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Lab Requestion Order:
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Ordering Provider:
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Priority
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Draw Requirements:
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If fasting, length of fast:
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ICD - 10 Codes:
• • •
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Bill to:
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Favorites:
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4-Pack (CBC, Metabolic, TSH, Lipid)
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Peyman Elison Protocol for Peripheral Neuropathy Lab Testing
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Tests
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Amylase Serum
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A1c
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ANA
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Basic Metabolic Panel (8)
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Calcium Serum
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CBC With Differential/Platelet
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Comp. Metabolic Panel (14)
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C-Reactive Protein Quant
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Creatine Kinase Total Serum
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ESR Erythrocyte Sedimentation Rate
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Folate (Folic Acid) Serum
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Insuln Resistance Test SST
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Hepatic Profile
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Iron and TIBC
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Iron Serum
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LDH
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Lipase Serum
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Lipid Panel With LDL/HDL Ratio
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Luteinizing Hormone(LH) S
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Magnesium Serum
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Prolactin
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TSH
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Uric Acid Serum
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Vitamin D 25-Hydroxy
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Vitamin B12
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ADDITIONAL LAB
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ADDITIONAL LAB
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