Influenza A/B, Qualitative NAAT

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. Influenza A/B, Qualitative NAAT
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

IDFLU

Test Workstation :

VIR1

Specimen Type:

One flocked swab in 3.0 mL M4 Viral Transport Medium collected from nasal or nasopharyngeal source.

Cause for Rejection:

Improper specimen type, improper storage/transport, improper swab, dry swab, swab not present, multiple swabs per vial, mislabeled, or unlabeled.

Storage:

Transport refrigerated required from off campus location. Upon arrival in laboratory, store refrigerated.

Availability:

Mon-Sun

Methodology:

Isothermal nucleic acid amplification.

Lab/Phone:

330-543-4863

TAT:

Two hours from the time the specimen arrives in the Akron laboratory.

CPT Code:

87502-QW

Synonyms:

Influenza; Flu