West Nile Virus PCR, CSF
| 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. West Nile Virus PCR, CSF | |
| 2. | |
| 3. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
WNVPR
Test Workstation :
MAYO
Specimen Type:
CSF
Tube Type:
Sterile Container
Collection Volume:
0.5 mL
Minimum Volume:
0.3 mL
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Real-Time Polymerase Chain Reaction (PCR)/RNA Probe Hybridization
Special Instructions:
Do not Centrifuge CSF. Vial number 2 is preferred, but any vial is acceptable.
Lab/Phone:
330-543-8418
TAT:
1-5 days
Additional Info:
Reference range is available on patient report
CPT Code:
87798
Synonyms:
WNV PCR, Flavivirus
