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Palomar Health Laboratory Services

Palomar Medical Center Pomerado Hospital Palomar Health Downtown Campus 2185 West Citracado Pkwy, 15615 Pomerado Road, 555 E. Valley Pkwy, Escondido, CA 92029 Poway CA, 92064 Escondido, CA 92025

Phone: 442-281-1571 Phone: 858-613-4358 Phone: 760-739-3030 Fax 760-233-7840 Fax 858-613-4789 Fax 760-739-2864

Directory of Laboratory Services 2015-2016 5th edition

Contact Information

Client Services

Hours: Monday to Friday 8am to 8pm Phone number -

442 281 1600

Fax number 760 233 3702

After hours number (8 pm – 8 am) Phone number: 442-281-1503 (PMC)

858-613-4358 (POM)

760- 613 4667 (SNF call for PMC)

Infection Control Numbers

760 443 4022 858 583 8554 (Emergency/After hours)

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Overview of Palomar Health Laboratories

Palomar Health Laboratories are full-service facilities offering comprehensive clinical and anatomic pathology testing to the community we serve. We have 30,000

square feet of laboratory space equipped with state-of- the-art instrumentation, positive patient identification, and patient centric culture providing high quality and most efficient services.

Our laboratories at Palomar Medical Center, Pomerado Hospital, and Palomar

Health Downtown Campus, are accredited by the College of American Pathologist, Joint Commission on Accreditation of Health Care Organizations, Centers for Medicare and Medicaid Services, and State of California Department of Health Services.

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Table of Contents

I. Laboratory Certification 4

II. Laboratory Leadership 5

III. Client Services Information 6 IV. Testing Policies 7-8

V. Physician Client Service 8-13 a. Summary of Services 8 b. Clinical Lab, Cytology Test Requisitions 9

c. Pathology Lab Requisitions 10 d. Examples of Different Requisitions 11-13

VI. Skilled Nursing Facilities 14-18 a. Summary of Services 14

b. Weekday and Weekend Services 15

c. Holiday Schedule Services 16

d. Test Requisition Information 17

e. Standing Order procedure 18 f. Change Order Procedure 18

VII. Appendix C – SNF Stat Test List 26- 27

VIII. Appendix D – Critical Values 28-29

IX. Appendix E – Specimen Collection Guide 30-33

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Laboratory Certification

Fully Accredited Laboratories

Palomar Health Laboratory Services is acknowledged as a high quality laboratory and is accredited by the following:

College of American Pathologists (CAP) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Centers for Medicare and Medicaid Services (CLIA) California Department of Public Health CDPH

Palomar Medical Center

CLIA ……………………………………………………………………. 05D2044832

CAP……………………………………………………………………… 8044198

Medicare Provider……………………………………………………….. 05-0115

Medical Provider …………………………………………………………1457321317

California Department of Public Health…………………………………. CLF 342634 NPI (Lab)………………………………………………………………… 1639427685

Pomerado Hospital

CLIA …………………………………………………………. ………… 05D0668540

CAP………………………………………………………………………. 23184-01

Medicare Provider ……………………………………………………….. 050636 Medical Provider ………………………………………………………… ZZT40636F

California Department of Public Health ………………………………… CLF3150

NPI (Lab)………………………………………………………………… 1811245863

Palomar Health Downtown Campus

CLIA …………………………………………………………………… 05D0671677 CAP……………………………………………………………………… 2314901

Medicare Provider……………………………………………………….. 05-0115

Medical Provider ……………………………………………………….. 1457321317

California Department of Public Health………………………………… CLF 1006

NPI (Lab) ……………………………………………………………… 1639427677

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Laboratory Leadership

Valley Pathology Medical Associates, Inc. Jerry Kolins, M.D. Medical Director

Blesilda Singh, M.D. Lachlan Macleay, M.D. Pamela Danque, M.D.

Linda Petroff, M.D.

Andrea D’Auria, D.O. Bradley Harward, M. D.

