VZV IgM Ab (Mayo)

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. VZV IgM Ab (Mayo)
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

VZMAB MAYO

Specimen Type:

Blood

Tube Type:

Red top tube

Collection Volume:

2.5 mL (minimum 0.5 mL)

Cause for Rejection:

Hemolysis, Lipemia

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Immunofluorescence Assay (IFA)

Lab/Phone:

330-543-8418

TAT:

1-3 days

Additional Info:

Reference range: Negative

Days Performed:Mon-Fri; 9-3 Sat & Sun varies

CPT Code:

86787

Synonyms:

Varicella Zoster IgM

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