PHL Test Details Oklahoma Department of Health, Public Health Laboratory 081720
COVID-19 TESTING REQUIRED PATIENT DEMOGRAPHIC INFORMATION

Fields needing attention are highlighted:
Patient Information











Sex: *
Race:
White Black or African American
American Indian/Native Alaskan Asian
Native Hawaiian/Pacific Islander Other
Ethnicity: Non-Hispanic Hispanic Unknown
Submitter Information
Clinical Information
Specimen Information
Collection Date: Time:   Collection By:   Outbreak:

Comment: 
        
Virology
Test Request Specimen Type/Source Details
Hepatitis B surface antigen (HBsAg) Serum 2 mL in spun serum separator tube; approved submitters only
HIV-1/2 antigen/antibodies Serum 2 mL in spun serum separator tube; approved submitters only
Human papillomavirus, high risk Residual ThinPrep 1 mL
Influenza virus A and B Swab, nasopharyngeal 1 or 2 synthetic swabs in viral transport medium; preferred specimen
Swab, nasal 1 or 2 synthetic swabs in viral transport medium
Swab, throat 1 or 2 synthetic swabs in viral transport medium
Other (specify source)
Contact laboratory prior to submission
Respiratory Pathogen Panel Swab, nasopharyngeal 1 or 2 synthetic swabs in viral transport medium; or other appropriate commercial medium (UTM, M4, and M4RT)
Rubella antibodies Serum 1 mL in spun serum separator tube; female county heath department patients only
2019 Novel Coronavirus (2019-nCoV) Select Source


Swabs: synthetic swabs in viral transport medium; or other appropriate commercial medium (UTM, M4, M4RT, and saline)

Fluids (i.e., sputum, BAL, etc.): 2 mL in sterile container
West Nile virus/St. Louis encephalitis virus, IgM Antibodies Serum 1 mL in spun serum separator tube
CSF 1 mL in sterile container (must be accompanied by serum)
Zika virus, Dengue virus, Chikungunya virus, PCR
Requires pre-approval by OSDH Acute Disease Service 		Serum 2 mL in spun serum separator tube
CSF 1 mL in sterile container (must be accompanied by serum)
Urine 1 mL in sterile container (must be accompanied by serum)
Amniotic fluid 1 mL in sterile container (must be accompanied by serum)
Bacteriology
Test Request Specimen Type/Source Details
Bacterial isolate: identification/serotyping/confirmation
Specify source
Plate or slant with visible growth, pure isolate only
Note: If organism suspected is not listed, write name in Comment field above
Bacteria, non-enteric: isolation and identification Specify source
Medical examiner or prior authorization only
Enteric pathogens: isolation and identification Stool, Cary Blair 2 g solid or 5-10 mL liquid feces in Cary Blair Transport Media
Stool, GN broth (STEC only) Visible growth in GN Broth
Chlamydia/Gonorrhea   Urine Collect first 20-60 mL of 1st morning void then transfer to UPT tube
Vaginal swab Use only BD vaginal specimen transport device (purple-shaft swab + transport tube)
Group B streptococcus Swab, vaginal and anal
Swab in LIM broth (combined vaginal/anal swab preferred)
Swab, vaginal
Swab in LIM broth
Swab, anal Swab in LIM broth
Bordetella: PCR Swab, nasopharyngeal 1 or 2 synthetic swabs in Reagan Lowe Transport Media
Cultured isolate (specify source)
Visible growth, pure isolate
Syphilis, serology (Reverse Algorithm) Serum 2 mL in spun serum separator tube
Bacteria, environmental Environmental (specify source)
Prior authorization required
Mycobacteriology
Test Request Specimen Type/Source Details
Fungal isolate identification
Specify source
Plate or slant with visible growth
Mycobacteria (acid-fast bacilli): smear and culture with reflex to identification Specify source
Blood: 5-10 mL ACD or heparin
Fluids: 5-10 mL
Sterile Fluids: 2-5 mL
Tissue: 1 g
Mycobacteria, isolate identification Specify source
Liquid: >3 mL, pure isolate; Solid: visible growth, pure isolate
M. tuberculosis complex: PCR
Select source
5-10 mL; includes AFB smear and culture per CDC guidelines
Parasitology
Test Request Specimen Type/Source Details
Parasites, blood Blood, stained smears (Babesia, trypanosomes, filariae) Giemsa or Wright-Giemsa-stained thin AND thick smears; at least one of each
Blood, stained smears and EDTA blood tube (Malaria) Giemsa or Wright-Giemsa-stained thin AND thick smears; at least one of each; 2-6 mL EDTA blood