Keith Lopes, PA

Palomar Health Laboratory Services: Gloria Austria, MBA/HCM,CLS

District Director, Laboratory Services Tim Barlow, MT (ASCP), CLS District Operations Manager

Interim Blood Bank Supervisor Joane Barriteau, MBA/HCM, MT (ASCP)

Hematology Supervisor

Susan DeWindt, MT (ASCP) Microbiology Supervisor

MaryAnn Snoke Phlebotomy Supervisor - PMC

Sandy Lajeunesse, MLT (ASCP) Central Processing Supervisor - PMC

Evelyn Chua, MT (ASCP) Evening Shift Supervisor – PMC

Robert Sharpell, MT (ASCP) Clinical Application Specialist, Cerner

Sue Richardson

Business Development Rep Leiann Crandall

Interim Customer Service Supervisor

Mariel Teng, MA, MT(ASCP), CLS

Interim QA/QM/Patient Experience Manager Debra Mason, MT (ASCP)

POCT Supervisor

Judy Cavallo, MT (ASCP) Chemistry Supervisor

Rebecca Anderson, MT (ASCP) Night Shift Supervisor – PMC

Susan David Phlebotomy Supervisor - Pomerado

Brian Bakerink Pathology Supervisor

Rose Pfliger Anatomic Pathology Transcription Supervisor

Jim Peters, MT (ASCP)

Clinical Application Specialist, Cerne

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Client Services

Telephone Inquiries Our Customer Service Representatives will gladly help you with your requests for test results, telephone orders, specimen requirements, and turnaround times. After hours, please call the PHLS Client Services Department and follow

the steps to be transferred to Palomar Medical Center or Pomerado Hospital.

PHLS Client Services Department:

Phone: (442) 281-1600, (760) 739-2867 or (858) 613-4282

Fax: (760) 733 - 3702 Hours of Operation: Monday – Friday

8:00 A.M. – 8:00 P.M.

Result Reporting Specimens are processed and test results are reported to the client as soon as possible. Since reporting times vary, a testing schedule is available from the Outreach Laboratory office.

STAT Results available within one (1) hour after specimen is received in the laboratory. ASAP Results are available within four (4) hours after specimen is received in laboratory.

Routine Results of most routine tests are available within 24 hours. Lab Result Calling After Hours

The CLS performing the test will call critical results with no time restrictions

NOTE: The front office personnel will check the requisition for complete physician information including after-hours contact number. In the event that the information is not available the laboratory personnel will:

Call the client to get the physician information.

If information is not available or the physician cannot be reached, the CLS will call the pathologist on call.

Result Faxing: All laboratory results will be automatically faxed to your office. This includes clinical, cytology and anatomic pathology

reports. Critical Value Handling

The laboratory will immediately call results that fall within a range, which has been determined to be Critical or may have an effect in delaying surgery or need to be brought to the attention of the physician. A complete list of Palomar Health Critical Values can be found in Appendix D of this manual.

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Testing Policies “STAT” Test List:

A complete list of Outpatient “STAT” tests can be found in the Appendix B of this manual.

Repeat Determinations

We will repeat a test without charge whenever the result does not correlate, in the physician’s opinion or with the clinical

picture presented by the patient. Contact the Outreach Laboratory office with any requests for repeats. Follow-up or confirmatory testing is not considered a repeat determination, and such specimens will therefore be processed as a new request.

Cancellation of Tests

Cancellations received prior to test setup will be honored at no charge. Requests received following test setup or resulting cannot be honored.

Referred Tests

Palomar Health Laboratory Services is a full service laboratory. Most tests are performed in our laboratories; however, a few highly esoteric tests are referred to reliable reference laboratories. Turn around time for results depend on the

days and frequencies tests are performed by the reference laboratory. We use the services of Quest Clinical Laboratories as our primary reference laboratory. The fees for referred tests are subject to change.

Professional Courtesy

California State and Federal Laws prohibits the offering of “professional courtesy testing”; therefore we cannot honor

requests for this service.

Billing Palomar Health will bill all insurance PPO, Medicare, Medical, and HMO insurance. However, it is the responsibility of the patient to check with his/her insurance company prior to using our laboratory services if Palomar Health Laboratories

is a network provider of his/her insurance carrier. Valley Pathology Medical Associates will bill for professional services provided by the pathologists. The pathologist’s

fee is normally covered by most health insurance providers. A separate bill will be sent to the patient if the insurance does not cover the professional fee. If you have any VPMA billing questions, please contact patient representative at

888 307 6064.

