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Lactic Acid
See Lactate, Cerebrospinal Fluid

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Lactate, Plasma		Test Code: LACT
CPT:	83605
Alternate Name:	Blood Lactate; Lactic Acid
Methodology:	Endpoint
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	2 mL plasma
Container:	Gray top (sodium fluoride) tube
Collection:	Submerged tube in wet ice immediately after collection. NOTE To prevent an increase in Lactic Acid, it is recommended that the patient refrain from clenching hand muscles during phlebotomy procedure. Phlebotomist should attempt collection without use of a tourniquet. If a tourniquet must be used, release as soon as blood flow begins.
Special Instructions and/or Comments:
•Transport to the laboratory immediately in wet ice. •If testing cannot be performed within 2 hours of collection, centrifuge, transfer plasma to plastic aliquot tube and refrigerate. •Patient should not exercise prior to testing.
Reference Range:
0.5-2.1 mmol/L
Critical Values:
>4.0 mmol/L
Clinical Utility:
Used to evaluate hypoxia, circulatory and hypoperfusion conditions.

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Lactate, Cerebrospinal Fluid		Test Code: CSLC
CPT:	83605
Alternate Name:	Cerebrospinal Fluid Lactic Acid; CSF Lactic Acid; Lactate, CSF; Spinal Fluid Lactate
Methodology:	Endpoint
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	0.5 mL cerebrospinal fluid
Container:	Sterile conical tube
Special Instructions and/or Comments:
Testing should be performed on tube #1.
Reference Range:
0.5-2.2 mmol/L
Clinical Utility:
Used to evaluate various diseases, disorders and trauma of the central nervous system.

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Lactate, CSF
See Lactate, Cerebrospinal Fluid

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Lactate Dehydrogenase, Body Fluid		Test Code: FLD
CPT:	83615
Alternate Name:	Body Fluid LDH
Methodology:	HNL Rate
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL body fluid
Container:	Red top tube, no serum separator
Reference Range:
Not established, must be interpreted with clinical findings.

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Lactate Dehydrogenase Fractionation
See Lactate Dehydrogenase Isoenzymes

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Lactate Dehydrogenase Isoenzymes		Test Code: LDEL
Includes:	•LD, Total •LD Isoenzymes 1, 2, 3, 4 and 5
CPT:	83615,83625
Alternate Name:	Lactate Dehydrogenase Fractionation; LD Electrophoresis; LD Isoenzymes
Methodology:	Photometric Rate, Electrophoresis Densitometry
Testing Schedule:	Routine, Monday-Friday only
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Must be kept at room temperature (ambient) during storage and transport •DO NOT refrigerate or freeze.
Reference Range:
Isoenzymes I (fast band)17.5-28.3% II30.4-36.4% III19.2-24.8% IV9.6-15.6% V (slow band)5.5-12.7%
Clinical Utility:
LD is useful in the investigation of a variety of diseases involving the heart, liver, muscle, kidney, lung, and blood; and differentiatingheart-synthesized LD from liver and other sources of LD.Isoenzymes are used by many clinicians in the diagnosis of MI in combination with total CK and CK-MB.Investigating unexplained causes of LD elevations. Detection of macro-LD.

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Lactate Dehydrogenase, Serum		Test Code: LD
CPT:	83615
Alternate Name:	LD, Serum; LDH Serum
Methodology:	Rate
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
<1 year <537units/L > =1 year <277 units/L >= 4 year <273 units/L >= 10 years <245 units/L >= 12 years <218 units/L >= 14 years <205 units/L >= 16 years <224 units/L >= 18 years <190 units/L
Clinical Utility:
Used to evaluate hepatic, pulmonary conditions, and myocardial infarctions..

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Lactoferrin, Stool		Test Code: SLAC
CPT:	83630
Alternate Name:	Fecal Lactoferrin
Methodology:	ELISA
Testing Schedule:	Routine, 2 times per week
Specimen Requirements:
Minimum Volume:	Entire Random stool collection
Container:	Plastic stool container with lid OR plastic urine container, no preservative Special Instructions
Special Instructions and/or Comments:
Freeze entire specimen. Once frozen, transport specimen submerged in dry ice. NOTE: Specimen must be frozen within 48-hours of collection.
Reference Range:
Negative
Clinical Utility:
Useful to screen for inflammatory diarrhea

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Lactose Consumption Test
See Lactose Tolerance Test, Oral

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Lactose Tolerance Test, Oral		Test Code: LTT
Includes:	Fasting, 1 and 2 Hour specimens
CPT:	82951
Alternate Name:	Lactose Consumption Test
Methodology:	Endpoint
Testing Schedule:	By appointment only
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL plasma per collection
Container:	Gray top (sodium fluoride) tube
Collection:	Collect fasting specimen (8 hour) •1 hour post lactose load •2 hours post lactose load
Special Instructions and/or Comments:
Test is performed by appointment only. Contact Technical Support at 610-402-8170 to ensure correct dose of lactose is ready for patient upon arrival. Provide weight of patient, day of testing desired and preferred Patient Service Center location.
Reference Range:
• Glucose, Fasting .....< 7 days 47-110 mg/dL .....> 7 days 65-99 mg/dL • Glucose, 1 Hour An increase of < 25 mg/dL is suggestive of an enzyme defect. • Glucose, 2 Hour .....< 7 days47-110 mg/dL .....> 7 days65-99mg/dL • The glucose level should return to the fasting level or less.
Clinical Utility:
Used in the evaluation of lactase deficiency; workup of lactose intolerance, malabsorption syndromes.

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Lamictal®
See Lamotrigine

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Lamotrigine		Test Code: LAMO
CPT:	80299
Alternate Name:	Lamictal®
Methodology:	High Performance Liquid Chromatography (HPLC)
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Red top tube, no serum separator
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Patients receiving the therapeutic dose usually have lamotrigine concentrations between 2.5 and 15.0 mcg/mL.
Clinical Utility:
Useful fo: 1. Monitoring serum concentration of lamotrigine assessing compliance. 2. Adjusting lamotrigine dose in patients receiving other anticonvulsant drugs which interact Parmacokinetically with lamotrigine. 3. Assessing compliance.

