Rubella IgM Ab
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Rubella IgM Ab | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
RUBLM
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Gold top SST (serum separator tube, no anticoagulant)
Collection Volume:
2.5 mL (minimum 1.5 mL)
Cause for Rejection:
Contaminated, heat inactivated, or grossly hemolyzed specimens are unacceptable.
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Semi- Quantitative Chemiluminescence Immunoassay (CLIA)
Special Instructions:
Allow specimen to clot completely at room temperature.
Remove serum from cells ASAP. Parallel testing is preferred and convalescent specimens MUST be received within 30 days from receipt of the acute specimens; please mark specimens as "acute" or "convalescent".
Lab/Phone:
330-543-8418
TAT:
1-3 days
Additional Info:
Reference range:
< or = 19.9 AU/ml: Not Detected
20.0-24.9 AU/mL: Indeterminate
> or = 25.0 AU/mL: Detected
CPT Code:
86762
