Transplant Monitor

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. Transplant Monitor
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

CD3PR SUMMA

Specimen Type:

Blood

Tube Type:

Purple top (EDTA): Whole Blood

Collection Volume:

5.0 mL (minimum 3.0 mL)

Cause for Rejection:

Clotted, refrigerated, or frozen

Storage:

Ambient

Availability:

Sent to reference lab

Methodology:

Flow Cytometry

Special Instructions:

Do not refrigerate specimen.

Lab/Phone:

330-543-8418

TAT:

72 hours

Additional Info:

Reference range is available on patient report

CPT Code:

88180

Panel Includes:

CD2, CD3 and CD25

Synonyms:

While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. It brings the entire family together for emotional support and understanding across multiple locations to reach you in the community where you live. Learn more...