Bartonella henselae PCR, Tissue

Molecular Diagnostics : DNA

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. Bartonella henselae PCR, Tissue
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

BARPR/DNA2

Specimen Type:

Tissue (formalin fixed paraffin embedded FFPE tissue)

Tube Type:

Specimen container

Collection Volume:

FFPE tissue (10-15, 5 micron sections)

Storage:

FFPE - Ambient

Availability:

Mon-Fri

Methodology:

Polymerase Chain Reaction (PCR)

Lab/Phone:

330-543-8722

TAT:

2-4 days

Additional Info:

Reference Range: Negative. No Bartonella henselae DNA detected

CPT Code:

87798

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