GC Culture

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. GC Culture
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

GCC MIC2

Specimen Type:

Vagina, cervix, urethra, eye, joint or body fluid

Tube Type:

ESwab

Collection Volume:

Inoculated swab

Cause for Rejection:

No swab in transport tube.

Storage:

Refrigerate Eswab if not sent to laboratory immediately. Do not refrigerate body fluids- send immediately to laboratory.

Availability:

Daily

Methodology:

Culture

Special Instructions:

GC culture is for isolation of Neisseria gonorrhoeae only. Eswab supports growth of GC. Deliver to laboratory immediately.

Lab/Phone:

330-543-8406

TAT:

72 hours

Additional Info:

Preliminary report available after 24 hours

CPT Code:

87081

Synonyms:

Neisseria gonorrhoeae Culture

Specimen Collection Procedures:

Conjunctival (Bacterial culture or Chlamydia viral culture of the eye), Genital Specimen Collection

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GC Culture

Infectious Disease Laboratories : Microbiology

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