Fung Cult-Skin, Nail, Hair
| 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. Fung Cult-Skin, Nail, Hair | |
| 2. | |
| 3. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
FUNGS
Test Workstation :
MIC2
Specimen Type:
Skin, hair, or nails collected in sterile container with secure lid.
Cause for Rejection:
Quantity not sufficient, improper specimen type, improper storage/transport, mislabeled, or unlabeled.
Storage:
Transport at room temperature. Upon arrival in laboratory, store refrigerated.
Availability:
Mon-Sun (0700-1600)
Methodology:
Culture
Lab/Phone:
330-543-8406
TAT:
4 weeks
CPT Code:
87101
Synonyms:
Dermatophyte Culture
