We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Neutrophil Antibody

Centralized Core Laboratory : Hematology

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. Neutrophil Antibody
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

NEUAB MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

4.0 mL (minimum 1.0 mL)

Cause for Rejection:

Specimen grossly hemolyzed

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Indirect Immunofluorescence

Special Instructions:

Only pretransfusion reaction specimen is acceptable

Lab/Phone:

330-543-8418

TAT:

7-15 days

Additional Info:

Reference range: Negative

CPT Code:

86021

Synonyms:

Granulocyte Antibody; Granulocyte Serology

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