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Lanoxin®
See Digoxin, Serum

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LAP
See Leukocyte Alkaline Phosphatase Stain

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LAP Score
See Leukocyte Alkaline Phosphatase Stain

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LAP Smear
See Leukocyte Alkaline Phosphatase
See Lactate Dehydrogenase Isoenzymes

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Laxative Screen, Urine		Test Code: ULAX
CPT:	80299
Alternate Name:	Cathartic Laxative Screen, random urine
Methodology:	Thin Layer Chromatography (TLC), Flame Atomic Absorption Spectroscopy (FAAS) and Inductively Coupled Plasma/Mass Spectroscopy (FAAS)
Testing Schedule:	Varies, Monday - Friday
Report Available:	10 - 14 days
Specimen Requirements:
Minimum Volume:	20 ml Random Urine
Container:	Plastic Urine Container
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Accompanies Report

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LD Isoenzymes
See Lactate Dehydrogenase Isoenzymes

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LDL Cholesterol, Direct		Test Code: LDL
CPT:	83721
Alternate Name:	Beta Lipoprotein; Direct LDL; LDLC; Low Density Lipoprotein Cholesterol
Methodology:	Endpoint ( Elimination/Catalase)
Testing Schedule:	Routine, daily
Report Available:	1-2 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Collection:	NOTE •Patient should discontinue use of drugs, if possible, for 3-4 weeks prior to testing. •Patient should be maintaining a stable weight, considered normal, for at least 1 week. •Wait 4-8 weeks after a myocardial infarction or a traumatic episode. •Patient should fast for 12-14 hours (nothing by mouth except water and any essential medications).
Special Instructions and/or Comments:
Testing is contraindicated for hospitalized patients, especially those on heparin therapy.
Reference Range:
<20 years <110 mg/dL > 20 <100 mg/dL Special Note: Reference Ranges reflect the NCEP Adult Treatment Panel (ATP) III guidelines published in JAMA MAy 16, 2001 Adults • Near/above Optimal 100 - 129 mg/dL • Borderline High 130 - 159 mg/dL • High 160 - 1899 mg/dL • Very High > 190 mg/dL Pediatrics • Borderline: 110 - 129 mg/dL • High: > 130 mg/dL

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LE Prep
See Antinuclear Antibody Screen

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Lead, Blood		Test Code: LEAD
CPT:	83655
Alternate Name:	Pb, Blood
Methodology:	Anodic stripping voltametry (ASV)
Testing Schedule:	Routine, 2 times per week
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	7 mL whole blood, 1 full Royal Blue top trace metal tube, lavender label OR lavender top (EDTA) tube OR half-full lavender top (EDTA) BD Microtainer™ tube
Container:	1 full Royal Blue top trace metal tube, lavender label OR lavender top (EDTA) tube OR lavender top BD Microtainer™ tube NOTE If unable to collect a full Royal Blue top trace metal tube, please collect in Microtainer™ tube. CollectionWash venipuncture site thoroughly with soap and water.Dry thoroughly with clean disposable towel.
Reference Range:
CDC guidelines •Children up to 6 years<10 µg/dL •Pregnant females<10 µg/dL •Adults<20 µg/dL For OSHA occupational monitoring, workers with whole blood lead levels at or above 40 µg/dL should be referred to a physician for medical evaluation and follow-up.
Clinical Utility:
Detecting lead toxicity.

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Lead, 24-Hour Urine		Test Code: LEDU
Includes:	•Volume Measurement •Collection Period •Lead, Urine
CPT:	81050, 83655
Methodology:	Inductively coupled plasma mass spectrometry (ICP-MS)
Testing Schedule:	Routine, daily
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	20 mL aliquot of a well mixed 24-Hour urine collection
Container:	24-Hour plastic urine container, no preservative
Collection:	NOTE: High concentration of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium or iodine containing contract media has been administered, a specimen cannot be collected for 96 hours. •Instruct the patient to void at the beginning of the collection period and discard the specimen. •Collect all urine including the final specimen voided at the end of the collection period. •Refrigerate during collection. •Container must be labeled with the patient’s name.
Special Instructions and/or Comments:
•Instruct patient not to void directly into container. •Transport to the laboratory promptly.
Reference Range:
•Normal < 80mcg /specimen •Inconclusive 80 - 400 mcg /specimen •Abnormal > 400 mcg/specimen
Clinical Utility:
Useful for detecting lead toxicity, however. blood lead analysis has the strongest correlation with toxicity.

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LE Antibodies
See Histopathology, Skin Biopsy, Immunofluorescence

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LS Ratio with PG		Test Code: LSRA
CPT:	82489, 83661
Alternate Name:	L/S Ratio with PG
Methodology:	Thin Layer Chromatography (TLC) with Quantitation by Densitometry
Testing Schedule:	Routine, daily
Report Available:	1-2 days
Specimen Requirements:
Minimum Volume:	10 mL of amniotic fluid
Container:	Amber plastic vial
Special Instructions and/or Comments:
•Centrifuge specimen. •Transfer supernatant to AMBER vile, or wrap plastic vial with aluminum foil to protect from light. •Freeze supernatant fluid. •Once frozen, transport submerged in dry ice.
Reference Range:
•L/S ratio of <2 suggests pulmonary immaturity. •A ratio of 2 to 3 probably represents maturity but a L/S ratio of 3 or greater is more reassuring •Although PG may be detectable, pulmonary immaturity may be present if the L/S ratio is <2. If the L/S ratio is > 2 and PG is detectable, then pulmonary maturity is almost assuredly present.
Clinical Utility:
In the early stages of gestation, phosphatidylinositol is not present in amniotic fluid. At about 32-33 weeks of gestation, lecithin and a sphingomyelin concentrations are about equal; subsequently, the lecithin concentration rises, and paralleling this , the concentration of another phospholipid, phosphatidylinositol concentration begins to decrease and phosphatidylglycerol begins to appear in the amniotic fluid. It is this appearance of phosphatidylglycerol that suggests the presence of a mature fetal lung. A lecithin/sphingomyelin (L/S) ratio of greater than 2:1, together with a quantity of phosphatidylglycerol (PG) greater than or equal to 2.0% may suggest mature fetal lung development.

