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    Laboratory Services Section
    MC 1947
    PO Box 149347 Austin, TX 78714-9347
    1100 W. 49th Street
    Austin, TX 78756-3199

    Phone: (512) 776-7318
    Fax: (512) 776-7294

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Microbiology Laboratory Tests: Anaerobic Bacterial Culture to Aspergillosis

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Microbiology
Anaerobic Bacterial Culture, Special (Isolation)
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Test Includes: Rapid ANA II, API AnaID, GLC, conventional biochemicals

Reporting

Results Available: 7-14 days Contact #s: (512) 458-7582

Reference

Method: Rapid ANA II, API AnaID, GLC, conventional biochemicals  
Turnaround Time:  7-14 days Reference Range:  No anaerobes isolated
Limitations: Transport method must be suitable for anaerobic conditions or organisms may not be viable for testing. Culture results may require additional clinical information about how specimen was obtained. Since many of these organisms are members of endogenous flora of the skin, oral cavity, genital tract, and gut, contamination by the normal flora during specimen acquisition is often a problem. Interpretation: Interpretation of culture results may require additional clinical information about how the specimen was obtained.

Specimen Requirements

Specimen Collection: Needle aspirates, abscess drainage. Swab collection is discouraged. Sample Type: Deep wounds; sterile fluids; abscess material.
Volume/Amount Required: aspirates or drainage >1mL. Tissues: small piece Preferred Specimen:  Deep wounds, sterile fluids, abscess material, tissue in anaerobe transport (stools for botulism only)
Collection/Preservation: Must be collected and shipped under anaerobic conditions. Storage Instructions: Store under anaerobic conditions.
Causes for Rejection: Shipped under aerobic conditions; no identifying markers on sample and/or paperwork, Sample Container: Sterile specimen collector designed to maintain anaerobic atmosphere
Sample Test Kit: Rapid ANA, API ANAID Availability: Tested Monday – Friday
Diagnostic Information:  Please indicate suspected organism(s) when submitting specimen. Culture includes the identification of the predominant organism or pathogen(s). For Clostridium botulinum see Botulism Culture –(Isolation).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handled as body fluids using universal precautions.
Transport Temperature: 2-8° C Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87073, 87075 Fees:


Microbiology
Anaerobic Bacterial Culture (Identification)
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Test Includes: Rapid ANA II, API anaID, GLC, conventional biochemicals

Reporting

Results Available: 7-14 days Contact #s: (512) 458-7582

Reference

Method: Rapid ANA II, API anaID, GLC, conventional biochemicals.
Turnaround Time:  7-14 days Reference Range:  By report
Limitations: Transport method must be suitable for anaerobic conditions or organisms may not be viable for testing. Interpretation: Interpretation of culture results may require additional clinical information about how the specimen was obtained.

Specimen Requirements

Specimen Collection: Dependent upon type of specimen to test. Sample Type: Pure culture under anaerobic conditions.
Volume/Amount Required: one specimen isolate per patient Preferred Specimen:  Pure Culture under anaerobic conditions.
Collection/Preservation: Must be collected under anaerobic conditions. Storage Instructions: Store under anaerobic conditions, ambient temperature.
Causes for Rejection: Shipped under aerobic conditions. Sample Container: Anaerobic containers required.
Sample Test Kit: Availability: Tested Monday – Friday.
Diagnostic Information:  Please indicate suspected organism(s) when submitting specimen. Anaerobic bacteria referred to TDSHS for complete identification or confirmation. Routine susceptibilities are not performed at TDSHS

Specimen Submission

Required Request Form: G-2B Specimen Handling: Specimen handled as Infectious agent
Transport Temperature:  Ambient temperature. Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87075 Fees:


Microbiology
Anaerobic Bacterial Toxin Detection (Isolation)
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Test Includes: Small animal inoculation, conventional biochemicals, Rapid ANA, API anaID

Reporting

Results Available: 2-10 days Contact #s: (512) 458-7185

Reference

Method: Small animal inoculation, conventional biochemicals, Rapid ANA, API anaID
Turnaround Time:  2-10 days Reference Range:  No toxin detected
Limitations: Ability to determine presence of toxin is dependent on ability to demonstrate protection with antitoxin. Interpretation: No toxin detected indicates that there was no detectable toxin present in the specimen for Clostridium botulinum. This does not preclude other bacterial toxins.

