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Akron Children's > For Healthcare Professionals > Lab Tests : Akron | Mahoning Valley

Quantiferon-TB Gold

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. Quantiferon-TB Gold  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
LAB1778
Specimen Type:
Whole Blood collected into a 6 mL Lithium Heparin tube without gel (dark green top)
Alternate Tube Type:
None
Collection Volume:
5.0 mL
Minimum Volume:
4.0 mL
Preferred Volume:
5.0 mL
Cause for Rejection:
If specimens are not collected and processed according to the collection procedure, refrigerated, frozen, or QNS specimen.
Storage:
Refrigerated
Availability:
Monday thru Friday (08:00 - 15:00)
Methodology:
Lymphocyte Stimulation with ELISA
Special Instructions:
Send immediately to the Akron Campus Centralized Core Lab (CCL). Tubes need to be processed no later than 48 hours after collection (if kept at refrigeration). CCL staff: delivery samples to Virology promptly upon receipt. It is preferred that the specimen is drawn the morning of testing and received in Akron Children's laboratory by 3:00 PM.
Lab/Phone:
330-543-8463
TAT:
48 hours
Additional Info:
Reference range available on patient report.
CPT Code:
86480

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