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Legal Alcohol
See Alcohol, Whole Blood, Legal

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Legionella Antibody
See Legionella pneumophila Antibody Profile

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Legionella Antigen, Urine		Test Code: ULEG
CPT:	87449
Alternate Name:	Legionella pneumophila Antigen; Urine Legionella Antigen
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, daily
Report Available:	1-3 days
Specimen Requirements:
Minimum Volume:	5 mL random urine
Container:	Plastic urine container, no preservative
Collection:	•Early morning specimen (yields highest bacterial counts from overnight incubation in the bladder). •Refrigerate
Reference Range:
•Negative not detected for Legionella pneumophila serogroup-1 antigen, suggesting no current or recent infection.Infections caused by other L. pneumophila serogroups, L. micdadei, or L. longbeachae are not detected by this assay.If results do not correlate with clinical presentation, culture is recommended. NOTE Early antibiotic treatment may decrease antigen excretion.
Clinical Utility:
This assay qualitatively detects the presence of Legionella pneumophila serogroup 1 antigen in human urine as an adjunct to culture for the presumptive diagnosis of past or current Legionnaire’s Disease.

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Legionella Culture
See Culture, Legionella

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Legionella G/M
See Legionella pneumophila Antibody Profile

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Legionella pneumophila Antibody Profile		Test Code: LEGAB
Includes:	•IgG antibodies to Legionella pneumophila serogroups 1-6 •IgM antibodies to Legionella pneumophila serogroups 1-6
CPT:	86713 x 12
Alternate Name:	Legionnaires’ Antibody; Legionella Antibody; Legionella G/M
Methodology:	Indirect Fluorescent Antibody (IFA)
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
<1:64 for both IgG and IgM
Clinical Utility:
Detect antibodies to Legionella; helps support the clinical diagnosis of Legionnaires’ disease

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Legionella pneumophila Antigen
See Legionella Antigen, Urine

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Legionella Smear
See Legionella, DFA, Smear or Tissue

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Legionella Species by Rapid PCR		Test Code: LEGPR
CPT:	87798
Methodology:	Rapid PCR
Testing Schedule:	Routine, daily
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	Acceptable specimens: Bronchial washings, bronchoalveolar lavage, lung tissue, pleural fluid, sputum, transtracheal aspirates, or tracheal secretions
Container:	Screw capped sterile container
Collection:	Indicate source
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Negative (Reported as positive or negative)
Clinical Utility:
Indications: • A positive PCR result for the presence of a specific sequence found within the Legionella 5S rRNA gene indicates the presence of a Legionella species DNA in the specimen and supports a diagnosis of legionellosis. • A negative PCR result provides evidence against a diagnosis of legionellosis. CAUTIONS: This assay does not differentiate between the Legionella species. This assay is not recommended as a test of cure because nucleic acid may persist after successful treatment.

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Legionnaires’ Antibody
See Legionella pneumophila Antibody Profile

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Legionnaires’ Disease
See Culture, Legionella

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Leiden Factor
See Factor V Leiden (R506Q) Mutation

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Leptin		Test Code: LEPN
CPT:	83519
Methodology:	Double Antibody RNA
Testing Schedule:	Routine,2 times per week
Report Available:	5-10 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
• Centrifuge specimen, transfer serum to plastic aliquot tube and freeze. • Once frozen, transport specimen submerged in dry ice
Reference Range:
Adults (BMI =22) Males Range 0.7-5.3 ng/mL Female Range 3.3-18.3 ng/mL Range is 5th - 95th percentile NOTE Leptin values are gender dependent and highly correlated with the Body Mass Index (MBMI). THis reference range is provided only for average BMI value to obtain appropriate data. Please furnish patient’s age and sex, plus height and weight or BMI.
Clinical Utility:
Leptin is a protein horomone priduced predominantly in the adipocytes. Small amounts are synthesized in the epithelium of the stomach and in the placenta. Leptin plays an important role in the regulation of body weight through the hypothalamic centers of hunger, body temperature and energy expenditure. Increased leptin levels are seen in obese individuals. The fact that elevated leptin levels fail to alter the obese state of these individuals may be related to a leptin resistance and an inability of leptin to enter the cerebral spinal fluid to reach sites in the hypothalamus to regulate appetite. Leptin levels have been shown to change under certain endocrine conditions. For example, when leptin levels are expressed per body adiposity, females have higher leptin levels than do males. THis may be related to the distribution of adipose tissue where omental fat vs. subcutaneous fat, which differs between genders, may have different leptin production rates. Its role in metabolism, insulin sensitivity, as a potential therapeutic modality for weight loss, as well as, involvement in endocrine function are still under investigation.

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Leptospira Antibody		Test Code: LEPT
CPT:	86720
Methodology:	Indirect Hemagglutination
Testing Schedule:	Routine, 3 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Negative NOTE Compare acute and convalescent titers for greatest diagnostic value.A four fold or greater increase in titer between acute and convalescent specimens confirms the diagnosis of recent infection.
Clinical Utility:
Useful for an aid in the diagnosis of leptospirosis

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Leptospira Culture
See Culture, Leptospira

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Leukemia/Lymphoma Profile, Blood/Bone Marrow, Flow Cytometry		Test Code: LEUPR
Includes:	Flow Cytometry markers appropriate for the clinical presentation.
CPT:	88184, 88185 (x25), 88189
Methodology:	Flow Cytometry
Testing Schedule:	Routine, Monday-Friday only
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	10 mL whole blood in green top (sodium heparin) tube AND 5 mL whole blood in lavender top (EDTA) tube OR 3 mL bone marrow in green top (sodium heparin) tube AND 2 mL bone marrow in lavender top (EDTA) tube
Container:	Green top (sodium heparin) tube AND lavender top (EDTA) tube.
Collection:	For special requests contact our Customer Care Department at 610-402-8170 prior to collecting specimen.
Special Instructions and/or Comments:
•Collect Monday-Friday ONLY before 1400, no holidays.Specimens must arrive in the laboratory no later than 1600. •Store as whole blood or bone marrow in original tube at room temperature. •DO NOT centrifuge, aliquot, refrigerate or freeze. •Submit specimen with a completed Hematopathology Requisition (HNL-05) Form.Clinical history, diagnosis, and specimen type are required. •Form can be requested by contacting our Customer Care Department at 610-402-8170.
Reference Range:
See report.
Clinical Utility:
Immunophenotyping by flow cytometry distinguishes among various hematopoietic cell populations and determines the degree of expression of a panel of cell surface antigens. The test is used along with morphologic, cytogentic, and molecular genetic analysis in the identification/classification of hematopoietic neoplasms (leukemia, lymphoma, myelodysplastic disorders).

