage Instructions For best results, deliver to lab within 1 hour. Accepted if
<24 hours from time of draw and sample was refrigerated or if less than 8 hours
from the time of draw and sample not refrigerated.
Container EDTA Vacutainer tube
Collection Routine venipuncture or line draw
Causes for Rejection
Clotted specimen, insufficient quantity, old specimen,
hemolysis, and misidentified specimens and requisitions
Reference Ranges Click here

Critical Values See table below

Less Greater
Critical Values than than Units
Absolute
0.5 N/A x 103 /uL
neutrophils
Hematocrit 20 None %
Platelet 20 1000 x 103 /uL

Interfering Substances
High WBC counts, sickle cells, RBC fragments, cold agglutinins,
elevated lipids, elevated chylomicrons, elevated bilirubin, nucleated red blood
cells, circulating micro-megakaryocytes, elevated serum urea nitrogen, clumped
platelets, and inappropriate anticoagulant.

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ERYTHROCYTE SEDIMENTATION RATE

Related Terms ESR, Sed Rate

Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 2mL
Container 2.4 mL lavender top Vacutainer tube
Unacceptable: any Microtainer tube
Storage Instructions Lavender top (EDTA) at room temperature within 4
hours Lavender top (EDTA) refrigerated within 12 hours
Collection Routine venipuncture or line draw
Causes for Rejection
Clotted specimen, insufficient quantity, misidentified specimens,
and requisitions
Reference Ranges
Female Male
Age Range Age Range
≤50y 0 – 20 ≤50y 0 – 15
>50y 0 – 30 >50y 0 – 20

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HEMATOCRIT

Related Terms Hct, Crit

Test included in these panels
 CBC
 CBANC
 CBD
 HBHCT

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 2 mL
Pediatric Volume One properly filled Microtainer (EDTA)
tube for pediatric capillary collection.
Container Lavender top (EDTA) tube
Collection Routine venipuncture or line draw
Causes for Rejection
Clotted specimen, insufficient quantity, old specimen, hemolysis,
misidentified specimens, and requisitions
Reference Ranges see Complete Blood Count
Critical Values see Complete Blood Count

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IMMATURE PLATELET FRACTION

Related Terms IPF, Reticulated platelet

Test Includes Immature platelet percentage, absolute immature platelet count
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 3 mL
Pediatric Volume One properly filled Microtainer (EDTA) tube for pediatric
capillary collection
Container Lavender top (EDTA) tube
Collection Routine venipuncture or line draw
Causes for Rejection
Clotted specimen, insufficient quantity, old specimen, hemolysis,
misidentified specimens, and requisitions
Reference Ranges
Immature
Platelet Units: %
Female Male
Age Range Age Range

0 mos. - 1.2 – 8.6 0 mos.- 1.2 – 8.6

Immature Units:
Platelet
thou/uL
Female Male
Age Range Age Range
0 mos. – 3.6 – 20.0 0 mos. – 3.6 – 20.0

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PLATELET COUNT

Related Terms Platelets, Thrombocyte Count

Test included in these panels

 CBC
 CBANC
 CBD

Lab Alliance Lab, Room G1-500

Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 2 mL
Pediatric Volume One properly filled Microtainer (EDTA)
tube for pediatric capillary collection.
Container Lavender top (EDTA) tube.
May also be drawn in blue top (citrate) if platelet clumps are present (Platelet values
will be corrected for the dilution factor).
Collection Routine venipuncture or line draw
Causes for Rejection
Clotted specimen, insufficient quantity, old specimen, hemolysis,
misidentified specimens, and requisitions
Reference Ranges see Complete Blood Count
Critical Values see Complete Blood Count

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RETICULOCYTE COUNT

Related Terms Retic Count

Test Includes An Absolute Reticulocyte count and
Reticulocytes expressed as a percentage in a total of 1000 RBCs
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours
Availability STAT or routine
Specimen Blood
Volume 2mL
Pediatric Volume One properly filled Microtainer (EDTA)
tube for pediatric capillary collection
Container Lavender top (EDTA) tube
Collection Routine venipuncture or line draw
Causes for Rejection
Clotted specimen, insufficient quantity, old specimen, hemolysis,
misidentified specimens, and requisitions
Reference Ranges
Retic Units: %
Female Male
Age Range Age Range

6 mos.- 0.5 – 2.5 6 mos.- 0.5 – 2.5

Retic Absolute Units: bil / L

Female Male
Age Range Age Range
15y – 25 – 125 15y – 25 – 125

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COVID/FLU/RSV RESPIRATORY PANEL, RAPID PCR

Related Terms COVID-19, Influenza, RSV, Rapid PCR

Test Includes Qualitative PCR by Cepheid GeneXpert Plus for SARS-
CoV-2, FLU A & B, and RSV
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours (M-F 6a-9p, S/S/Holidays 7:30a-
4:30p, remaining orders will be canceled and reordered for transport to and
testing by UW Virology) Availability In order of receipt only
Specimen Nasopharyngeal or Nasal Swab in 3mL approved viral
transport media
Volume 3mL
Pediatric Volume n/a
Container Swab in viral transport media
Collection Nasopharyngeal swab: Insert the swab into either nostril, passing
it into the posterior nasopharynx. Rotate swab by firmly brushing
against the nasopharynx several times. Remove and place the
swab into the tube containing 3 mL of viral transport medium or
saline. Break swab at the indicated break line and cap the
specimen collection tube tightly.

Nasal swab: Insert a nasal swab 1 to 1.5 cm into a nostril. Rotate

the swab against the inside of the nostril for 3 seconds while
applying pressure with a finger to the outside of the nostril. Repeat
on the other nostril with the same swab, using external pressure on
the outside of the other nostril. To avoid specimen contamination,
do not touch the swab tip to anything other than the inside of the
nostril. Remove and place the swab into the tube containing 3 mL
of viral transport medium or saline. Break swab at the indicated
break line and cap the specimen collection tube tightly.
Causes for Rejection
Swab collected from other body sites (throat, etc.)
Transport media other than viral transport media
or saline Specimens with less than 3 mL viral
transport media/saline
Reference Ranges Negative

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SARS-COV-2 (COVID-19) QUALITATIVE RAPID PCR

Related Terms COVID-19, 2019-nCoV, COVID, COVID19, nCoV, PUI nCoV, SARS,
SARS-CoV-2, Wuhan Coronavirus
Test Includes Qualitative PCR by Cepheid GeneXpert Plus for SARS-CoV-2
Lab Alliance Lab, Room G1-500
Satellite Labs, South Lake
Union Community Site Labs
Request Form Fred Hutchinson Cancer Center Clinical Lab Request:
fill out completely, including ICD codes
CPOE orders will be interfaced to Sunquest upon order activation
in Epic.
*NOTE – This test is only available with pre-approval by Fred
Hutchinson Cancer Center Infection Prevention.
Phone SLU 606-1088
EVG 425-441-2640
Testing Frequency Throughout service hours (M-F 6a-9p, S/S/Holidays 7:30a-
4:30p, remaining orders will be canceled and reordered for transport to and
testing by UW Virology) Availability In order of receipt only
Specimen Nasopharyngeal or Nasal Swab in 3mL approved viral
transport media
Volume 3mL
Pediatric Volume n/a
Container Swab in viral transport media
Collection Nasopharyngeal swab: Insert the swab into either nostril,
passing it into the posterior nasopharynx. Rotate swab by
firmly brushing against the nasopharynx several times.
Remove and place the swab into the tube containing 3 mL
of viral transport medium or saline.
Break swab at the indicated break line and cap the
specimen collection tube tightly.

