Rheumatoid Factor IgM

Centralized Core Laboratory - Quest Diagnostics : Send Out

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. Rheumatoid Factor IgM
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

RFIGM

Test Workstation :

QUEST

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

3.0 mL

Minimum Volume:

0.8 mL

Cause for Rejection:

SST Tube

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Immunoturbidimetric

Lab/Phone:

330-543-8418

TAT:

1-7 days

Additional Info:

Reference range is available on patient report < or = 6 Negative >6 Positive

CPT Code:

83520

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