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

HIV 1 and 2 Ag and Ab Screen

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. HIV 1 and 2 Ag and Ab Screen  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
HIVD
Test Workstation :
E8011
Specimen Type:
Blood
Tube Type:
Purple top (EDTA) tube
Collection Volume:
10.0 mL (minimum 3.0 mL)
Minimum Volume:
1.5 mL (3 mL if confirmatory testing is required.)
Preferred Volume:
3 mL
Storage:
Shipping- Send Refrigerated; Storage- Room Temp: 7 days; Refrigerated: 4 weeks; Frozen: 3 months
Availability:
24 hours/day, 7 days/week
Methodology:
Roche- Electrochemiluminescence Immunoassay sandwich principle
Special Instructions:
Initially Reactive specimens will be sent out for supplemental HIV Antibody Confirmation/ Differentiation testing. If confirmatory testing is required, EDTA plasma is the only acceptable specimen type.
Lab/Phone:
330-543-8418
TAT:
4 hours
Additional Info:
Reference range: Non-Reactive
CPT Code:
87389

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