Nasal swab: Insert a nasal swab 1 to 1.5 cm into a nostril.

Rotate the swab against the inside of the nostril for 3
seconds while applying pressure with a finger to the outside
of the nostril. Repeat on the other nostril with the same
swab, using external pressure on the outside of the other
nostril. To avoid specimen contamination, do not touch the
swab tip to anything other than the inside of the nostril.
Remove and place the swab into the tube containing 3 mL
of viral transport medium or saline. Break swab at the
Causes for Rejection indicated break line and cap the specimen collection tube
tightly.

Swab collected from other body sites (throat, etc.)

Transport media other than viral transport media
or saline Specimens with less than 3 mL viral
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transport media/saline
Reference Ranges Negative

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BONE MARROW ASPIRATE / BIOPSY

Related Terms Bone marrow, iliac crest, bone marrow core

Test Includes Gross and microscopic examination with
diagnosis, other laboratory tests as ordered
Lab Alliance Lab staff assists with Bone Marrow
procedures and distributes specimens to other laboratories including
Hematology, Pathology, UW Hematopathology, Microbiology and Virology.
Request Form Fred Hutchinson Cancer Center Requisition(s) specific
for above laboratories
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone SLU 606-1088
Availability M – F 8am – 4:30pm
Turnaround Time If the specimen is placed in fixative by 1pm and delivered to
Pathology by 3pm the same day, results are provided the second business day.
If time frames are not met, results are provided the third business day. Holidays
may extend result times. Refer to other entries, for turnaround times of other
testing.
Pathology hours are:
Monday 9am – 6:30pm,
Tuesday-Friday 6:00am –
6:30pm Saturday 6am –
2:30pm
Sundays and after hours if STAT processing is required,
contact the on-call Fred Hutchinson Cancer Center Pathology Technologist at
573-0892.
Specimen Approximately 2 cc of bone marrow aspirate collected in
syringe with no additive to be placed in a 6mL lavender EDTA tube. Invert tube 8-
10 times to coat the walls of the tube to ensure adequate mixing of additive with
aspirate. Pour the aspirate into a petri dish or watch glass to make 12 aspirate
coverslips. After cover slips are made, place 1cc of aspirate back into the 6mL
lavender top tube for Flow Cytometry, the rest of the sample to be sent to
Pathology as requested. Place 3cc bone marrow aspirate collected in syringe with
no additive into a 4mL lavender top tube for Molecular. Place 3cc bone marrow
aspirate collected in Preservative-free Heparin syringe for Cytogenetics in a 4 mL
green top tube.

(Continued)

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Bone Marrow Aspirate/Biopsy continued

If cultures for bacteria, fungus and/or AFB are requested, 1-3cc of bone marrow
aspirate is placed into a SPS or AFB tube.

For viral cultures, 1-3cc of bone marrow aspirate is placed into an EDTA tube.
Bone Marrow aspirate (1-2cc) for CMV PCR is placed into an EDTA tube.

If a bone marrow biopsy is obtained, make 3-4 touch preps, and then place the
bone marrow core removed for biopsy diagnostic interpretation into 10%
buffered formalin.
If there is a special request or special handling is needed,
contact the Bone Marrow Lead at 606-1088 or page 206-540-3431.
Container Well-constructed container with 10% buffered formalin with secure
lid and sealed plastic bag for the bone biopsy.
Collection Bone marrow aspirate and bone marrow core biopsy
Causes for Rejection
Improper handling, misidentified specimens, and requisitions
After Hours To arrange for a bone marrow tech to assist after
available hours M – F (8am – 4:30pm) call the Specimen Processing staff at 606-
1088.
For all testing done at UW, contact UW
Hematopathology Lab at 598-6231 to arrange specimen processing.

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BRONCHOALVEOLAR LAVAGE

Related Terms BAL, Bronchial Aspirate, Bronchial Wash

Test Includes Detection of abnormal cells, malignant cells, infectious
agents Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form.
Complete a Lab Medicine Microbiology and/or Virology Request if ordered. Fill
out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am – 2:30pm

Sundays and all other times; if STAT processing is

required, contact the on-call Pathology Technologist at
573-0892.
Turnaround Time Preliminary results are available within 3.5 hours of specimen
receipt at Fred Hutchinson Cancer Center Pathology; final report is provided the
next business day.
Specimen Bronchial wash fluid or bronchoalveolar lavage fluid
Specimen Collection:
Bronchial Washings Pass the bronchoscope transnasally or transorally in
nonintubated patients or via the endotracheal tube in intubated patients. Wedge
the tip of the bronchoscope in a segmental bronchus. Inject sterile
nonbacteriostatic saline (generally 5- to 20-ml aliquots) from a syringe through a
biopsy channel of the bronchoscope. Gently suction the saline into a sterile
container before administering the next aliquot. Keep aliquots separate during
collection. Send to laboratory immediately. Refrigerate if delay is unavoidable.

(Continued)

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Bronchoalveolar Lavage, continued

Bronchial Brushing Pass the bronchoscope transnasally or transorally in

nonintubated patients or via the endotracheal tube in intubated patients. Insert
a telescoping double catheter plugged with polyethylene glycol at the distal end
(to prevent contamination of the bronchial brush) through the biopsy channel of
the bronchoscope. Once the brushing is obtained, cut off the brush end and
send it to the laboratory in physiological saline. Send to laboratory
immediately. Refrigerate if delay is unavoidable.
Volume Minimum volume is 5 mL
Container Well-constructed, sterile container with secure lid and sealed plastic
bag
Specimen Handling

Collection from a Patient at Fred Hutchinson Cancer Center Ambulatory Clinic

🞂 Notify Fred Hutchinson Cancer Center Pathology in advance of procedure by

calling 606- 1355.
Outside normal business hours contact the on-call Pathology
Technologist at 573-0892.
🞂 Pathology specimens should be sent immediately, unfixed, and at ambient
temperature to the Fred Hutchinson Cancer Center Pathology Laboratory.
🞂 Pulmonary physicians will divide the specimen for Microbiology and Virology
culture.
🞂 Specimens for culture should be delivered to the Alliance Laboratory for
transport to the Microbiology and Virology Labs.
🞂 Specimen delivered by courier to Fred Hutchinson Cancer Center Pathology
(G7-910)
🞂 Fred Hutchinson Cancer Center Histology Tech accessions the specimen in the
computer immediately. If there is a need to evaluate the specimen for
malignancy it will be sent to Harborview Medical Center Cytology.