Specimen Requirements

Specimen Collection: venipuncture, bowel movement, water enema Sample Type: Stool, serum
Volume/Amount Required: 15-20 mL serum
25-50 g stool; infant botulism: 2 mL serum, as much stool as possible.
Preferred Specimen:  Stool, Serum
Collection/Preservation: Specimens Storage Instructions: 2-8° C
Causes for Rejection: Clinical history not consistent with botulism or no clinical history provided. Insufficient sample. Sample Container: Tightly sealed, sterile leak proof container; sterile screw cap tube for serum
Sample Test Kit: Rapid ANA; API anaID Availability: Routinely Monday-Friday, With telephone notification Saturday-Sunday
Diagnostic Information:Clostridium botulinum, Clostidium septicum, See Botulism Culture –(Isolation)

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handled as infectious and toxic agent using universal precautions. (C botulinum toxin is one of the most powerful natural toxins known)
Transport Temperature: 2-8°C Shipping Requirements: Overnight shipment, Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87001 Fees:


Microbiology
Anaerobic Bacterial Toxin Detection (Identification)
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Test Includes: Small animal inoculation, conventional biochemicals, Rapid ANA, API anaID

Reporting

Results Available: 2-10 days Contact #s: (512) 458-7582

Reference

Method: Small animal inoculation, conventional biochemicals, Rapid ANA, API anaID
Turnaround Time:  2-10 days Reference Range:  No toxin detected
Limitations: Culture must be viable Interpretation: No toxin detected indicates that there was no detectable toxin present in the specimen.

Specimen Requirements

Specimen Collection: n/a Sample Type: Pure culture
Volume/Amount Required: one isolate per patient Preferred Specimen:  Pure cultures, 24 hour growth
Collection/Preservation: Isolated should be maintained for viability until shipment has been verified. Storage Instructions: ambient temperature
Causes for Rejection: Specimen broken, transported aerobically. Sample Container: Anaerobic transport tube or plate system.
Sample Test Kit: Rapid ANA, API anaID Availability: Test performed Monday-Friday
Diagnostic Information:  Clostridium botulinum see Botulism Culture  (Toxin Detection), Clostidium septicum, Clostridium tetani, see Tetanus (Culture – Identification)

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agent
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87001 Fees:



Microbiology
Anthrax Culture (Isolation)
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Test Includes: Conventional biochemical methods, PCR, DFA

Reporting

Results Available: 3-5 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemical methods, PCR, DFA  
Turnaround Time:  Preliminary 1 day after receipt; Final 3-5 days after receipt Reference Range:  None isolated
Limitations: Quality of specimen collection will affect the ability to isolate pathogenic organisms from clinical specimens. Interpretation:

Specimen Requirements

Specimen Collection: Intestinal specimens: Should be obtained early in course of illness. Freshly passed stools are better than rectal swabs. Sample Type: Exudate; Blood; Sputum; CSF; Tissue
Volume/Amount Required: Preferred Specimen:  Exudate; Blood; Sputum
Collection/Preservation: Storage Instructions: Do not freeze or refrigerate whole blood. Keep stools, tissue, body fluids, wound exudates, and sputum at 2-8°C.
Causes for Rejection: Insufficient amount of sample to test due to leakage or other circumstances; no identifying marks on sample and/or paperwork; name discrepancies. Sample Container: Stool- sterile feces container
Rectal swab: Aimes, Stuart’s or Cary Blair transport tube
Blood: Tiger top vacutainer
Body fluids: Sterile collection tube
Sample Test Kit: Availability: Tested Monday-Friday. With notification Saturday and Sunday.
Diagnostic Information:  Prior notification is requested.  (512) 458-7185.  Bioterrorism Investigation Section. CDC serology available only with prior approval and with submission of patient history.  Reports of confirmed Bacillus anthracis will be called to the submitter immediately upon completion of testing.  Please insure that an accurate telephone number and contact name is included on the submission form. For suspected Bioterrorism agents, see Bioterrorism agents (Clinical -Isolation).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Universal precautions
Transport Temperature:  2-8°C Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87076 Fees:


Microbiology
Anthrax Culture (Identification)
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Test Includes: Conventional biochemical methods, PCR, DFA

