HIV-1 Antibody, Rapid

Centralized Core Laboratory - : Chemistry

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. HIV-1 Antibody, Rapid
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

HVRAP

Test Workstation :

MCHM

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube - Serum

Collection Volume:

3.0 mL (minimum 1.0 mL)

Cause for Rejection:

Grossly hemolyzed, Grossly lipemic

Storage:

Ambient

Availability:

Daily, 24 hours, STAT

Methodology:

Rapid Immunoassay

Special Instructions:

Test cannot be individually ordered. This test is part of the "Blood and Body Fluid Exposure, Patient" Test. Notify Employee Health in the event of a Blood and Body Fluid Exposure.

Lab/Phone:

330-543-8418

TAT:

2 hours

Additional Info:

Reference range: Nonreactive

CPT Code:

86701

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HIV-1 Antibody, Rapid

Centralized Core Laboratory - : Chemistry

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