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Akron Children's > For Healthcare Professionals > Lab Tests : Akron | Mahoning Valley

Anti-Neutrophil Cytoplasmic Antibody

PATIENT INFO
Patient Name:
Medical Record #:
BD:       /      /         Sex:   F   M

PHYSICIAN INFO
Physician Name :
Address:
Ph: (      )      -          Fax: (      )      -       
Additional Report to:
Ph: (      )      -          Fax: (      )      -       

TESTS REQUESTED
Test Name: ICD9 Code: (required)
1. Anti-Neutrophil Cytoplasmic Antibody  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
ANCAB
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Gold top SST ( Serum Separator) tube
Collection Volume:
2.0 mL
Minimum Volume:
1.0 mL
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Multiplex Flow Immunoassay
Special Instructions:
Days Performed: MonSat
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference range: Negative
CPT Code:
86255, (plus 86256 Titer, if appropriate)

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