Hepatitis B Core Total Antibody

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. Hepatitis B Core Total Antibody
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

HEPBC

Test Workstation :

E8011

Specimen Type:

Blood

Tube Type:

SST (serum separator tube, no anticoagulant)

Collection Volume:

3.0 mL (minimum 1.5mL)

Minimum Volume:

1.5 mL

Preferred Volume:

3 mL

Storage:

Shipping- Send Refrigerated; Storaged- Refrigerated: 7 days; Frozen 3 months

Availability:

24 hours/day, 7 days/week

Methodology:

Roche- Electrochemiluminescence Immunoassay

Lab/Phone:

3305438418

TAT:

4 hours

Additional Info:

Reference range available on patient report