Reportable Disease

All reportable diseases are reported to the County of San Diego, Public Health Department as outlined by Title 17 California Code of Regulations (17CCR). Within 24 hours of identifying a reportable organism, a Confidentiality

Morbidity Report (CMR) is completed and faxed to San Diego County Public Health . Specimen Collection Information

A complete list of tests performed at Palomar Health Laboratories, specimen requirements, and special handling can be found in Appendix A of this manual.

Specimen Size/Sample Size Without adequate sample size, testing cannot be performed. This inadequate specimen collection is detrimental to patient

and patient care. Computer generated labels/ requisitions contain recommended sample sizes, tube type and recommended handling; consult specific departments for questions regarding sample size, minimum sample volumes, and specimen handling guidelines for tests not contained in this section.

Unacceptable Specimens

Improperly labeled/Unlabeled Specimens: Palomar Health Laboratory Services will not accept specimens

submitted without patient identification (patient name and date of birth). o Note: In the event the specimen is identified as irreplaceable, Palomar Health Laboratory Services will

process the specimen only if authorized by the physician or client. The report will have documentation that the specimen was received as improperly labeled or unlabeled.

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Needles: Palomar Health Laboratory Services will not accept, transport or test any specimen with a needle attached.

In cases where syringes must be submitted, the syringe must be plastic and have Lauer Lock securely attached. Glass Tubes: Glass tubes should be avoided due to the increased risk of broken glass and biological contamination.

A. Physician Client Services

Summary of Services

Palomar Health Laboratories provide STAT and Routine Laboratory services for physicians, medical groups, and reference laboratories. These services include: Client Service Department is available Monday to Friday from 8 am – 5:00 pm

Laboratory service 7 days a week

STAT turn-around-time in 60-90 minutes after specimen is received in the laboratory

Most routine results available the next day

All critical values are called to the attending physician during normal business hours or on

call physician after hours.

Laboratory reports are distributed via fax, courier, or web-based.

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Test Requisition Information

Palomar Health Laboratory Services provide four types of personalized requisition forms for your convenience. They

include:

Clinical Laboratory testing - Blue/White form

Cytology testing – Purple

Tissue/Surgical testing – Green

Skilled Nursing Facility testing- Yellow A requisition form or physician’s order must accompany each laboratory order or specimen you submit.

I. Clinical Laboratory Testing (Blue/White and SNF/Yellow Requisitions) used by physicians, skilled

nursing facility, and other laboratories when sending specimens to Palomar Health Laboratories

Filling Out the Clinical Laboratory Testing Requisitions:

1. Patient’s full name (last, first, middle initial) 2. Current address

3. Phone number 4. Date of Birth 5. SSN, if possible

6. Check appropriate billing category and attach a copy of insurance card 7. Provide ICD-9 code(s) or chief complaint. This is a federal requirement and failure to provide may

result in insurance denial. 8. Clearly mark tests to be performed. If not listed, use the “Write-In” area. 9. Clearly label each specimen being submitted with patient’s name, date and time of collection. Use the

identification labels provided. 10. Microbiology testing – please indicate the “source” of the specimen being submitted for culture. The back of the requisition contains a complete list of panel components, specimen collection tube codes

and reflexive tests.

II. Cytology Testing Requisition (Purple/White Requisition)

Filling Out the Test Requisition: All fields in bold red print on the requisition slip are required fields and must be filled out prior to specimen

processing. Failure to do so may result in a delay of diagnosis.

1. Patient’s full name (last, first, middle initial) 2. Current address 3. Phone number

4. Date of Birth 5. SSN, if possible 6. Ordering physician

7. Date and time of procedure 8. Check appropriate billing category and attach a copy of insurance card

9. Provide the Clinical History, prior history or clinical symptoms of the patient. 10. Provide ICD-9 code(s) or chief complaint. This is a federal requirement and failure to provide may

result in insurance denial.

