Epstein-Barr Virus (EBV), Qualitative PCR

Molecular Diagnostics - : DNA

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. Epstein-Barr Virus (EBV), Qualitative PCR
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

LAB3335/EBVPC

Test Workstation :

DNA2

Specimen Type:

2 mL blood collected in one EDTA (purple top) tube.
2.0 mL bronchoalveolar lavage (BAL) or bronchial wash collected in sterile container.
0.5 mL cerebrospinal fluid (CSF) collected in sterile container.

Minimum Volume:

Plasma minimum volume is 0.5 mL.
CSF minimum volume is 0.2 mL.
BAL and bronchial wash minimum volume is 1.2 mL.

Cause for Rejection:

Quantity not sufficient, specimen clotted, improper anticoagulant, improper specimen type, improper storage/transport, mislabeled, or unlabeled.

Storage:

Refrigerated

Availability:

Mon-Fri (7:30-16:00)

Methodology:

Real-time Polymerase Chain Reaction

Special Instructions:

Upon arrival in laboratory, promptly centrifuge blood specimen tube and send 1.0 mL of the plasma to the Molecular laboratory. Refrigerate.

Lab/Phone:

330-543-8722

TAT:

1-3 days

CPT Code:

87798

Synonyms:

Epstein Barr Virus DNA; EBV DNA

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Epstein-Barr Virus (EBV), Qualitative PCR

Molecular Diagnostics - : DNA

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