Collection from a Patient at UWMC for infection

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 Call the Fred Hutchinson Cancer Saturdays follow the procedure below
Center Pathology Department IN except between 6:00am to 2pm - during
ADVANCE at 606-1355. Call the in- these hours notify the Saturday Tech
house courier at 598- 8603 for a in the Fred Hutchinson Cancer Center
STAT pick-up. Pathology Department at 606-1355.

Bronchoalveolar Lavage, continued

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🞂 BAL specimens are routed to 🞂 In ADVANCE contact the

Microbiology for dividing and Fred Hutchinson Cancer Center
distributed to Pathology and Pathology Tech at 573-0892
Virology Labs.
🞂 BAL specimens are routed to
Microbiology for dividing and
distributed to Pathology and
Virology Labs.

🞂 Transport all Pathology 🞂 Specimen delivered by courier to

specimens in shipping Fred Hutchinson Cancer Center
containers at ambient Pathology (G7- 910)
temperature.
🞂 Send to Fred Hutchinson Cancer
Center Pathology Lab, Room G7-
910.
🞂 Call Fred Hutchinson Cancer
Center Pathology Tech and tell them
the specimen is being shipped.

Collection on a Patient at UWMC for malignancy

 Specimen delivered by UWMC courier or Pulmonary staff to UWMC

Pathology (EC 239)
 UWMC Histology Tech accessions the specimen in the computer and sends the
specimen to Harborview Medical Center for processing.

Causes for Rejection

Delayed delivery of fresh specimens, misidentified specimens
and requisitions, insufficient pertinent clinical history.

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ENDOSCOPY

Test includes Gross and microscopic exam with diagnosis

Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Complete a Lab Medicine Microbiology and/or Virology Request if ordered. Fill out
completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am – 6:30pm
Tuesday-Friday 6:00am –
6:30pm Saturday 6:00am –
2:30pm
Sundays and all other times, if STAT processing is
required, contact the on-call Pathology Technologist at 573-0982.
Turnaround Time If specimen is placed in fixative by 1pm and delivered to
Fred Hutchinson Cancer Center Pathology by 3pm, results will be provided the
second business day.
If the time frame is not met, results are provided on the third business day.
Holidays may extend result times.
Container Well-constructed container with 10% buffered formalin
fixative with secure lid and sealed plastic bag.
Specimen Handling

Collection on a Patient at Fred Hutchinson Cancer Center Ambulatory Clinic

🞂 Place biopsies for morphology in 10% Buffered formalin, noting on the bottle
the date and time of placement in the fixative.
🞂 Deliver to Fred Hutchinson Cancer Center Pathology.
🞂 Biopsies for culture should be placed in transport media and taken to the
Alliance Laboratory for transport to the Microbiology and Virology Labs.

(Continued)

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Endoscopy, continued

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 Tissue for culture should be sent Saturdays follow the procedure below
directly from the procedure room except between 6am to 2pm
to UWMC Microbiology and/or During these hours notify the
Virology. Saturday Tech in the Fred Hutchinson
Cancer Center Pathology Department
🞂 Place Pathology specimens in 10% at
buffered formalin fixative. 606-1355
🞂 Package specimen for transport. 🞂 In ADVANCE contact the Fred
Transport all Pathology specimens in Hutchinson Cancer Center Pathology
shipping containers at ambient Tech at 573-0892
temperature.
🞂 Tissue for culture should be sent
🞂 Send to Fred Hutchinson Cancer directly from the procedure room
Center Pathology Lab, Room to UWMC Microbiology and/or
G7-910. Virology.
🞂 Use a courier to transport the 🞂 Specimens are sent by the floor via
package to the commodities box Delivery Express to the Pathology
Department at the Fred Hutchinson
Cancer Center, Room G7- 910

After hours: do not send the specimen

to UWMC Pathology Department.

Collection of Fred Hutchinson Cancer Center GenOnc/Heme or UWMC Patients at

UWMC
 Specimen in 10% buffered formalin fixative delivered by UWMC courier or
Pulmonary staff to UWMC Pathology (EC 239).

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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FINE NEEDLE ASPIRATIONS

Related Terms FNAs

Test Includes Gross and microscopic exam with diagnosis
Lab Harborview Cytology
Request Form University of Washington Medical Centers/Harborview
Medical Center Cytology Request. Fill out completely, including ICD codes.
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone Harborview Cytology 744-4279
Availability Monday – Friday 8am – 5pm
Specimen Collection
Fine Needle Aspirate (FNA)
For deep aspirates, sterile technique is required for cleansing of the skin and
local anesthetic is usually required. A quick motion should be used in passing
the needle through the skin.
The needle is then advanced through the subcutaneous tissue into the mass. With
the needle in the mass, the needle tip should be moved in short motions initially
to loosen cells within the mass. Negative pressure is then applied by pulling back
on the plunger of the syringe. If blood or material appears in the hub of the
needle, the aspiration should be stopped. Prior to withdrawing the needle,
negative pressure must be released to prevent suction of the material into the
barrel of the syringe when the needle exits the skin. The fluid may be used to
prepare smears. These slides should be immediately fixed in 95% ethanol.
The fluid may also be deposited into the vial of CytoLyt solution.

(Continued)

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Fine Needle Aspirations, continued

Specimen Handling

Collection at Fred Hutchinson Cancer Center Ambulatory Clinic

🞂 Deliver the specimen to Fred Hutchinson Cancer Center Pathology.
🞂 Fred Hutchinson Cancer Center Pathology Tech will place the specimen on a
packing list. It will be sent via courier to Harborview Cytology.

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri.

