Centralized Core Laboratory - Toxoplasma Serology Lab :
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. Toxoplasma PCR, Palo Alto
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SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
TOPCR
Test Workstation :
TSL
Specimen Type:
Amniotc Fluid
Tube Type:
Sterile Container
Collection Volume:
10 mL
Minimum Volume:
3.0 mL
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Polymerase Chain Reaction (PCR)
Special Instructions:
Specimen collected at greater than or equal to 18 weeks gestation.
Specimens received by noon (PST) on Tuesday will have verbal results available Wednesday p.m. (PST). Specimens received by noon (PST) on Friday will have verbal results available by 4 p.m. (PST).
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference range is available on patient report
CPT Code:
87798
Toxoplasma PCR, Palo Alto
Test ID/Workstation :
TOPCR
Specimen Type:
Amniotc Fluid
Tube Type:
Sterile Container
Collection Volume:
10 mL
Storage:
Frozen
Availability:
Sent to reference lab
Methodology:
Polymerase Chain Reaction (PCR)
Special Instructions:
Specimen collected at greater than or equal to 18 weeks gestation.
Specimens received by noon (PST) on Tuesday will have verbal results available Wednesday p.m. (PST). Specimens received by noon (PST) on Friday will have verbal results available by 4 p.m. (PST).
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference range is available on patient report
CPT Code:
87798
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