Eosinophil Count, Nasal

Infectious Disease Laboratories : Microbiology

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. Eosinophil Count, Nasal
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

EOSN/Quest

Specimen Type:

Nasal

Tube Type:

Sterile Flocked Nasal Swab

Cause for Rejection:

Poor smear quality

Storage:

Room Temperature

Availability:

Sent to Reference Laboratory

Methodology:

Microscopic Examination/Wright's Stain

Special Instructions:

Collect 1 Nasal Flocked Swab. Deliver to the laboratory ASAP. Lab - Make two air-dried slides (minimum one air-dried slide).

TAT:

1-2 days

CPT Code:

89190

Synonyms:

Eos, nasal Nasal Eosinophils

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