Business Hours Weekends & Holidays
🞂 Immediately deliver Pathology 🞂 In ADVANCE page UWMC
specimens to UWMC Pathology on-call Histology Tech (663-
8098)
🞂 All FNAs will be sent to
Harborview Cytology for 🞂 Immediately deliver Pathology
processing. specimens to UWMC Pathology
🞂 All FNAs will be sent by UWMC
Pathology to Harborview Cytology

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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LIP OR SKIN BIOPSY

Test Includes Gross and microscopic exam with diagnosis

Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Complete a Lab Medicine Microbiology and/or
Virology Request if ordered
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am – 2:30pm

Sundays and all other times, if STAT processing is required, contact the on-call
Pathology Technologist at 573-0892
Turnaround Time If specimen is placed in fixative by 1pm and delivered to
Fred Hutchinson Cancer Center Pathology by 3pm, results will be provided the
second business day.
If the time frame is not met, results are provided on the third business day.
Holidays may extend result times.
Container Container with 10% buffered formalin
Specimen Handling

Collection at Fred Hutchinson Cancer Center Ambulatory Clinic

🞂 If Microbiology and/or Virology culture or fibroblast expansion for genetic testing
is requested, place fresh specimen in appropriate transport media: do NOT use
formalin.
🞂 Specimens for culture should be delivered to the Alliance Laboratory for
transport to the appropriate lab (Microbiology, Virology Labs or Cytogenetics
Lab). See Cancer Genomics Skin Fibroblast Expansion.
🞂 Pathology specimens should be placed immediately to 10% buffered formalin
at ambient temperature and sent to the Fred Hutchinson Cancer Center
Pathology laboratory.
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Lip or Skin Biopsy, continued

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 If fungal or bacterial infection is Saturdays follow the procedure below
suspected, fresh tissue for culture except between 6am to 2pm
should be sent directly from the
procedure room to UWMC During these hours notify the
Microbiology and/or Virology. Saturday Tech in the Fred Hutchinson
Cancer Center Pathology Department
🞂 Place specimens in 10% buffered at
formalin and deliver to UWMC 606-1355
Pathology (EC 239) for routing to
Fred Hutchinson Cancer Center 🞂 In ADVANCE contact the Fred
Pathology Lab Hutchinson Cancer Center Pathology
Tech at 573-0892
🞂 Package specimen for transport.
Transport all Pathology specimens 🞂 Place tissue in 10% buffered
in shipping containers at ambient formalin and deliver from the floor via
temperature. Delivery Express to the Pathology
Department at the Fred Hutchinson
🞂 Send to Fred Hutchinson Cancer Cancer Center,
Center Pathology Lab, Room Room G7-910.
G7-910.
🞂 Call Fred Hutchinson Cancer
Center Pathology Tech and tell them
the specimen is being shipped.
🞂 Business hours: Use a courier to
transport the package to the After hours: do not send the specimen
commodities box. to UWMC Pathology Department.

Collection of Fred Hutchinson Cancer Center GenOnc/Heme or UWMC Patients at

UWMC
 Specimen in 10% formalin delivered to UWMC Pathology (EC 239)

 UWMC Histology Tech accessions the specimen in the computer for processing
at UWMC Anatomic Pathology.

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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LIVER BIOPSY

Test Includes Gross and microscopic exam with diagnosis

Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Complete a Lab Medicine Microbiology
Request and/or Virology Request if ordered
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday- Friday 6:00am – 6:30pm
Saturday 6:00am to 2:30pm

Sundays and all other times, if STAT processing is required, contact the on-call
Pathology Technologist at 573-0892.

Turnaround Time For specimens received in Fred Hutchinson Cancer Center

Pathology by 3pm, results will be provided the second business day. If the time
frame is not met, results are provided on the third business day. Holidays may
extend result times.
Container Submit specimens for culture in a sterile container
with secure [Link] for morphology are placed in 10% buffered formalin.

(Continued)

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Liver Biopsy, continued

Specimen Handling

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 IN ADVANCE call the Fred Saturdays follow the procedure below
Hutchinson Cancer Center except between 7:30am to 6pm
Pathology Department at 606-1355.
Call the in-house courier at 598- 8603 During these hours notify the
for a STAT pick-up. Saturday Tech in the Fred Hutchinson
Cancer Center Pathology Department
at
606-1355
🞂 Place specimens in 10% buffered 🞂 In ADVANCE contact the Fred
formalin fixative and deliver to UWMC Hutchinson Cancer Center
Pathology (EC 239) immediately for Pathology Tech at 573-0892
routing to Fred Hutchinson Cancer
Center Pathology Lab. 🞂 Place pathology specimens in 10%
buffered formalin fixative.
🞂 If fulminant viral hepatitis or an
infectious abscess is suspected, 🞂 Specimens are sent from the floor
tissue for culture should be sent via Delivery Express to the
directly from the procedure room to Pathology Department at the Fred
UWMC Microbiology and/or Hutchinson Cancer Center, Room
Virology. G7-910.

🞂 Package specimen for transport.

Transport all Pathology specimens
After hours: do not send the specimen
in shipping containers at ambient
to UWMC Pathology Department.
temperature.
🞂 Send to Fred Hutchinson Cancer
Center Pathology Lab, Room
G7-910.
🞂 Call Fred Hutchinson Cancer
Center Pathology Tech and tell them
the specimen is being shipped.
🞂 Have a courier transport the
package to the commodities box.

(Continued)

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Liver Biopsy, continued

Collection of Fred Hutchinson Cancer Center GenOnc/Heme or UWMC Patients at

UWMC
 Specimen prepared as requested by surgeon.
 If the procedure is done in the Operating Room, place the specimen in the
Operating Room Pathology refrigerator. It will be picked up by UWMC
Pathology Tech.
 If done in Interventional Radiology, specimen delivered by Intervention
Radiology staff to UWMC Pathology (EC 239)
 UWMC Histology Tech accessions the specimen in the computer immediately
and sets up for processing at UWMC Anatomic Pathology.

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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LUNG BIOPSY

Test Includes Gross and microscopic exam with diagnosis

Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am to 2:30pm
Sundays and all other times, if STAT processing is required,
contact the on call Pathology Technologist at 573-0982.
Turnaround Time If specimen is delivered to Fred Hutchinson Cancer Center
Pathology by 3pm, results will be provided the second business day. If the time
frame is not met, results are provided the third business day. Holidays may
extend result times.
Final results are provided the following business day. Routine and special stains
for malignancies and microorganisms will be performed on frozen sections and
touch preps.
If intra-operative frozen sections are required for any reason, the entire specimen will
be retained by the institution of origin for culture and diagnosis.
Container Well-constructed sterile container with secure lid and sealed plastic bag
Specimen Handling

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 IN ADVANCE call the Fred Saturdays follow the procedure below
Hutchinson Cancer Center except between 6 am to 2pm
Pathology Department at 606-1355.
Call the in-house courier at 598- 8603 During these hours notify the
for a STAT pick-up. Saturday Tech in the Fred Hutchinson
Cancer Center Pathology Department
at 606-1355.