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Leukemia/Lymphoma Profile, Tissue/Fluid, Flow Cytometry		Test Code: LYTPR
Includes:	Flow cytometry markers appropriate for the clinical presentation.
CPT:	88184, 88185 (x18), 88189
Methodology:	Flow Cytometry
Testing Schedule:	Routine, Monday-Friday only
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	2 mL tissue OR fluid
Container:	•Submit tissue in an RPMI media. •Submit fluid in sterile conical tube.
Collection:	For special requests contact our Customer Care Department at 610-402-8170 prior to collecting specimen.
Special Instructions and/or Comments:
•Collect Monday-Friday ONLY before 1400, no holidays.Specimens must arrive in the laboratory no later than 1600. •Refrigerate •Submit specimen with a completed Hematopathology Requisition (HNL-05) Form and include clinical history, diagnosis, and specimen type. •Form and RPMI Media can be requested by contacting our Customer Care Department at 610-402-8170.
Reference Range:
Immunophenotyping by flow cytometry distinguishes among various hematopoietic cell populations and determines the degree of expression of a panel of cell surface antigens. The test is used along with morphologic, cytogenetic, and molecular genetic analysis in the identification/classification of hematopoietic neoplasms (leukemia, lymphoma, myelodysplastic disorders).

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Leukocyte Alkaline Phosphatase Stain		Test Code: LAP
CPT:	85540
Alternate Name:	LAP; LAP Score LAP Smear
Methodology:	Semiquantitative Cytochemical Stain Microscopy
Testing Schedule:	Routine, Monday-Friday only
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	3 mL whole blood
Container:	Green top tube, lithium heparin
Special Instructions and/or Comments:
Please forward to lab promply Monday through Friday ONLY. 5 peripherial slides must be prepared from blood sample within 24 hours of collection.All slides should be dried,unfixed, and unstained.
Reference Range:
Score 40-100
Clinical Utility:
Useful for differentiating CML from Polycythemia and leukomoid reations.

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Leukocyte Count
See WBC, No Differential
See WBC with Manual Differential

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Leukocytes, Stool		Test Code: SWB
CPT:	89055
Alternate Name:	Fecal Leukocyte Stain Stool for WBC’s Stool for White Cells White Cells Stool Wrights Stain Stool
Testing Schedule:	Routine, daily
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	0.5 g fresh random stool
Container:	Para-Pak® C&S container OR Para-Pak O & P container (formalin) OR specimen container
Special Instructions and/or Comments:
• Transport to the laboratory immediately (significant deterioration of the cells occurs with prolonged storage). • Refrigerate
Reference Range:
No WBC’s observed.
Clinical Utility:
Leukocytes present in a fecal smear indicate inflammation, the product of bacteria and host interaction.

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Leyden Factor
See Factor V Leiden (R506Q) Mutation

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Levetiracetam		Test Code: KEPRA
CPT:	80299
Alternate Name:	Keppra
Methodology:	High Performance Liquid Chromatography (HPLC)
Testing Schedule:	Routine, daily
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	1.0 mL serum
Container:	Red top tube, or Gold top (serum separator)
Collection:	Collect specimen prior to barium procedures.
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•Peak concentration 10-63 ug/mL •Trough concentration 3-34 ug/mL
Clinical Utility:
Useful for, monitoring levetiracetam therapy. Because levetiracetam has a wide therapeuti index and linear dose-concentration dependence, drug monitoring is not indicated in all patients. Drug concentration monitoring can be useful in documenting failure to respond that may be due to noncompliance, or to guide dosage adjustments in patients with renal failure.

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LH
See Luteinizing Hormone, Serum Li, Blood

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LiCO3
See Lithium, Serum

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Lice
See Arthropod Identification

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Lidocaine		Test Code: LIDO
CPT:	80176
Alternate Name:	Xylocaine®
Methodology:	Immunoassay (IA)
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	0.5 mL serum
Container:	Red top tube, no serum separator
Collection:	Collect specimens 12 hours after initiating therapy for arrhythmia prophylaxis, then every 24 hours thereafter.Obtain specimens every 12 hours when cardiac or hepatic insufficiency exists.
Reference Range:
Therapeutic 1.5-5.0 µg/mL
Critical Values:
Toxic >5.µg/mL
Clinical Utility:
Useful for assessing therapeutic drug levels and potential toxicity.

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Lipase, Fluid		Test Code: FLIP
CPT:	83690
Methodology:	Rate
Testing Schedule:	Routine daily, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL body fluid
Container:	Red top no serum separator tube
Reference Range:
Not established. Must be interpreted with clinical findings
Clinical Utility:
Used in evaluation of disorders of the pancreas.

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Lipase, Serum		Test Code: LIPS
CPT:	83690
Methodology:	HNL Rate
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
<50 units/L
Clinical Utility:
Used in evaluation of disorders of the pancreas.

