Neonatal CMV Screen

Molecular Diagnostics - : DNA

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. Neonatal CMV Screen
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

CMVNE/DNA2

Specimen Type:

0.5 mL urine collected in sterile container.

Minimum Volume:

Specimen minimum volume is 0.2 mL.

Cause for Rejection:

Quantity not sufficient, improper specimen type, improper storage/transport, mislabeled, or unlabeled.

Storage:

Refrigerated

Availability:

Mon-Fri (7:30-16:00)

Methodology:

Real-time Polymerase Chain Reaction

Special Instructions:

Testing for patients <= 4 weeks of age ONLY.

Lab/Phone:

330-543-8722

TAT:

1-3 days

CPT Code:

87496

Synonyms:

CMV PCR Cytomegalovirus PCR

While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. It brings the entire family together for emotional support and understanding across multiple locations to reach you in the community where you live. Learn more...