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Akron Children's > For Healthcare Professionals > Lab Tests : Akron | Mahoning Valley

Cytomegalovirus (CMV), Qualitative PCR - Neonatal Screen, Urine

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. Cytomegalovirus (CMV), Qualitative PCR - Neonatal Screen, Urine  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
LAB1332
Specimen Type:
Urine
Collection Volume:
Urine: 2.0 mL collected in a Sterile Container (0.2 mL minimum)
Cause for Rejection:

Quantity Not Sufficient
Specimen Not Received
Specimen Mislabeled
Specimen Not Labeled
Broken/Spilled in Transport
Hemolyzed
Specimen Clotted
Unacceptable Type or Source Submitted
Wrong Container
Improperly Preserved/Processed
Sample Stored at Incorrect Temperature
Sample Exceeds Holding Time

Storage:
Refrigerated
Availability:
Mon-Fri (7:30-16:00)
Methodology:
Real-Time Polymerase Chain Reaction
Special Instructions:
Testing for patients <= 4 weeks of age ONLY.
Lab/Phone:
330-543-8722
TAT:
1-3 days
CPT Code:
87496
Synonyms:
CMV DNA
CMVQL

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