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Lung Biopsy, continued

🞂 The entire unfixed and undissected 🞂 In ADVANCE contact the Fred

biopsy is placed in a sterile container Hutchinson Cancer Center Pathology
and brought immediately to the Tech at 573-0892
UWMC Pathology lab (EC 239NW) for
routing to Fred Hutchinson Cancer
🞂 The entire unfixed and undissected
Center Pathology Lab.
biopsy is placed in a sterile container
🞂 Appropriate instructions for and sent by the floor via Delivery
specimens to be submitted for Express to the Pathology Department
culture must accompany the at the Fred Hutchinson Cancer
specimen. Center, Room G7-910.
🞂 Package specimen for transport. 🞂 Appropriate instructions for
Transport all Pathology specimens specimens to be submitted for
in shipping containers at ambient culture must accompany the
temperature. specimen.
🞂 Send to Fred Hutchinson Cancer 🞂 Specimens for culture will be divided
Center Pathology Lab, Room and distributed by the Fred
G7-910. Hutchinson Cancer Center Pathology
Lab. The Fred Hutchinson Cancer
🞂 Call Fred Hutchinson Cancer Center Tech will be responsible for
Center Pathology Tech and tell them filling out the correct Lab Requisitions
the specimen is being shipped. to be sent with the specimens to be
submitted for culture.

🞂 Have a courier transport the

package to the commodities box.
After hours: do not send the specimen
🞂 Specimens for culture will be divided to UWMC Pathology Department.
and distributed by the Fred
Hutchinson Cancer Center Pathology
Lab. The Fred Hutchinson Cancer
Center Tech will be responsible for
completing the correct Lab
Requisitions to be sent with the
specimens to be submitted for culture.

Collection of Fred Hutchinson Cancer Center GenOnc/Heme or UWMC Patients at

UWMC
 Place the specimen in the Operating Room Pathology refrigerator. It will be
picked up by UWMC Pathology Tech.
 UWMC Histology Tech accessions the specimen in the computer for processing
at UWMC Anatomic Pathology.

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Causes for Rejection Improper handling, misidentified specimens, and requisitions

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LYMPH NODE BIOPSY

Test Includes Gross and microscopic exam with diagnosis

Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am – 2:30pm

Sundays and all other times, if STAT processing is required, contact the on-call
Pathology Technologist at 573-0892.
Turnaround Time Specimens received in Fred Hutchinson Cancer Center
Pathology by 3pm will have results provided the second business day. If time
frame is not met results are provided on the third business day. Holidays may
extend result times.
Container Well-constructed, sterile container with secure lid
and sealed plastic bag
Specimen Handling In advance of procedure, notify Fred Hutchinson Cancer
Center Pathology

7am to 4:30pm Mon – Fri

Business Hours
🞂 IN ADVANCE call the Fred Hutchinson Cancer Center Pathology Department at
606-1355.
Call the in-house courier
at 598-8603 for a STAT pick-up.

(Continued)

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Lymph Node Biopsy, continued

🞂 Place entire biopsy in a sterile container and keep moist with a sterile gauze
pad soaked with sterile, non-bacteriostatic saline. Transport specimen container
immediately to UWMC Pathology (EC 239NW) for routing to Fred Hutchinson
Cancer Center Pathology.
🞂 Specimens for lymphoma or LN Adenopathy will have touch preps made and
portions of the tissue placed in RPMI for flow cytometry by UWMC Pathology.
🞂 Transport all Pathology specimens in shipping containers at ambient
temperature.
🞂 Send to Fred Hutchinson Cancer Center Pathology Lab, Room G7-910.
🞂 Call Fred Hutchinson Cancer Center Pathology Tech and tell them the
specimen is being shipped.
🞂 Have a courier transport the package to the commodities box.

Collection at Fred Hutchinson Cancer Center Ambulatory Clinic

🞂 If Microbiology and/or Virology culture is requested, place fresh specimen in

appropriate transport media and deliver to the Alliance Laboratory.
🞂 Specimens for flow cytometry should be placed in RPMI and
sent to UWMC Hematopathology.
🞂 Pathology specimens should be placed immediately in 10% buffered formalin
at ambient temperature and sent to the Fred Hutchinson Cancer Center
Pathology Laboratory.

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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THINPREP® PAP TEST COLLECTION

Test includes Microscopic exam with diagnosis

Lab HMC Cytology
Request Form Cytology Request Form
Fill out completely, including ICD codes For Fred
Hutchinson Cancer Center Ambulatory Clinic, a CPOE requisition will
be generated for those lab tests requiring a requisition form
Phone 744-2166
Availability Monday – Friday 8am – 5pm
Turnaround Time If specimen is delivered to Fred Hutchinson Cancer Center
Pathology by 10am, it is sent to
HMC Cytology the same day. If it is not received by 10am, it is sent to HMC Cytology
the next business day. Samples are screened the next business day after receipt.
Container Vial containing PreservCyt® Solution.
Specimen Collection
Label a PreservCyt® vial with patient’s name and medical record number.

With patient in lithotomy position, expose cervix using a vaginal speculum

moistened with warm water. Visually examine vaginal mucosa and cervix for
lesions, ulceration, or discharge. Document findings of the examination on
patient’s record and note the relevant clinical findings on the requisition for
optimum cytological interpretation.

To collect a specimen from the ectocervix, select contoured end of plastic spatula
and rotate it 360º around the entire ectocervical surface. Remove spatula.

Rinse the contoured end of plastic spatula in a vial of PreservCyt® Solution by

swirling vigorously ten (10) times. Discard plastic spatula. Place cap on vial.

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Thinprep PAP Test, continued

Insert Cytobrush® Plus GT device into the endocervix until only the bottom-most
bristles are exposed. Slowly rotate ¼ to ½ turn in one direction. Remove device.
Do not over-rotate.
Additional rotating may cause bleeding and contaminate the specimen.

Rinse the Cytobrush® Plus GT device in the vial of PreservCyt® Solution by

rotating the device in the solution ten (10) times while pushing it against the wall
of the vial. Swirl the device vigorously to further release the material. Discard
device.

Tighten the PreservCyt® vial cap so that the torque line on the cap passes the
torque line on the vial.

Specimen Handling

Collection at Fred Hutchinson Cancer Center Ambulatory Clinic

 Deliver the specimen to Fred Hutchinson Cancer Center Pathology by 10am for
delivery to HMC Cytology the same day

 Fred Hutchinson Cancer Center pathology Laboratory will package and transport to
HMC Cytology department.

Collection at UWMC

 Deliver the specimen to UWMC Anatomic Pathology

 UWMC Anatomic Pathology will accession and transport to HMC Cytology department.

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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SINUS BIOPSY OR ASPIRATE

Test Includes Gross and microscopic exam with diagnosis.

Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am – 2:30pm

Sundays and all other times, if STAT processing is required, contact the on-call
Pathology Technologist at 573-0892.
Turnaround Time If specimen is delivered to Fred Hutchinson Cancer Center
Pathology by 3pm, results will be provided the second business day. If the time
frame is not met, results are provided the third business day. Holidays may
extend result times.
Specimen Sinus biopsy or sinus aspirate removed for
diagnostic interpretation
Container Well-constructed sterile container with secure lid
and sealed plastic bag
Specimen Handling

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 IN ADVANCE call the Fred Saturdays follow the procedure below
Hutchinson Cancer Center except between 6am to 2 pm
Pathology Department at 606-1355.
During these hours notify the
Call the in-house courier at 598-
Saturday Tech in the Fred Hutchinson
8603 for a STAT pick-up.
Cancer Center Pathology Department
at 606-1355.

