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

Chlamydia/Gonorrhoeae Amplified RNA

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. Chlamydia/Gonorrhoeae Amplified RNA  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CGRNA
Test Workstation :
MAYO
Specimen Type:
Urine
Tube Type:
Sterile Urine Container
Collection Volume:
Refrigerated 20-50 mL random urine in sterile container
Cause for Rejection:
Unlabeled specimen, QNS, contaminated
Storage:
Refrigerated
Availability:
Sent to reference laboratory
Methodology:
Transcription Mediated Amplification
Special Instructions:
Collection Instructions: 1. Patient should not have urinated for at least 1 hour prior to specimen collection. 2. Patient should collect first portion of random voided urine (first part of stream) into a sterile, plastic, preservativefree container.
Lab/Phone:
330-543-8418
TAT:
1-4 days
CPT Code:
87591 and 87491
Panel Includes:
Chlamydia Amplified RNA and Gonorrhoeae Amplified RNA

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