11. Provide the Clinical History, prior history or clinical symptoms of the patient. 12. Clearly mark site of specimen and laterality. 13. Clearly label each specimen being submitted with patient’s name, date and time of collection.

**Note: All “Rush” cases MUST have a direct physician contact number (preferably cell phone or

pager) provided on the submission requisition to ensure timely communication by the pathologist to the treating physician.

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III. Pathology Testing Requisition (Green/White Requisition) Filling out the Test Requisition:

All fields in bold red print on the requisition slip are required fields and must be filled out prior to specimen processing. Failure to do so may result in a delay of diagnosis

1. Patient’s full name (last, first, middle initial) 2. Current address

3. Phone number 4. Date of Birth 5. SSN, if possible

6. Ordering physician 7. Date and time of procedure 8. Check appropriate billing category and attach a copy of insurance card

9. Provide the Clinical History, prior history or clinical symptoms of the patient. 10. Provide ICD-9 code(s) or chief complaint. This is a federal requirement and failure to provide may

result in insurance denial. 11. Provide the Clinical History, prior history or clinical symptoms of the patient. 12. Clearly mark site of specimen and laterality.

13. Clearly label each specimen being submitted with patient’s name, date and time of collection. **Note: All “Rush” cases MUST have a direct physician contact number (preferably cell phone or

pager) provided on the submission requisition to ensure timely communication by the pathologist to the treating physician.

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Palomar Health Clinical Laboratory Test Requisition

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B. Skilled Nursing Facility Client Services 1. Summary of Services

Palomar Health Laboratories provide mobile phlebotomy services across San Diego County.

Advantages of using Palomar Health include:

Fast turn-around times

Prothrombin Time results between 10 a.m. – 12 p.m.

STAT testing results in 2 – 4 hours from your call. Most routine results before 3

p.m.

All STAT testing performed in-house 7 days a week on most tests

High quality results. Specimens are tested shortly after collection to minimize

hemolysis and ensure accuracy.

All critical values are communicated to the facility by a telephone call and fax.

Extremely competitive rates

Infection Prevention Nurses available for consultation

Serving Skilled Nursing Facilities for more than 21 years

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2. Weekday and Weekend Services

Weekdays Weekends

Routine Testing:

All routine test requests fulfilled the same

day on contracted phlebotomy days. *

Routine Testing:

Routine test requests fulfilled the day for any

test on Appendix A when requests are phoned by 7:00 p.m.

STAT Testing:

Standard Service STAT Test Menu available

24 hours a day

STAT Testing:

Standard Service STAT Test Menu available

24 hours a day

Standing Orders:

All routine (standing) orders are fulfilled Note: Clearly mark on the requisition write in

section “Standing Order, Expiration date: _____ )

Standing Orders:

Routine (standing) orders on file are fulfilled on Saturdays** and Sundays ** on limited

tests Note: Clearly mark on the requisition write in

section “Standing Order, Expiration date: _____ )

Time Draws:

Peak and trough therapeutic drug level

requests fulfilled as routine service on weekdays with 24-hour prior arrangement for the following therapeutic drugs: Amikacin, Gentamicin, Tobramycin, and

Vancomycin

Time Draws:

Peak and trough therapeutic drug level

requests fulfilled as routine service on weekdays with 24-hour prior arrangement for the following therapeutic drugs: Amikacin, Gentamicin, Tobramycin, and

Vancomycin

Facility collected specimens will be picked up at the next scheduled phlebotomy visit

Facility collected specimens will be picked up at the next scheduled phlebotomy visit.

Unless the specimen integrity will be compromised, pick up will be done on the same day.

Weekdays are defined as the period between

Monday at 4:30 am through Friday at 11:30 P.M

Weekends are defined as the period between

Friday at 11:31 P.M. through Monday 4:31 A.M.

