Anti-Enterocyte Antibodies

Centralized Core Laboratory : Chemistry

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-Enterocyte Antibodies
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

EPICA MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant)tube

Collection Volume:

2.5 mL

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Indirect Immunofluorescence

Special Instructions:

Must be accompanied by and Anti-Enterocyte Clinical Form.

Lab/Phone:

330-543-8418

TAT:

4-8 weeks

Additional Info:

Reference range:

IgG: Negative

IgA: Negative

IgM: Negative

CPT Code:

88346, 88350

Synonyms:

Anti-Epithelial Cell Ab

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Anti-Enterocyte Antibodies

Centralized Core Laboratory : Chemistry

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