Trichinella IgG Ab
| 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. Trichinella IgG Ab | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
TRICG
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Red Top Tube(no additive)
Collection Volume:
2.5 mL (minimum 0.5 mL)
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Enzyme-Linked Immunosorbent Assay
Special Instructions:
Used to screen for trichinella exposure. This test is not diagnostic and must be correlated with supporting patient history and pathological findings.
Lab/Phone:
330-543-8418
TAT:
4-11 days
Additional Info:
Reference range: Negative
CPT Code:
86784