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3. Skilled Nursing Facility Services Holiday Schedule February President’s Day Open for regular business

May Memorial Day Closed: STAT service only

July Fourth of July Closed: STAT service only

September Labor day Closed: STAT service only

November Thanksgiving Closed: STAT service only

December Christmas Closed: STAT service only

January New year’s Day Closed: STAT service only

PLEASE NOTE OUR HOLIDAY POLICY

1. Palomar Health will accept STAT orders for tests that appear on the SNF STAT Test menu only. (Refer to Appendix C)

2. Call all routine orders before 7:00 PM the day before the holiday. 3. Daily standing orders that fall on the holiday will be performed as

scheduled. 4. All other standing orders will be rescheduled for the business day prior

to, or the first business day following the holiday. 5. No peaks and troughs will be scheduled on the holiday.

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1. Test Requisitions Filling Out the Skilled Nursing Facility Testing Requisitions:

a. Patient’s full name (last, first, middle initial) b. Room # and Bed #

c. Date of Birth d. SSN, if possible e. Check appropriate billing category and attach a copy of insurance card

f. Provide ICD-9 code(s) or chief complaint. This is a federal requirement and failure to provide may result in insurance denial.

g. Clearly mark tests to be performed. If not listed, use the “Write-In” area.

h. Clearly label each specimen being submitted with patient’s name, date and time of collection. Use the identification labels provided.

i. Microbiology testing – please indicate the “source” of the specimen being submitted for culture. j. For Standing Orders: Write “Standing Order” in the Write order/Special Instruction area and the

expiration date of the standing order.

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2. New Routine Standing Order Procedure

*A standing order is valid until its expiration date, but no longer than 12 months

a. To initiate a routine (standing) Order, use the Palomar Health (triplicate) requisition form.

b. Write in “Standing Order, Expiration Date______” once a week or every Monday as

an example. c. Complete all required information, patient name, date of birth, room #, bed#, billing

information, tests ordered” File the completed requisition in the card file by the first letter of the last name.

3. Change Order Form for Pre-Existing Routine (standing) Order a. Palomar Health requires written authorization to change pre-existing routine

(standing) orders to be in compliance with the State law and the Office of the

Inspector General of the Department of Health and Human Services. b. Please write the appropriate change/s below. c. Authorized person must sign and date the form. d. Fax the form to the appropriate location marked on the form (Palomar or Pomerado)

e. For new orders, a new requisition must be filled out.

SNF Change Order Form Palomar Medical Center Pomerado Hospital

2185 W. Citracado Pkwy., 1 5615 Pomerado Road,

Escondido, CA 92029 Poway, CA 92064

Phone:442 281 1571 Phone: 858 613 4358

Fax: 760 233 7840 Fax: 858 613 4789

DO NO T USE FO R NEW O RDERS

Attention: Director of Nurses/Medical Director Palomar Health requires written authorization to change pre-existing routine (standing) orders to be in compliance with the State law and the Office of the Inspector General of the Department of Health and Human Services. Please write the appropriate chan ge/s

below. Sign, date, and fax the form to the marked location (Palomar or Pomerado)

O rders MUST be received before 3:30 P.M. Monday – Friday in order to be processed

Please check action/s that applies: Add on Test Cancel T est Change Order

Note: For Change O rder please fill out a new requisition

FACILITY: _____________________________

Resident’s Name: ____________________ Sex: ________ Room #: ____

Date of Birth: _____________________ Diagnosis Code: _____________

Physician: ______________________ Physician Phone: _____________

( Last, First name)

Test(s) Added-on: ______________________________________________

Test(s) Canceled: ______________________________________________

Authorized by: _____________________ Date:__________ Time: ____

Print

Signature: ___________________

For Palomar Health Use only:

Patient’s MRN: ______________________________ Original Accession #: _________________________ Date and Time Collected: ______________________ Completed by : _____________________ Date: ___________

