Chlamydia trachomatis / Neisseria gonorrhoeae DNA PCR Panel
| PATIENT INFO |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
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| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Chlamydia trachomatis / Neisseria gonorrhoeae DNA PCR Panel | |
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| SPECIMEN INFO |
| Collection Date & Time: |
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5 mL first-catch urine collected in sterile container.
GeneXpert swab collected from vaginal/endocervical source in GeneXpert swab transport reagent tube.

