Enterovirus PCR, Plasma

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. Enterovirus PCR, Plasma
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

EVPCP / MAYO

Specimen Type:

Blood

Tube Type:

Purple Top (EDTA) tube

Collection Volume:

2.5 mL (minimum 1.0 mL)Plasma in a Purple top (EDTA) tube

Storage:

Refrigerated

Availability:

Sent to Reference Laboratory

Methodology:

Real-Time Polymerase chain Reaction (PCR)/RNA Probe Hybridization

Special Instructions:

Spin down specimen ASAP.

Lab/Phone:

330-543-8418

TAT:

1-5 days

Additional Info:

Reference Value: Negative

CPT Code:

87498

Synonyms:

Enterovirus

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Enterovirus PCR, Plasma

Centralized Core Laboratory : Chemistry

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