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Appendix C

Skilled Nursing Facility Client STAT Services Acetaminophen Level

Acetone

Albumin Level Blood

Alcohol Level Blood

Alkaline Phosphatase

ALT

AST

Bilirubin Direct

Bilirubin Indirect

Bilirubin Total

Blood Gas Arterial

Blood Gas Venous

BMP-Mini Panel

BNP

BUN

Calcium Level Blood

Calcium Level Ionized

Carbamazepine Level

Carbon Dioxide Blood

Carboxyhemoglobin Blood

CBC

CBC w/ Differential

Chem Panel

Chloride Level Blood

CK

CKMB

Co-Oximetry

Creatinine Blood

D-Dimer

Digoxin Level

Electrolyte Panel

Fibrin Degradation Products

Fibrinogen

Gentamicin Level Peak

Gentamicin Level Random

Gentamicin Level Trough

GGT

Glucose Blood

Gram Stain

HCG Qualitative

HCG Quantitative

KOH

Lactic Acid Blood

LD Blood

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Lipase Level

Liver Panel

Magnesium Level Blood

Methemoglobin

Mono Screen

pH Blood Venous

Phenobarbital Level

Phenytoin Level

Phosphorus Level Blood

Platelet Count Automated

Potassium Level Blood

Procainamide Level

Protein Blood Total

Protime

PTT

Renal Panel

Respiratory Syncytial Virus by EIA

Retic Count

Salicylate Level

Sed Rate

Sodium Level Blood

Strep Gr A Rapid Immunoassay

Theophylline Level

Tobramycin Level Peak

Tobramycin Level Random

Tobramycin Level Trough

Troponin I

Uric Acid Blood

Urinalysis Screen Dipstick

Urinalysis Sedimentation Microscopic

Urine Drug Screen (In House Test)

Valproic Acid Level

Vancomycin Level Peak

Vancomycin Level Random

Vancomycin Level Trough

WBC Smear

Wet Mount

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Appendix D

Palomar Health Laboratories Critical Values Table

Table 1. Blood Gas, Coagulation, Chemistry, and Hematology

Test Unit Critical Values Low High

Blood Gases pH, Arterial or Venous N/A <7.20 >7.60

pCO2, Arterial or Venous mm Hg n/a >60

pO2, Arterial mm Hg <50 N/A

Chemistry Calcium, Total mg/dl <6.0 >13.5

CO2 mmol/L <10 >40

Glucose mg/dl <40 >500

Magnesium mg/dl <1.0 >6.9

Phosphorus mg/dl <1.0 > 12.0

Potassium mmol/L < 2.8 > 6.2 Sodium mmol/L <120 >160

Troponin ng/mL N/A >0.5

Urea Nitrogen (BUN) mg/dL N/A N/A

Coagulation Prothrombin Time – INR N/A N/A >4.0

Partial Thromboplastin Time (PTT) seconds N/A > 150

Hematology Absolute Neutrophil Count (ANC) X1000 mm3 < 0.5 N/A

Hematocrit % <19.8 >70

Hemoglobin g/dL < 6.6 > 23

Platelet X1000 mm3 <20 >1000

White Blood Cells X1000 mm3 < 1.0 N/A

Table 2. Therapeutic Drugs

Test Unit Therapeutic Drugs

Through Peak Gentamicin mcg/mL >2.0 >25 Tobramycin mcg/mL >2.0 >25

Vancomycin mcg/mL >25 >50

Test Unit Potentially Toxic Values Carbamezapine mcg/mL >15

Digoxin mcg/mL >2.2

Lithium mcg/mL >1.5

Phenobarbital mcg/mL >50 Phenytoin mcg/mL >25

Theophylline mcg/mL >20

Valproic Acid mcg/mL >200

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Table 3. Microbiology

Malarial smears - Any positive

Blood Culture - Any positive CSF Gram Stain or Culture – Any positive

Gram Stain or Culture from any sterile body fluid – Any positive

CSF Latex antigens – Any positive

India Ink – Any positive

Gram Stain or culture on tissue abscess or aspirate from a visceral organ (ex. lung, liver, or brain - Any positive

Carbapenem resistant Enterobacteriaceae

Extended spectrum Beta lactamase producing organism Methicillin Resistant Staphylococcus aureus (MRSA) with a MIC as caused of an infection

Vancomycin Resistant Enterococci (VRE) with a MIC as caused of an infection

Stool Positive for Clostridium difficile Toxin

Stool Positive for Shiga Toxin

Table 4. Anatomic Pathology

All first time malignant diagnoses (with the exception of carcinoma of the skin). Absence of chorionic villi when clinically expected (potential ectopic pregnancy)

Change of a frozen section diagnosis after review of permanent sections.

Significant unexpected findings and/or significant discordant pre-op and post-op diagnoses.