(Continued)

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Sinus Biopsy, continued

🞂 Place entire biopsy in a sterile 🞂 In ADVANCE contact the Fred

container and keep moist with a Hutchinson Cancer Center Pathology
sterile gauze pad soaked with Tech at 573-0892
sterile, non-bacteriostatic saline.
🞂 Place entire aspirate in a sterile 🞂 Place entire biopsy in a sterile
container. container and keep moist with a
🞂 Specimen will be divided in Fred sterile gauze pad soaked with
Hutchinson Cancer Center Pathology sterile, non-bacteriostatic saline.
and distributed to appropriate labs. 🞂 Place entire aspirate in a sterile
The Fred Hutchinson Cancer Center container.
Tech will be responsible for completing
the correct Lab Requisitions sent with
the specimens to be submitted for
culture.
After hours: do not send the specimen
🞂 Deliver Pathology specimens to
to UWMC Pathology Department.
UWMC Pathology (EC 239) for routing
of specimens to Fred Hutchinson
Cancer Center Pathology Lab.
🞂 Package specimen for transport.
🞂 Transport all Pathology specimens
in shipping containers at ambient
temperature.
🞂 Send to Fred Hutchinson Cancer
Center Pathology Lab,
Room G7-910.
🞂 Call Fred Hutchinson Cancer
Center Pathology Tech and tell them
the specimen is being sent.
🞂 Use a courier to transport the
package to the commodities box.

Collection of Fred Hutchinson Cancer Center GenOnc/Heme or UWMC Patients at

UWMC
Operating Room delivers specimen to Operating Room Pathology refrigerator.
 UWMC Histology Tech accessions the specimen in the computer immediately and
sets up for processing at UWMC Anatomic Pathology.

Causes for Rejection

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Delayed delivery of fresh specimens, misidentified specimens

and requisitions, insufficient pertinent clinical history

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SURGICAL SPECIMENS

Surgical Specimens Specimens not specifically described in the Specimen

Handling Procedure Manual, e.g., spleen, kidney, thoracentesis, laparoscopy.
Test Includes Gross and microscopic exam with diagnosis
Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am – 2:30pm

Sundays and all other times if STAT processing is required, contact the on-call
Pathology Technologist at 573-0892.

Turnaround Time For specimens received in Fred Hutchinson Cancer Center

Pathology by 3pm, results will be provided the second business day. If the time
frame is not met, results are provided on the third business day. Holidays may
extend result times.
If intra-operative frozen sections are required for any
reason, the entire specimen will be retained by the institution of origin for culture
and diagnosis.
Container See below.
Specimen Handling The type of container, transport temperature, appropriate
transport media, fixative, or other handling details should be determined prior to
specimen collection by consulting the appropriate Pathology Laboratory, the on-
call Path Tech, or Pathologist.

(Continued)

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Surgical Specimens, continued

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Weekends & Holidays
🞂 IN ADVANCE call the Fred Saturdays follow the procedure below
Hutchinson Cancer Center except between 6am to 2pm
Pathology Department at 606-1355
During these hours notify the
Call the in-house courier at 598-
Saturday Tech in the Fred Hutchinson
8603 for a STAT pick-up.
Cancer Center Pathology Department
🞂 Deliver Specimens to UWMC at
Pathology (EC 239NW) for routing of 606-1355
specimens to Fred Hutchinson
Cancer Center Pathology.
🞂 In ADVANCE contact the Fred
🞂 Fred Hutchinson Cancer Center
Hutchinson Cancer Center
Pathology will divide and route
Pathology Tech at 573-0892
specimens to appropriate labs per
protocol.
🞂 The Fred Hutchinson Cancer 🞂 Fred Hutchinson Cancer Center
Center Tech will be responsible for Pathology will divide and route
completing the appropriate Lab specimens to appropriate labs per
Requisitions sent with the protocol.
specimens to be submitted for 🞂 The Fred Hutchinson Cancer
culture. Center Tech will be responsible for
🞂 Transport all Pathology specimens completing the appropriate Lab
in shipping containers at ambient Requisitions sent with the
temperature. specimens to be submitted for
culture.
🞂 Send to Fred Hutchinson Cancer
Center Pathology Lab, Room 🞂 Specimens are sent by the floor via
G7-910. cab to the Pathology Department
at the Fred Hutchinson Cancer
🞂 Call Fred Hutchinson Cancer Center, Room G7-910.
Center Pathology Tech and tell them
the specimen is being shipped. .
🞂 Have a courier transport the After hours: do not send the specimen
package to the commodities box. to UWMC Pathology Department.

Collection of Fred Hutchinson Cancer Center GenOnc/Heme or UWMC Patients at

UWMC

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 Place the specimen in the Operating Room Pathology refrigerator. It will be

picked up by UWMC Pathology Tech.
 UWMC Histology Tech accessions the specimen in the computer for processing
at UWMC Anatomic Pathology.

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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OTHER FLUID SPECIMENS

Other Fluids Specimens not specifically described in the Specimen

Handling Procedure Manual, e.g., CSF, Urine.
Test Includes Gross and microscopic exam with diagnosis
Lab Specimens processed by Harborview Cytology
Request Form University of Washington Medical Centers/Harborview
Medical Center Cytology Request. Fill out completely, including ICD codes.
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone Harborview Cytology 744-2166
Availability Monday – Friday 8am – 5pm
Specimen Collection
All specimen containers must be labeled with patient name and medical record
number or birthdate. They must be accompanied by a completed requisition.

Please note that the following collection procedures are a suggested guideline.
Techniques vary based on personal preference, and specific clinical
circumstances must be taken into account when deciding on the collection
method utilized.

Cerebrospinal Fluid (CSF)

A lumbar puncture is performed with the patient either lying down with knees
bent or sitting. After the back is cleaned, an anesthetic is injected into the lower
spine. Once the spinal needle is inserted, spinal fluid pressure is measured, and
fluid collected. The fresh fluid is highly perishable. Minimum volume needed is 1
ml. Send to laboratory immediately.
Refrigerate if delay is unavoidable.
Sputum Have the patient cough deeply to expectorate sputum
directly into the sterile container. Do not contaminate the rim of the container
with sputum. Do NOT include any saliva or postnasal discharge. Three
consecutive early morning specimens increase the yield of cells. Send to
laboratory immediately. Refrigerate if delay is unavoidable.

