Herpesvirus-6 PCR, Cincinnati Child.

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. Herpesvirus-6 PCR, Cincinnati Child.
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

HV6CC

Test Workstation :

CINCI

Specimen Type:

Blood or Bone Marrow

Tube Type:

Purple top (EDTA) tube

Collection Volume:

5.0 mL (minimum 2.0 mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Polymerase Chain Reaction (PCR)

Special Instructions:

Also acceptable any fluid (0.2 mL); tissue (25 mg) fresh; 2.0 mL Sodium Heparin (Whole Blood)

Lab/Phone:

330-543-8418

TAT:

3-5 days

Additional Info:

Reference range: Negative

CPT Code:

87532