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Lipid Panel		Test Code: LIPAN
Includes:	•Cholesterol, Total •Triglycerides •HDL Cholesterol, Direct •Non-HDL Cholesterol •LDL Cholesterol, Calculated* •Cholesterol/HDL Ratio
CPT:	80061
Alternate Name:	Coronary Heart Disease Risk Index
Methodology:	See individual test listings
Testing Schedule:	Routine, daily
Report Available:	1-2 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Collection:	NOTE •Patient should discontinue use of drugs, if possible, for 3-4 weeks prior to testing and should be maintaining a stable weight, considered normal, for a least 1 week. •Wait 4-8 weeks after a myocardial infarction or a traumatic episode. •Patient should fast for 12-14 hours (nothing by mouth except water and any essential medications).
Reference Range:
See individual test listings. Reference Ranges for Calculated Parameters (NCEP Adult Treatment Panel III guidelines) NON-HDL Cholesterol 1. Very High/Highest risk patient (known CVD, diabetes with elevated risk): <130 mg/dL, optional goal: <100 mg/dL 2. High Risk Patient, CHD-risk equivalent, (Framingham 10 year risk score >20%/10y, diabetes without other major risk factors): <130 mg/dL 3. Moderately-high/intermediate risk patient (>2 major CVD risk factors, Framington 10-year risk score from 10-20%): <160 mg/dL, optional goal: <130 mg/dL LDL Cholesterol, Calculated 1. Near/above optimal: 100-129 2. Borderline high: 130 - 159 3. High: 160 - 189 4. Very High: >190 CHOL/HDL Ratio Relative Risk: • 1/2 Average Risk 3.43 • Average Risk 4.97 • 2X Average Risk 9.55 • 3X Average Risk 23.39 *NOTE The calculation of LDL by the Freidewald formula becomes invalid when the Triglyceride level is >400 mg/dL.
Clinical Utility:
Useful for cardiovascular risk assessment.

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Lipid Profile with LDL		Test Code: LIPLD
Includes:	•Cholesterol, Total •Triglyceride •HDL Cholesterol •Non-HDL Cholesterol •LDL Cholesterol, Direct •Cholesterol/HDL Ratio
CPT:	80061, 83721
Methodology:	See individual test listings
Testing Schedule:	Routine, daily
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Collection:	NOTE •Patient should discontinue use of drugs, if possible, for 3-4 weeks prior to testing and should be maintaining a stable weight, considered normal, for a least 1 week. •Wait 4-8 weeks after a myocardial infarction or a traumatic episode. •Patient should fast for 12-14 hours (nothing by mouth except water and any essential medications).
Reference Range:
See individual test listings. Reference Ranges for Calculated Parameters (NCEP Adult Treatment Panel III guidelines) NON-HDL Cholesterol 1. Very High/Highest risk patient (known CVD, diabetes with elevated risk): <130 mg/dL, optional goal: <100 mg/dL 2. High Risk Patient, CHD-risk equivalent, (Framingham 10 year risk score >20%/10y, diabetes without other major risk factors): <130 mg/dL 3. Moderately-high/intermediate risk patient (>2 major CVD risk factors, Framington 10-year risk score from 10-20%): <160 mg/dL, optional goal: <130 mg/dL CHOL/HDL Ratio Relative Risk: • 1/2 Average Risk 3.43 • Average Risk 4.97 • 2X Average Risk 9.55 • 3X Average Risk 23.39 *NOTE The calculation of LDL by the Freidewald formula becomes invalid when the Triglyceride level is >400 mg/dL.
Clinical Utility:
Useful for cardiocascular risk assessment.

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Lipoprotein(a)		Test Code: LPA
CPT:	83695
Alternate Name:	Lp(a)
Methodology:	Automated Turbidometric Immunoassay
Testing Schedule:	Routine, daily
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Collection:	Overnight fast (12-14 hours) required
Special Instructions and/or Comments:
•Transport to the laboratory immediately. •Must be processed and frozen immediately. •Centrifuge, transfer to plastic aliquot tube and freeze.Once frozen, transport specimen submerged in dry ice.
Reference Range:
•Normal <30 mg/dL •Values >30 mg/dL may suggest increased risk of coronary heart disease.

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Liquid Based ThinPrep® Test
See Cytopathology, Cervical/Vaginal without Reflex HPV DNA
See Cytopathology, Cervical/Vaginal with Reflex HPV DNA

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Lithium, Serum		Test Code: LITH
CPT:	80178
Alternate Name:	Eskalith®; Li, Blood; LiCO3
Methodology:	Endpoint
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Collection:	Collect at a standard time from last dose (6-12 hours recommended).
Reference Range:
Therapeutic 0.6-1.2 mmol/L
Critical Values:
>2.0 mmol/L
Clinical Utility:
Measurements are used as an aid in the monitoring of lithium therapy.

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Liver Function Panel		Test Code: LFP
Includes:	•Alanine Aminotransferase (ALT) •Albumin •Alkaline phosphatase •Aspartate Aminotransferase (AST) •Bilirubin, Direct •Bilirubin, Total •Protein, Total
CPT:	80076
Alternate Name:	Hepatic Function Panel
Methodology:	See individual test listings.
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
To maintain consistency in Bilirubin methodology, an infant who has had a Liver Function Panel, Neonatal or Bilirubin, Total Neonatal or Bilirubin, Direct Neonatal ordered and becomes >14 days old, should continue to have a Liver Function Panel, Neonatal ordered– DO NOT SWITCH TO THE LIVER FUNCTION PANEL.
Reference Range:
See individual test listing.
Critical Values:
See individual test listing.
Clinical Utility:
Used in the evaluation of hepatic function and hepatic disorders.

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Liver Function Panel, Neonatal (<15 days old)		Test Code: NLFP
Includes:	•Alanine Aminotransferase (ALT) •Albumin •Alkaline Phosphatase •Aspartate Aminotransferase (AST) •Bilirubin, Direct Neonatal •Bilirubin, Total Neonatal •Protein, Total
CPT:	80076
Alternate Name:	Hepatic Function Panel
Methodology:	See individual test listings
Testing Schedule:	Routine, STAT testing available
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube OR 2 full yellow or red BD Microtainer™ tubes
Special Instructions and/or Comments:
To maintain consistency in Bilirubin methodology, an infant who has had an Liver Function Panel, Neonatol or Bilirubin, Total Neonatal or Bilirubin, Direct Neonatal ordered and becomes >14 days old, should continue to have a Liver Function Panel, Neonatal ordered– DO NOT SWITCH TO THE LIVER FUNCTION PANEL.
Reference Range:
See individual test listing.
Critical Values:
See individual test listing
Clinical Utility:
Used in the evaluation of hepatic function and hepatic disorders of the newborn.

