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Parvovirus B19 IgG & IgM Ab

Infectious Disease Laboratories : Immunology

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. Parvovirus B19 IgG & IgM Ab
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PARVO MAYO

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

1.5mL

Cause for Rejection:

Gross hemolysis, gross lipemia, or gross icterus

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Enzyme Immunoassay (EIA)

Lab/Phone:

330-543-8418

TAT:

2-3 days

Additional Info:

Reference range available on patient report

CPT Code:

86747x2

Panel Includes:

Parvovirus B19 IgG, Parvovirus B19 IgM

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