Eosinophil Count, Sputum

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, Sputum
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

EOSS/Quest

Specimen Type:

Sputum

Tube Type:

Sterile Container

Cause for Rejection:

poor smear quality

Storage:

Room Temperature

Availability:

Sent to Reference Laboratory

Methodology:

Microscopic Examination/Wright's Stain

Special Instructions:

Collect sputum in sterile container. Deliver to laboratory ASAP. Lab - Make two air-dried slides (Minimum one air-dried slide).

Lab/Phone:

330-543-8377

TAT:

1-2 days

CPT Code:

85999

Synonyms:

Eos, Sputum Sputum Eosinophil

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Eosinophil Count, Sputum

Infectious Disease Laboratories : Microbiology

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