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Liver/Kidney Microsomal Type 1 Autoantibody		Test Code: LKMIC
CPT:	86376
Alternate Name:	Anti-LKM Antibody; LKM Antibodies
Methodology:	Enzyme-Linked Immunosorbent Assay (ELISA)
Testing Schedule:	Routine, 3 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•Negative....................... < 20.0 Units •Equivocal .........................20.1-24.9 Units •Positive.......................... > 25.0 Units
Clinical Utility:
Useful for, the evaluation of patients with liver disease of unknown etiology

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LKM Antibodies
See Liver/Kidney Microsomal Type 1 Autoantibody

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Lorazepam		Test Code: LORAZ
Includes:	Identification and quantitation of lorazepam
CPT:	80154
Alternate Name:	Ativan
Methodology:	LC/MS/MS
Testing Schedule:	Once per week
Specimen Requirements:
Minimum Volume:	2mL whole blood, serum or plasma minimum volume: 1mL
Container:	Gray top, red top or lavendar top
Special Instructions and/or Comments:
Refrigerate
Reference Range:
Lorazepam therapeutic ....................50-240ng/mL
Clinical Utility:
Monitoring therapy or assessing toxicity

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Lovenox®
See Heparin Level, Low Molecular Weight, Plasma

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Low Density Lipoprotein Cholesterol
See LDL Cholesterol, Direct

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Lower Respiratory Culture
See Culture, Bronchoscopy
See Culture, Sputum

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Loxapine		Test Code: LOXAP
Includes:	•Loxapine •8-Hydroxyloxapine metabolite
CPT:	82492
Alternate Name:	Loxitane®
Methodology:	Gas Chromatography (GC) – Nitrogen Phosphorus Detection
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Red top tube, no serum separator
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•Loxapine ..........................5.0-30.0 ng/mL •8-Hydroxyloxapine...........20-100.0 ng/mL
Critical Values:
•Loxapine ..........................60.0 ng/mL •8-Hydroxyloxapine...........200.0 ng/mL
Clinical Utility:
Useful for monitoring compliance

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Loxitane®
See Loxapine

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LP
See Cell Count, Cerebrospinal Fluid

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Lp(a)
See Lipoprotein(a)

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L/S Ratio with PG
See Lecithin/Sphingomyelin Ratio with Phosphatidyl Glycerol

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LUA
See Lupus Anticoagulant Profile

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LUAC
See Lupus Anticoagulant Profile

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Ludiomil®
See Maprotiline

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Lumbar Puncture
See Cerebrospinal Fluid Profile

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Lumbar Tap Cytology
See Cytopathology, Cerebrospinal Fluid

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Luminal®
See Phenobarbital

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Lung Maturity, Fetal
See Fetal Lung Maturity

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Lupus Anticoagulant
See Lupus Anticoagulant Profile

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Lupus Anticoagulant Profile		Test Code: LUAPR
Includes:	• dRVVT Screen* • PTT (Lupus Sensitive)* • Thrombin Time • Interpretation • Reflexed when appropriate: .........• dRVVT Confirm .........• Hexagonal Phase Phospholipid Neutralization PTT Mixing Study .........• Reptilase Time *When the Thrombin Time (TT) and Prothrombin Time (PT) are normal, at minimum, the PTT & dRVVT Screen are performed.
CPT:	85613, 85730, 85670; Reflexed when appropriate 85597, 85597, 85732, 85635
Alternate Name:	LUA; LUAC; Lupus Anticoagulant
Methodology:	See individual test listings.
Testing Schedule:	Routine, 1 time per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	4 mL prepared “platelet poor plasma” split equally into 4 plastic aliquot tubes and FROZEN immediately
Container:	4 Blue top (sodium citrate) tubes
Collection:	See special handling instructions for “Coagulation Studies”, listed under Specimen Collection, Preparation, and Handling Section
Special Instructions and/or Comments:
•Testing is contraindicated for patients on Heparin or Coumadin therapy. •Preparation and submission of “platelet poor plasma” is critical for accurate test performance and interpretation.See collection note above. Causes for rejection •Extended transport time to laboratory •Clotted specimens •Hemolyzed specimens •Blue top sodium citrate tubes insufficiently filled •Aliquots not received frozen on dry ice •Frozen aliquots not clearly identified as “platelet poor plasma”
Reference Range:
See individual test listings.
Clinical Utility:
The presence of Lupus Anticoagulant can cause thrombotic complications as well as spontaneous abortions. Due to its heterogenous nature, testing for LA with different reagents increases the possibility of detection of the inhibitor.

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Lupus Band Test
See Histopathology, Skin Biopsy, Immunofluorescence

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Luteinizing Hormone, Serum		Test Code: LH
CPT:	83002
Alternate Name:	ICSH; Interstitial Cell Stimulating Hormone; LH
Methodology:	Direct Chemiluminescence
Testing Schedule:	Routine, STAT testing available 0600-2100
Report Available:	1 day
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
•Testing must be performed within 8 hours of collection. •If delay in transport centrifuge, transfer to plastic aliquot tube, and refrigerate tube in the upright position.Specimen should remain capped until time of testing.
Reference Range:
•Normally menstruating Follicular Phase 1.9-12.5 mIU/mL Midcycle Peak 8.7-76.3 mIU/mL Luteal Phase 0.5-16.9 mIU/mL •Pregnant<0.1-1.5 •Post menopause15.9-54.0 mIU/mL •Contraceptives 0.7-5.6 mIU/mL •Males 20-70 years 1.5-9.3 mIU/mL >70 years 3.1-34.6 mIU/mL •Children<0.1-6.0 mIU/mL
Clinical Utility:
Used in the evaluation of fertility, menstrual irregularities and disorders of the pituitary, ovaries and testes.

