| LAB | CODE | TEST NAME | CPT CODE | 
|---|---|---|---|
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB3013
                                                         
                                                 | 
                                            
                                                 
                                                                Container:
                                                                    Pink Top tube; Alternate: lav top tube (EDTA)
                                                         
                                                        
                                                                Place of Service:
                                                                    St. Michael Medical Center
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB3185
                                                         
                                                 | 
                                            
                                                 
                                                                Container:
                                                                    Pink Top tube; Alternate: lav top tube (EDTA)
                                                         
                                                        
                                                                Place of Service:
                                                                    St. Michael Medical Center
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB9013
                                                         
                                                 | 
                                            
                                                 
                                                                    86850 001 86900 001 86901 001
                                                         
                                                 | 
                            |
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB5308
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP BURLINGTON
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB43
                                                         
                                                 | 
                                            
                                                 
                                                                Container:
                                                                    Lithium Heparin/Green Top (Prefered),  
                                                        SST/Gold Top, Serum/Red Top 
                                                                Place of Service:
                                                                    St. Michael Medical Center
                                                         
                                                 | 
                                            
                                                 
                                                                    80143
                                                         
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB4500 - 811984
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    MEDTOX LABORATORIES INC
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB545
                                                         
                                                 | 
                                            
                                                 
                                                                Container:
                                                                    Red; Alternate: Na-heparin (Lt. green), SST (Gold).
                                                         
                                                        
                                                                Place of Service:
                                                                    St. Michael Medical Center
                                                         
                                                 | 
                                            
                                                 
                                                                    82009
                                                         
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB838
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP BURLINGTON
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB4500 - 510354
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP RTP
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB836
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP BURLINGTON
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB877
                                                         
                                                 | 
                                            
                                                 
                                                                Container:
                                                                    Sterile container with tight screw-cap seal or green-top (sodium heparin) tube or Isolatorâ„¢
                                                         
                                                        
                                                                Place of Service:
                                                                    LABCORP BURLINGTON
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB511
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP SEATTLE
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB512
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP BURLINGTON
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    LAB9239
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP BURLINGTON
                                                         
                                                 | 
                                            
                                                 | 
                            
| 
                                                 
                                                                    SMMC
                                                         
                                                 | 
                                            
                                                 
                                                                    Lab11692
                                                         
                                                 | 
                                            
                                                 
                                                                Place of Service:
                                                                    LABCORP
                                                         
                                                 | 
                                            
                                                 |