Coccidiodes Abs

Infectious Disease Laboratories : Immunology

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. Coccidiodes Abs
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

COCID CLEVE

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

7.5 mL (minimum 1.5 mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Complement Fixation (CF) / Immunodiffusion (ID)

Special Instructions:

Separate serum from cells ASAP or within 2 hours of collection and transfer serum to an aliquot tube. Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens; please mark specimens as "acute" or "convalescent." For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).

Lab/Phone:

330-543-8418

TAT:

2-4 days

Additional Info:

Reference range is available on patient report

CPT Code:

86635 X 2