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Lyme Antibody, CSF
See Lyme Disease Antibody, Cerebrospinal Fluid/Serum Ratio

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Lyme C6 Peptide Antibody		Test Code: LC6P
CPT:	86618
Alternate Name:	Borrelia burgdorferi C6 Peptide Antibody
Methodology:	Enzyme Immunoassay (EIA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Reference Range:
•No antibody detected<0.90 •Equivocal0-.90-1.10 •Antibody detected>1.10
Clinical Utility:
C6 peptide is a synthetic peptide derived from the IR6 constant region of the VlsE protein of Borrelia burgdorferi, the causative agent of Lyme disease. The peptide sequence is highly conserved among B. burgdorferi strains in the United States and Europe, including B. afzelii and B. garinii. When humans are infected with B. burgdorferi, there is a strong immunogenic antibody response against the C6 peptide sequence and this can be used to assess exposure to B. burgdorferi. The Lyme C6 Peptide Ab DetectR test measures both IgM and IgG antibody responses to B. burgdorferi in human serum, utilizing an enzyme immunoassay methodology (EIA). It has been demonstrated to have superior clinical sensitivity and specificity over the two-tier, whole-cell sonicate (WCS) EIA and immunoblot (IB) tests in assessment of exposure to B. burgdorferi during early- and late-stage Lyme disease. False-positive rates seen seen with the WCS EIA test are also greatly reduced. Patients who have received the LYMErix vaccine are negative for C6 peptide antibody, allowing for differentiation from exposure and immunization. The Lyme C6 Peptide Ab DetectR test can also be used to assess exposure to European strains of B. burgdorferi including B. afzelii and B. garinii. Longitudinal measurements of C6 peptide antibody levels may be useful in therapeutic monitoring.

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Lyme Disease Antibody Profile		Test Code: LYMEP
Includes:	•Lyme Antibody, Total (IgG/IgM) •Lyme Antibody, IgM •Reflexed when appropriate on initial equivocal or positive screens •Lyme Antibody, Western Blot IgG •Lyme Antibody, Western Blot IgM
CPT:	86618, 86618, Reflexed when appropriate 86617, 86617
Alternate Name:	Borrelia burgdorferi Antibodies; Lyme Arthritis Antibodies; Lyme Arthritis Serology; Lyme IgG/IgM
Methodology:	ELISA; Reflex: Western Blot
Testing Schedule:	Routine, 3 times per week
Report Available:	3-5 days (may be extended if Western Blot required)
Specimen Requirements:
Minimum Volume:	2 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any confirmed positive result.
Reference Range:
•For both Lyme Total (G/M) and IgM specific antibodies ...ELISA values ...........•Negative <0.80 ...........•Equivocal 0.81-0.99 ...........•Positive >1.00 •Equivocal and/or Positive screens will automatically be confirmed by Western blot.These are preliminary until Western blot results are available and final interpretation is made.
Clinical Utility:
This test is used as a screen for assessment of exposure to B. burgdorferi during early- and late-stage disease. All IgM and IgG EIA positive results are confirmed by Western Blot.

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Lyme Disease Antibody, Western Blot		Test Code: NLYWB
Includes:	• Borrelia burgdorferi IgG Antibodies-IB, p18,p23,p28, p30, p39, p41, p45, p58, ,p66, p93 and • Borrelia burgdorferi IgM Antibodies-IB, p23, p39, p41
CPT:	86617 (x2)
Alternate Name:	Borrelia burgdorferi Western Blot; Lyme WB; Lyme Western Blot
Methodology:	Western Blot (WB)
Testing Schedule:	Routine, 2-3 times per week
Report Available:	5-7 days
Special Instructions and/or Comments:
The Department of Health requires mandatory reporting of any confirmed positive result.
Reference Range:
The CDC recommends that at least 2 of 3 IgM bands (23,39 or 41 kDa) must be present for an interpretation of an IgM positive blot. For interpretation of an IgG positive blot, at least 5 of 10 bands (18, 23, 28, 30, 39, 41, 45, 66, or 93 kDa) must be present. Only positive and negative interpretations are reported. Follow-up Western Blot† Result Interpretation Nonreactive IgG/IgM No serological evidence of exposure to B. burgdorferi. Reactive IgG only Consistent with past exposure to B. burgdorferi or past acute Lyme disease Reactive IgM only Consistent with acute Lyme disease, although IgM antibody may persist. Reactive IgG/IgM Consistent with a recent active infection with B. burgdorferi. *Result discrepancies of the conventional Lyme ELISA and Western blot may occur as a function of cross-reacting antibodies, diminishing antibody response, or nonspecific binding of immunogenic proteins to the solid phase. Strong cross-reacting, nonspecific antibodies, such as gp41, gp60, and gp66 may produce false-positive EIA results. †All results must be interpreted with respect to the patient’s clinical signs and symptoms. Clinical Utility:Following the two-tier test algorithm proposed by the CDC for assessment of exposure to B. burgdorferi during early and late stage disease, both EIA IgM and IgG antibody responses to B. burgdorferi in human serum, are confirmed by using an immunoblot (IB) method where whole-cell sonicate (WCS) B. burgdorferi antigens are utilized in identifying B. burgdorferi specific antigen binding reactivity.

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Lyme IgG/IgM
See Lyme Disease Antibody Profile

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Lyme, PCR, Blood		Test Code: LYPRB
Includes:	Lyme DNA PCR, Blood
CPT:	87476
Alternate Name:	Borrelia burgdorferi PCR, Blood Lyme Disease Molecular detection, PCR, blood
Methodology:	Polymerase Chain Reaction (PCR)
Testing Schedule:	Routine, 3 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	2 mL whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
•Refrigerate as whole blood in original tube. •DO NOT centrifuge, aliquot, refrigerate or freeze.
Reference Range:
Not detected.
Clinical Utility:
• Confirmation of active Lyme disease: • Monitoring Lyme disease treatment • Diagnosing and monitoring Lyme arthritis PCR testing should be limited to patients with at least an equivocal or positive serologic test for antibody to Borrelia burgdorferi.

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Lyme, PCR, Cerebrospinal Fluid		Test Code: LYPRC
Includes:	Lyme DNA PCR, CSF
CPT:	87476
Alternate Name:	Borrelia burgdorferi PCR, CSF
Methodology:	Real Time (PCR)
Testing Schedule:	Routine, 3 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL sterile cerebrospinal fluid
Container:	Sterile conical tube
Special Instructions and/or Comments:
• DO NOT centrifuge. • Refrigerate NOTE: Can be kept refrigerated up to 7 days before testing. For longer storage, freeze.
Reference Range:
Not detected.
Clinical Utility:
Confirmation of active Lyme disease. Monitoring of lyme disease treatment. This real-time PCR assay uses primers and probe that do not cross-react with other tick-borne pathogens .