Reporting

Results Available: 3-5 days Contact #s: (512) 458-7185

Reference

Method: Conventional biochemical methods, PCR, DFA  
Turnaround Time:  Preliminary 1 day after receipt; Final 3-5 days after receipt Reference Range:  By report
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Dependent upon type of specimen to be tested. Sample Type: Pure culture
Volume/Amount Required: 1 slant or agar plate Preferred Specimen:  Pure Culture safely contained
Collection/Preservation: Ambient temperature Storage Instructions: Store at temperature and atmospheric conditions that are suitable for growth dependent on organism.
Causes for Rejection: Insufficient amount of sample to test; no identifying markers on sample and/or paperwork. Sample Container: Agar slant, handled as infectious agent.
Sample Test Kit: Availability: Tested Monday-Friday
Diagnostic Information:  Prior notification is requested.  (512) 458-7185.  Bioterrorism Investigation Section. CDC serology available only with prior approval and with submission of patient history.  Reports of confirmed Bacillus anthracis will be called to the submitter immediately upon completion of testing.  Please insure that an accurate telephone number and contact name is included on the submission form. For suspected Bioterrorism agents, see Bioterrorism agents (Referred -identification) For PCR testing see: Bioterrorism agents (Referred Identification - PCR).

Specimen Submission

Required Request Form: G-2B Specimen Handling: Handled as infectious agent using universal precautions.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87073, 87075 Fees:


Microbiology
Anthrax (Serological)
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Test Includes: EIA for total anthrax antibodies

Reporting

Results Available: 3 weeks Contact #s:512-458-7760

Reference

Method: EIA  
Turnaround Time:  3 weeks Reference Range:  <1.00
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. Interpretation: Nonreactive

Specimen Requirements

Specimen Collection: Venipuncture Sample Type: Serum
Volume/Amount Required: 10 mL whole blood Preferred Specimen:  Serum, Paried Serum
Collection/Preservation: Red top or tiger top tube Storage Instructions: Do not freeze whole blood. Separate serum from the clot if possible store in a screw cap vial
Causes for Rejection: Discrepancy between name on tube and name on form, insufficient quantity of serum for testing, hemolysis Sample Container: red top or tiger top vacutainer
Sample Test Kit: Availability: Specimen will be sent to the CDC in Atlanta
Diagnostic Information:  Prior notification is requested, 512-458-7760.  A single serum specimen is acceptable, however, in order to determine if it is a recent infection, an acute and convalescent specimen drawn at least 14-16 days apart is necessary. A detailed patient history is required. Forwarded by TDSHS to CDC for testing.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Use Universal Precautions
Transport Temperature:  Ambient temperature for specimens on the blood clot, separated serum at 2-8°C (refrigerated) or -20°C (frozen). Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8°C), or frozen (-20°C) and mailed on dry ice.

Billing

CPT Code: 87001 Fees:


Microbiology
Arbovirus (Culture-Isolation)
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  5-15 days Reference Range:  No virus isolated
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Brain, Blood/Serum (See notes)
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Host systems which support the growth of a variety of arboviruses (including California Group, Eastern Equine, St. Louis, Venezuelan Equine, Western Equine Encephalitis, and West Nile viruses) are inoculated and observed for 10-14 days.  If signs of viral infection are detected, identification tests will be performed. For arboviral surveillance program, see Mosquitoes (Culture - Virus Isolation).

Specimen Submission

Required Request Form: G-2A Specimen Handling:
Transport Temperature: Shipping Requirements:

Billing

CPT Code: 86790, 86652, 86653, 86654, 86651 Fees:


Microbiology
Arbovirus (Culture-Identification)
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:  
Turnaround Time:  5-14 days Reference Range:  By Report
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Clinical isolate
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Identification is based on immunofluorescence tests.           

Specimen Submission

Required Request Form: G-2A Specimen Handling:
Transport Temperature: Shipping Requirements:

Billing

CPT Code: 86790, 86652, 86653, 86654, 86651 Fees:


Microbiology
Arizona Salmonella (Arizona) Culture (Isolation)
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Test Includes: Conventional biochemicals, serological typing

Reporting

Results Available: 3-7 days Contact #s: (512) 458-7582

Reference

Method: Conventional biochemicals, serological typing  
Turnaround Time:  3-7 days Reference Range:  No Salmonella (Arizona) isolated
Limitations: Specimen should be collected before antibiotic treatment has been initiated. Interpretation: A preliminary report can be issued as soon as a presumptive identification of Salmonella is obtained through either biochemical or serological “O” studies. A confirmed identification is issued when both biochemical and serological methods are completed.

