Echinococcus Abs

- : 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. Echinococcus Abs
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

ECHNA

Test Workstation :

CLEVE

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

2.5 mL (minimum 0.5 mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Immunoblot

Special Instructions:

Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of acute specimens.

Lab/Phone:

330-543-8418

TAT:

2-6 days

Additional Info:

Reference range is available on patient report

CPT Code:

86682

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Echinococcus Abs

- : Immunology

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