HIV-1 Antibody, Rapid
| 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 Antibody, Rapid | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
HVRAP
Test Workstation :
MCHM
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube - Serum
Collection Volume:
3.0 mL (minimum 1.0 mL)
Cause for Rejection:
Grossly hemolyzed, Grossly lipemic
Storage:
Ambient
Availability:
Daily, 24 hours, STAT
Methodology:
Rapid Immunoassay
Special Instructions:
Test cannot be individually ordered. This test is part of the "Blood and Body Fluid Exposure, Patient" Test. Notify Employee Health in the event of a Blood and Body Fluid Exposure.
Lab/Phone:
330-543-8418
TAT:
2 hours
Additional Info:
Reference range: Nonreactive
CPT Code:
86701