Specimen Requirements

Specimen Collection: Passed liquid or stool, venipuncture Sample Type: feces, rectal swab, blood (typhoid fever)
Volume/Amount Required: > 2 mL or 10 g Preferred Specimen:  10 g fresh stool in enteric transport, blood (typhoid fever)
Collection/Preservation: Collect passed liquid or stool into a clean, dry container. Transport < 24 hours, 4°C. 
If unable to transport within 24 hours, place in enteric transport, 4°C or ambient temperature.
Blood: Collect blood by venipuncture, specimen held at ambient temperature.
Storage Instructions: 4°C < 24 hours.
Causes for Rejection: Unpreserved and > 4°C for > 24 hours. Sample Container: Sterile feces container or clean, dry container. Enteric transport collector.
Sample Test Kit: n/a Availability: Monday-Friday. Outbreak investigations with prior notification Saturday-Sunday.
Diagnostic Information:  Fecal specimens are accepted only with prior approval.  Isolates will be identified as Salmonella species.  See Salmonellosis Culture –(Typing). Cultures include selective and enrichment procedures for isolation of Campylobacter, Vibrio, Salmonella, Shigella, Yersinia, E. coli O157:H7, and Toxigenic E. coli.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids using universal precautions.
Transport Temperature:  2-8° C Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87045 Fees:


Microbiology
Arizona Salmonella (Arizona) Culture (Identification)
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Test Includes: Conventional Biochemical studies, Serological typing, Pulse-Field Gel Electrophoresis

Reporting

Results Available: 7-14 days Contact #s: (512) 458-7784

Reference

Method: API 20E, Conventional biochemicals, Serological typing “O” , “H” , and Vi determination, Pulse-Field Gel Electrophoresis
Turnaround Time:  7-14 days Reference Range:  By Report
Limitations: Organism must be viable and in pure culture. Interpretation: Determination of the “O” and “H” antigens allows for complete serological typing of the organism. Pulse-Field Gel Electrophoresis is performed to determine relatedness to other strains identified.

Specimen Requirements

Specimen Collection: Sample Type: Pure culture
Volume/Amount Required: One specimen per patient Preferred Specimen:  Pure culture on agar slant
Collection/Preservation: 24 hour growth on agar slant Storage Instructions: Ambient temperature
Causes for Rejection: Broken specimen Sample Container: Agar slant in test tube.
Sample Test Kit: Availability: Test performed Monday-Friday
Diagnostic Information:  Organisms will be identified as Salmonella species.  See Salmonellosis Culture –(Typing)

Specimen Submission

Required Request Form: G-2B Specimen Handling: Infectious agents handled using universal precautions.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for infectious agents.

Billing

CPT Code: 87045 Fees:


Microbiology
Ascariasis (Microscopic - Direct Concentration)
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Test Includes: Microscopic examination, direct concentration

Reporting

Results Available: 1 day Contact #s: (512) 458-7760

Reference

Method: Microscopic examination, direct concentration  
Turnaround Time:  24 hours Reference Range: No parasites found
Limitations: Parasites or ova must be visible under microscopic examination. Interpretation: No parasites found indicates that there were no visually detectable parasites in the specimen.

Specimen Requirements

Specimen Collection: Fecal specimens must be sent in as fresh (less that five hours) or in formalin. Sample Type: Feces; Worm; Sputum; Tissue Section
Volume/Amount Required: stool 10 g Preferred Specimen:  Feces; Worm; Sputum; Tissue Section
Collection/Preservation: Fecal specimens must be sent in as fresh (less that five hours) or in formalin. Storage Instructions: Ambient temperature
Causes for Rejection: Specimen not preserved and too old. Sample Container: Clean, dry container, tightly sealed.
Sample Test Kit: Availability: Monday-Friday
Diagnostic Information:  Detection of eggs in fecal specimens must be sent in as fresh (less that five hours) or in formalin. Adult worms should be submitted in ethyl alcohol or formalin. Referred material accepted from hospital, private, and reference labs.

Specimen Submission

Required Request Form: G-2B Specimen Handling: Body fluids handled with universal precautions. Formalin is a poison, handle with caution.
Transport Temperature:  Ambient temperature Shipping Requirements: Triple contained in accordance with federal shipping regulations for diagnostic specimens.