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Other Fluid Specimens, continued

Body Cavity Fluids Clean and disinfect the needle puncture site to prevent
introduction of infection. The physician will aseptically perform percutaneous
aspiration to obtain pleural, pericardial, peritoneal, or synovial fluids. Expel any
air bubbles from the syringe, and immediately inject the specimen into sterile
container. Add 0.5 ml EDTA to the container for each 100 ml collected.
Urine (voided) First morning urine specimen should not be sent for
cytological studies (since the first morning urine is usually made up of
degenerative exfoliated cell materials and concentrated urine waste products,
which obscure the cellular detail). At least 100 ml of “clean catch” urine is
required for cytology. In cases with residual urine problems or with severe
urethritis or vaginitis, the urine should be obtained by catheterization. Send to
laboratory immediately. Refrigerate if delay is unavoidable.
Urine (catheterized) This specimen is collected under sterile conditions by
passing a hollow tube through the urethra into the bladder. Send to laboratory
immediately. Refrigerate if delay is unavoidable.
Bladder Washing Bladder washing samples are taken by placing a balanced salt
solution into the bladder through a catheter (tube) and then removing the
solution for microscopic testing. Collect into a sterile container. Send to
laboratory immediately. Refrigerate if delay is unavoidable. If delay is more than
24 hours, add an equal volume of 50% ethanol.
Specimen Handling

Collection on a HSCT Patient at Fred Hutchinson Cancer Center Ambulatory Clinic

 Deliver the specimen to Fred Hutchinson Cancer Center Pathology.

 A Fred Hutchinson Cancer Center Pathology Technician will accession all of these
specimens. They will be sent via cab to Harborview Cytology

(Continued)

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Other Fluid Specimens, continued

Collection on a HSCT Patient at UWMC

7am to 4:30pm Mon – Fri 4:30pm to 7am Mon – Fri

Business Hours Saturdays, Sundays, and Holidays
🞂 Follow collection guidelines above. 🞂 In ADVANCE page UWMC
on-call Histology Tech (663-
🞂 Immediately deliver Pathology
8098).
specimens to UWMC Pathology.
🞂 Follow collection guidelines above.
🞂 Fluid specimens will be sent to
Harborview Cytology for processing. 🞂 Immediately deliver Pathology
specimens to UWMC Pathology.
🞂 Fluid specimens will be sent by
UWMC Pathology to Harborview
Cytology

Causes for Rejection Improper handling, misidentified specimens, and requisitions.

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SURGICAL SPECIMENS
Collected at FHCC Ambulatory Clinic

Surgical Specimens Specimens collected at Fred Hutchinson Cancer Center

Ambulatory Clinic not specifically described in the Specimen Collection and
Handling Manual
Test Includes Gross and microscopic exam with diagnosis
Lab Fred Hutchinson Cancer Center Pathology, Room G7-
910 Request Form Surgical Pathology Order or Anatomic Pathology Specimen
Request Form
Fill out completely, including ICD codes
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 606-1355
Availability Monday 9:00am –
6:30pm Tuesday – Friday 6:00am – 6:30pm
Saturday 6:00am – 2:30pm

Sundays and all other times, if STAT processing is required, contact the on-call
Pathology Technologist at 573-0892.
Turnaround Time For specimens received in Fred Hutchinson Cancer Center
Pathology by 3pm, results will be provided the second business day. If the time
frame is not met, results are provided on the third business day. Holidays may
extend result times.
Container See below
Specimen Handling The type of container, transport temperature, appropriate
transport media, fixative, or other handling details should be determined prior to
specimen collection by consulting the appropriate Pathology Laboratory, the on-
call Path Tech, or Pathologist.

Collection at Fred Hutchinson Cancer Center Ambulatory Clinic

7am to 4:30pm Mon – Fri

Business Hours

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🞂 Internal courier delivers the specimen to Fred Hutchinson Cancer Center

Pathology
🞂 If the specimen is from a HSCT or Heme-Onc patient, Fred Hutchinson
Cancer Center Path Tech accessions the specimen in the computer for
processing at Fred Hutchinson Cancer Center Pathology
🞂 If the specimen is from a solid tumor patient, the Fred Hutchinson Cancer
Center Path Tech places the specimen on a packing list and transports it to
UWMC Pathology Lab, Room EC 239NW.

Causes for Rejection Improper handling, misidentified specimens, and requisitions

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THERAPEUTIC DRUG MONITORING OF BUSULFAN

Test includes AUC (mg x h/L) result and dose

recommendations (mg every 6, 8, 12 or every 24 hours)
Lab Pharmacokinetics, 188 E. Blaine, Suite 250
Request Form Busulfan Requisition Form (available on UWMC-7NE, 8NE, and
Fred Hutchinson Cancer Center outpatient blood draw area)
Fill out completely, including ICD codes, actual time of the draw, infusion start
and stop time, date of dose,
dose amount given, and time given.
For Fred Hutchinson Cancer Center Ambulatory Clinic, a
CPOE requisition will be generated for those lab tests requiring a requisition
form.
Phone 206-606-7389
Availability Tuesday – Saturday, 8am –
5pm Sundays, Mondays, and Holidays: ON CALL
Turnaround Time If the dose is given before or at the standard time of
8am, results available
between 4pm and 5pm on the same day
Specimen Blood (only plasma is analyzed)
Volume 1-3 mL oral, 1-4 mL IV formulation
Container Green Top 4 mL sodium heparin Vacutainer® tube
Collection The following patient information must be recorded on the
requisition form: busulfan dose given (mg), and the date and time it was given.
Label tubes with patient name, U#, date, the actual time of blood draw, initials of the
person drawing the blood, and record this information on the requisition form. Place
samples on wet ice within 10 minutes and deliver immediately to Alliance
Laboratory
(G1-500) for pick-up.
Note: Special contracted courier service will pick up
samples on 7 or 8 NE if the patient is an inpatient at the UW Medical Center.

(Continued)

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Therapeutic Drug Monitoring of Busulfan, continued

Oral Busulfan every 6 hours
Collect 1-3 mL of whole blood at the following post dose times in minutes for
dose 1: 15 (suspension only), 30, 60, 90,120, 180, 240, 300, 360.

Collect 1-3 mL of whole blood at the following times for doses 5 and 9: 0
(immediately prior to dose), 30, 60, 120, 240, 360.

Note: If there was emesis during the dose or previous doses, have the amount of
busulfan given as a redose.
IV Busulfan every 6 hours
Collect 1-4 mL of whole blood at the following post-dose
times in minutes for dose 1: End of infusion (120), 135,
150, 240, 300, 360.

Collect 1-4 mL of whole blood at the following times for

doses 5 and 9: 0 (immediately prior to dose), end of infusion (120), 135, 240, 300, 360.

Be sure the entire drug has been delivered, and the lines have been flushed
thoroughly of busulfan before drawing the post-infusion sample.
IV Busulfan every 24 hours
Collect 1-4 mL of whole blood at the following post-dose
times in minutes for dose 1: End of infusion (180), 195,
240, 300, 360, 480.