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Lyme PCR, Synovial fluid		Test Code: LYSYN
CPT:	87476
Alternate Name:	Borrelia burgdorferi PCR, Synovial fluid
Methodology:	Real Time PCR
Testing Schedule:	Routine, 3 times per week
Specimen Requirements:
Minimum Volume:	1mL Synovial
Container:	Sterile plastic vial, no additive
Special Instructions and/or Comments:
Do not centrifuge. Freeze, once frozen transport submerged in dry ice. NOTE: Please provide source (ie. right knee)
Reference Range:
Not detected
Clinical Utility:
Useful for confirmation of active lyme disease, diagnosing and monitoring Lyme arthritis, monitoring lyme disease treatment.

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Lyme, PCR, Tick Only		Test Code: LYPRT
CPT:	87476
Methodology:	Real-time PCR
Testing Schedule:	Routine, 2 times per week
Report Available:	5-7 days
Specimen Requirements:
Minimum Volume:	Isolated tick
Container:	Sterile container or tube
Special Instructions and/or Comments:
•DO NOT place tick in alcohol or any type of preservative solution •Store at room temperature
Reference Range:
Not Detected
Clinical Utility:
Detection of Borrelia burgdorferi DNA in clinical specimens can aid in diagnosis of Lyme disease in suspected patients. This real-time PCR assay uses primers and probe that do not cross-react with other tick-borne pathogens.

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Lyme Test Index		Test Code: LYMTI
CPT:	82040, 82042, 82784(X2), 86618(X4)
Alternate Name:	• CSF/Serum Index • Borrelia burgdorferi Lyme Index
Methodology:	Immunoassay Nephelometric
Testing Schedule:	Routine, 1 time per week
Specimen Requirements:
Minimum Volume:	2mL Serum AND 2mL CSF
Container:	Gold top (serum separator) tube AND sterile conical tube
Special Instructions and/or Comments:
• Testing cannot be performed unless both cerebrospinal fluid and serum are submitted • Refrigerate
Reference Range:
Accompanies Report
Clinical Utility:
The Borrelia burgdorferi Antibody Index is used as an aid in the diagnosis of neuroborreliosis. An increased Borrelia burgdorferi Antibody Index (>1.2), accompanied by a control Antibody Index of less than 1.0 and an Albumin Ratio of less than 0.0078, is strong evidence for intrathecal synthesis of organism-specific antibody and thus CNS involvement by B. burgdorferi. Evaluation of either the control antibody index, the Albumin Ratio, or both may indicate leakage of antibody across the blood-brain barrier, which may falsely elevate the B. burgdorferi Antibody Index..

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Lyme WB
See Lyme Disease Antibody, Western Blot

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Lyme Western Blot
See Lyme Disease Antibody, Western Blot

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Lymphocyte Subset Profile		Test Code: LSUBP
Includes:	•CD45 Total Lymph Count •Absolute B cells and % B cells (CD19) •Absolute T cells and % T cells (CD3) •Absolute Helper cells and % Helper cells (CD4) •Absolute Suppressor cells and % suppressor cells (CD8) •Helper/Suppressor Ratio (CD4/CD8 Ratio) •Absolute NK cells and % NK cells (CD3-CD56+)
CPT:	86355, 86357, 86359, 86360
Methodology:	Flow Cytometry (FCM)
Testing Schedule:	Routine, daily Monday- Friday
Report Available:	2-4 days
Specimen Requirements:
Minimum Volume:	0.5 mL whole blood
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
Call laboratory for holiday collection instructions.Store as whole blood in original tube at room temperature.DO NOT centrifuge, aliquot, refrigerate or freeze.The Department of Health requires mandatory reporting of any abnormal CD4 result.
Reference Range:
See report.
Clinical Utility:
Monitor patient’s individual T, B, and NK cell populations to infer cellular and humoral immune status.

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Lymphocytic choriomeningitis Virus Antibody Profile		Test Code: LCMVP
Includes:	IgG and IgM Antibodies
CPT:	86727 (x2)
Alternate Name:	LCM Antibodies
Methodology:	Indirect Fluorescent Antibody (IFA)
Testing Schedule:	Routine, 2 times per week
Report Available:	3-5 days
Specimen Requirements:
Minimum Volume:	1 mL serum
Container:	Gold top (serum separator) tube
Special Instructions and/or Comments:
Refrigerate
Reference Range:
•IgG .......<1:16 •IgM ......<1:20
Clinical Utility:
Antibody to LCM is often detectable within a few days of clinical symptoms. An elevated IgM titer is indicative of recent or current infection. A four-fold rise in IgG titer between acute and convalescent specimens also indicates recent infection.

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Lysosomal Enzyme		Test Code: LYEN
CPT:	82657
Methodology:	Enzyme Analysis
Testing Schedule:	Volume dependent
Report Available:	4-6 weeks
Specimen Requirements:
Minimum Volume:	5 mL whole blood
Container:	Green top (sodium heparin) tube
Special Instructions and/or Comments:
•Collect Monday-Thursday ONLY before 1400, no holidays.Specimens must arrive in the laboratory no later than 1600. •Store as whole blood in original tube at room temperature. •DO NOT centrifuge, aliquot, refrigerate or freeze.
Reference Range:
Useful for diagnosing lysosomal storage disease.

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Lysozyme		Test Code: LYZYM
See Electrolytes, Serum
CPT:	85549
Alternate Name:	Muramidase
Methodology:	Turbidimetric
Testing Schedule:	Routine Mon.-Fri. ONLY
Specimen Requirements:
Minimum Volume:	3 mL (1 mL minimum) EDTA plasma
Container:	Lavender top (EDTA) tube
Special Instructions and/or Comments:
Centrifuge, transfer to plastic aliquot tube and freeze. Once frozen, transport specimen submerged in dry ice.
Reference Range:
0.2 to 15.8 ug/mL
Clinical Utility:
Useful for confirming marked increases in the granulocyte or monocyte pools as in granulocytic or monocytic leukemias, myeloproliferative disorders, and malignant histiocytosis. Also used for following the course of therapy in cases of chronic granulocytic or chronic monocytic leukemias.

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Lytes, Urine
See Electrolytes, Urine