Billing

CPT Code: 87177 Fees:


Microbiology
Aspergillosis (Culture - Isolation)
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Test Includes: Isolation of fungus and identification of Aspergillus species by morphological tests

Reporting

Results Available: 28 days Contact #s: 512-458-7455 for prior approval. 
Technical questions:  512-458-7586

Reference

Method: Slide culture  
Turnaround Time:  21-28 days Reference Range:  Negative
Limitations: Delay in transport of specimen could compromise isolation of organism. Interpretation:

Specimen Requirements

Specimen Collection: Sample Type: Clinical Specimen
Volume/Amount Required: 3 mL to 15 mL Preferred Specimen:  exudate; Tissue; Sputum
Collection/Preservation: No preservative Storage Instructions: Transport specimen as soon as possible.  If transport is delayed over one hour, refrigerate specimen. 
Causes for Rejection: Specimens received frozen, in formalin, or in culture medium will be rejected.  Swabs are discouraged unless the only specimen available; submit swabs in 5 mL sterile saline. Sample Container: Triple-contained.  Sterile, leak-proof, 50 mL conical tube preferred for primary container.  Add up to 10 mL sterile saline if needed to maintain moisture of tissue during transport.
Sample Test Kit: Availability: Testing available upon approval by Dr. Penfield.
Diagnostic Information:  Approval for this testing must be obtained prior to shipping by telephoning Dr. Susan Penfield at 512-458-7455.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Ambient acceptable but 2-8º C preferred for non-sterile specimens Shipping Requirements: Triple-contained and packaged to meet requirements of DOT, USPS, PHS, and IATA for shipping of clinical specimens.

Billing

CPT Code: 87101, 87102, 87103 Fees:


Microbiology
Aspergillosis (Culture-Identification)
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Test Includes: Morphological examination and/or physiological tests for identification of isolate

Reporting

Results Available: 7-10 days Contact #s: 512-458-7586

Reference

Method: Slide culture  
Turnaround Time:  7-10 days Reference Range:  By report
Limitations: Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: Preferred Specimen:  Pure Culture
Collection/Preservation: No preservative Storage Instructions:
Causes for Rejection: Infestation with mites Sample Container: Triple-contained
Sample Test Kit: Availability: Tested 5 days/week: Monday - Friday
Diagnostic Information:  Fungal isolates (pure culture) submitted to this Laboratory for definitive identification.  Drug susceptibility testing on these organisms not available at TDSHS laboratory.

Specimen Submission

Required Request Form: G-2B Specimen Handling:
Transport Temperature:  Room temperature Shipping Requirements: Triple-contained and packaged to meet rigorous performance tests as outlined in the DOT, USPS, PHS, and IATA regulations for shipping of infectious substances.

Billing

CPT Code:87101, 87102, 87103 Fees:


Microbiology
Aspergillosis (Serological-Immundiffusion)
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Test Includes:

Reporting

Results Available: Contact #s:

Reference

Method:
Turnaround Time:  5-7 days Reference Range:  Negative
Limitations: May not detect a recent infection, or infection in a person with a severely compromised immune system. Interpretation:

Specimen Requirements

Specimen Collection: Sample Type:
Volume/Amount Required: 2 mL serum/CSF Preferred Specimen:  Single Serum; Spinal Fluid
Collection/Preservation: Storage Instructions:
Causes for Rejection: Sample Container:
Sample Test Kit: Availability:
Diagnostic Information:  Tests are performed with standardized antigens of Aspergillusflavus, A. niger and A. fumigatus. Positive results, represented by one or more precipitin lines are indicative of fungus ball, bronchopulmonary aspergillosis (ABA) or invasive aspergillosis. One or two bands are present in any clinical phase; three or more bands indicate invasive disease. Test is performed once per week.

Specimen Submission

Required Request Form: G-2A Specimen Handling: Use Universal Precautions
Transport Temperature: Cold (2-8º C) on ice packs if received within 48 hours from time of collection.  Frozen (≤-20°) on dry ice if received more than 48 hours from time of collection. Shipping Requirements: Triple contain, separated serum may be shipped on cold packs (2-8° C), or frozen (-20° C) and mailed on dry ice.

Billing

CPT Code: 86606 Fees:
Last updated September 15, 2010