Collect 1-4 mL of whole blood at the following times for

doses 2 and 3: 0 (immediately prior to dose), end of infusion (180), 195, 240, 360, 480.

Be sure the entire drug has been delivered, and the lines have been flushed
thoroughly of busulfan before drawing the post-infusion sample.

Causes for Rejection

Misidentified specimens and requisitions, improper storage,
gross hemolysis, or clotting, and/or insufficient sample volume will be rejected,
and the appropriate personnel at the patient care facility will be notified.

Additional requirement for specimens delivered to us by post courier: specimen

must arrive frozen.
After Hours Page Pharmacokinetics Laboratory staff at (206) 994-5942 to schedule

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PHARMACOGENETIC TESTING

Test includes CYP2C19 genotyping assay and dosing guidance for

voriconazole and clopidogrel.
Lab Pharmacokinetics, 188 E. Blaine, Suite 250
Request Form Requisition form will be generated upon ordering the
CYP2C19 genotype test on EPIC. Requisition should include patient identification
information, ICD codes, date and time of specimen collection, specimen type,
and which drug the test is being ordered for.
Phone 206-606-7389
Availability Tuesday – Saturday, 8am –
5pm Sundays, Mondays, and Holidays: ON CALL
Turnaround Time Results will be available 96 hours from sample receipt.
Specimen Blood
Volume 1-3 mL
Container Lavender/Purple Top 4 mL potassium EDTA Vacutainer®
tube Collection Specimens must be accompanied by a paper requisition
printed from an electronic ordering system or a confirmed verifiable EPIC test
order explicitly requesting/ordering the test. The requisition form must be signed
by a medical provider. Label tubes with patient name, U#, date, and the actual time of
blood draw. In a biohazardous transport bag, place the sample in front pocket and
insert the requisition into the rear pocket. Samples are stable at room
temperature and should be delivered to the Pharmacokinetics Lab.

Causes for Rejection Misidentified specimens and requisitions, improper

storage, gross hemolysis, or clotting, and/or insufficient sample volume will be
rejected, and the appropriate personnel at the patient care facility will be
notified.
After Hours Page Pharmacokinetics Laboratory staff at (206) 994-
5942 to schedule

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CREATININE (POCT)

Related Terms Creatinine, Crea

Test includes Creatinine
Lab POCT – Imaging Unit
Phone POCT Office: 606-
7635 MRI: 606-6988
MRI @ Valley: 606-2997
OBS: 606-7184
Testing Frequency Monday – Saturday, testing time is dependent on care plan.
Specimens may be sent to Alliance Lab for confirmation or as needed.
Availability STAT
Specimen Whole Blood
Volume 0.5 mL
Container 1-3mL sterile syringe. If specimen is sent to Alliance
Lab for testing, collect plasma or serum in 5 mL lime top PST, green top, red
top, gold top SST or orange top RST
Collection Routine venipuncture or line draw
Causes for Rejection Misidentified specimens and requisitions, specimen QNS

Reference
Female Male
Ranges
Age Range Age Range
>=18 yrs. 0.38-1.02 >=18 yrs. 0.51-1.18

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GLUCOSE (POCT)

Related Terms Blood sugar

Lab POCT – Procedure Suite, Imaging Unit,
Infusion/ACE/CTU, Radiology Oncology
Phone POCT Office:606-7635
Procedure Suite: 606-
1329
Imaging: 606-7184
Infusion/ACE/CTU: 606-2157
Radiation Oncology: 606-7318

Testing Frequency Monday – Sunday, testing time is dependent on care plan

or rapid response code. Specimens may be sent to Alliance Lab for
confirmation or as needed. Availability STAT
Specimen Whole Blood
Volume 0.5 mL
Container For capillary specimen collection, use auto-disabling
single-use lancing device. If specimen is sent to Alliance Lab for testing, see
Glucose for container type. Collection Capillary fingerstick, routine
venipuncture or line draw.
Specimen Handling Separate plasma or serum from cells as soon as
possible to minimize loss of glucose through glycolysis
Causes for Rejection Misidentified specimens and requisitions, specimen QNS
Reference Ranges Glucose, fasting: 62–125 mg/dL
Critical Values <55 mg/dL or >500 mg/dL

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IONIZED CALCIUM, WHOLE BLOOD (POCT)

Related terms iCA, Ionized Calcium

Lab POCT – Apheresis Unit
Phone POCT Office: 606-
7635 Apheresis:
606-2120
Testing Frequency Monday – Sunday, testing time is dependent on care plan.
Specimens may be sent to Alliance Lab for confirmation or as needed.
Availability STAT
Specimen Whole Blood
Volume 1 mL
Container 1-3 mL balanced heparin syringe. If specimen is sent to
Alliance Lab for testing, see Calcium for container type.
Collection Routine venipuncture or line draw
Causes for Rejection Misidentified specimens and requisitions, specimen QNS,
clotted specimen
Reference Ranges > 1 year 1.18 mmol/L - 1.38 mmol/L
< 1 year 1.16 mmol/L - 1.45 mmol/L
Critical Values < 0.78 mmol/L or > 1.58 mmol/L

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POTASSIUM (POCT)

Related Terms K+, K, Potassium

Lab POCT – Apheresis Unit
Phone POCT Office: 606-
7635 Apheresis:
606-2120
Testing Frequency Monday – Sunday, testing time is dependent on care plan.
Specimens may be sent to Alliance Lab for confirmation or as
needed.
Availability STAT
Specimen Whole blood
Volume 1 mL
Container 1-3 mL balanced heparin syringe. If specimen is sent to
Alliance Lab for testing, see Potassium for container type.
Collection Routine venipuncture or line draw do not draw specimen
from an arm receiving intravenous transfusion. Avoid hemolysis, as it can lead to
falsely elevated K+ levels.
Causes for Rejection Misidentified specimens and requisitions, specimen QNS,
clotted specimen
Reference Ranges 3.6 – 5.2 mEq/L
Critical Values <3.0 mEq/L or >6.0 mEq/L

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KOH PREP(POCT/PPT)

Related Terms Skin KOH, Skin Fungal with Direct Exam

Test included in these panels
Fungal elements seen on skin or other keratinized specimens
rd
Lab 3 floor, Skin Oncology
Phone POCT Office: 606-
7635 Skin Oncology:
606-2201
Testing Frequency Clinic hours 8am to 5pm. Testing is dependent on care plan.
Availability Performed at patient’s bedside
Specimen Skin and other keratinized specimens
Volume N/A
Container Glass slide with one drop of 10% (or20%) KOH to the
slide and mix well with the specimen.
Collection Skin scrapings with sterile blade, clipper, or scissor
Causes for Rejection Specimen QNS, Specimens will be rejected if received >
24 hours after collection. Viability of organisms is significantly reduced after 24
hours.
Reference Ranges Yeast/Fungi are absent

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