Mycobacterial, fungal or other significant infectious organisms identified on special stains.

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Palomar Health Specimen Collection Guide

Transport Container Test(s) Transport Container Test(s)

E Swab Aerobic wound

Anaerobic wound

Cervical Culture

Throat Culture (not

rapid Group A screen)

Yeast Screen

Strep A or B Culture Screen

MRSA or VRE Culture Screen

KOH

Wet Mount NO TE: DO NO T collect

body fluid and t issue with a

swab, send in sterile

container

Room Temperature

Sterile Container

Urine Culture Stool Culture Stool for WBC C.diff toxin Rapid Rotavirus Ova and Parasites Shiga Toxin Tissue Culture* Body Fluid* Sputum Nasopharyngeal

wash for a. Rapid RSV

b. Rapid Influenza

A/B Catheter tip*

*Room Temperature,

all others refrigerate

BBL Red Top Double Swab or White Top Single Swab

Rapid Group A Strep

NO TE: DO NO T use for

tissue, body fluid or

anaerobic wound

Room Temperature

UTM w/ Flocked Swab

Viral culture (DFA

or PCR)

Mycoplasma

culture

Ureaplasma culture

Chlamydia culture

Rapid Influenza

A/B

Rapid RSV

Refrigerate

BBL Green Top-Mini Tip

Pertussis

Culture/DFA/PCR

[nasopharyngeal( NP)

swab]

Eye Culture

Urethral Culture

NOTE: Collect 1 NP swab

for each test method

Room Temperature

Copan Red Capped Swab with RED

Lettering on Plastic Tube Group B Strep

Screen by PCR

MRSA Nasal

Screen by PCR

Room Temperature

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Transport Container Test(s) Transport Container Test(s)

Hemosure Fecal Occult Blood

BD AFFIRM

Vaginal swab

DNA Probe

Candida species

Trichomonas vaginalis,

Gardnerella vaginalis

Room Temperature

GC/Chlamydia

APTIMA® Collection Kit Nucleic Acid

Amplification Test

(NAAT)

Endocervical or Male

urethral swab

Urine – collect in sterile urine container

Refrigerate

Sure Swab®

APTIMA® Vaginal Collection Kit (Orange Label) Nucleic Acid

Amplification Test (NAAT)

Vaginal swab ONLY!

Chlamydia trachomatis

Neisseria gonorrhoeae

Candida albicans

Candida glabrata

Candida tropicalis

Candida parapsilosis

Trichomonas vaginalis

Bacterial vaginosis

Herpes Simplex Virus

1&2

Room Temperature

UA Screen and Culture & Sensitivity Transport

Urinalysis w/ culture

Urinalysis w/ Culture

if indicated Note: Submit both urine

cup and urine tube with boric acid (UBOR) to the

lab) Refrigerate Urine Cup only

Urine C&S Preservative Tube

Urine for Culture and

Sensitivity, not

acceptable for

urinalysis

Note: Fill the tube with urine up to fill line

(minimum of 4 ml)

Room Temperature

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Transport Container Tests(s) Transport Container Test(s)

Platelet Function Assay

(PFA-EPI) AKA Platelet Function

Epinephrine

NOTE: 4.5 ml GLASS tube only. DO NOT use plastic tubes.

DO NOT SPIN

Room Temperature

Platelet Function

PF P2Y12 (Plavix

Inhibition)

PF Aspirin NOTE: 2.0 ml Special partial fill Blue Top

tube

DO NOT send platelet function test tubes via pneumatic tube system

DO NOT Spin Room Temperature

QuantiFERON-TB Gold Tubes

Shake tubes 10 times

Room Temperature

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Blood Culture Room Temperature

Amount per Venipuncture

Amount in

BACTEC Plus Aerobic Vial

Amount in

BACTEC Plus

Anaerobic Vial

Amount in

BACTEC Ped Plus

Vial

16 – 20 mL Split equally between aerobic and anaerobic vials

13 – 16 mL 8 mL 5 – 8 mL

10 – 12 mL 5 – 7 mL 5 mL

3 – 9 mL entire blood amount 0

< 3 ml entire blood amount