Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Peanut Component Panel - The ImmunoCAP® Peanut Component Allergen Test helps to assess a patient's level of risk of a life-threatening reaction, and may reassure patients when the risk for allergic symptoms is low or when they will most likely experience mild or localized reactions upon exposure to peanut. The test helps the health care provider identify primary, species-specific allergic sensitization, differentiate between symptoms caused by a primary allergen source and those caused by cross-reactivity, assess the level of risk for life-threatening allergic reactions, and provide clarity regarding the patient's risk of an allergic reaction to ease fears and help target effective management. Preferred Specimen(s) 1 mL serum Minimum Volume 0.6 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Includes Ara h 2 (f423), Ara h 1 (f422), Ara h 3 (f424), Ara h 9 (f427), Ara h 8 (f352) Methodology Immunoassay (IA) Reference Range(s) Ara h 2 (f423)    <0.10 kU/L Ara h 1 (f422)    <0.10 kU/L Ara h 3 (f424)    <0.10 kU/L Ara h 9 (f427)    <0.10 kU/L Ara h 8 (f352)    <0.10 kU/L Alternative Name(s) ImmunoCAP®

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Penicillium notatum (m1) IgE - This allergen-specific IgE antibody test quantifies an individual’s IgE response to Penicillium notatum. It is an in vitro quantitative assay that is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare provider after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Perennial Rye Grass (g5) IgE - This test quantifies an individual’s IgE response to perennial rye grass. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare professional after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Persimmon (Kaki Fruit) (f301) IgE - This test is an allergen-specific IgE antibody test that quantifies an individual’s IgE response to persimmon (Kaki fruit). It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of food allergy [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. Food-specific IgE tests are extremely sensitive. However, a positive test result only indicates that a patient is IgE sensitized to the food of concern. Many IgE-sensitized patients do not develop any symptoms when this food is ingested. A diagnosis of food allergy should only be made by a trained medical provider, after conducting a thorough clinical evaluation [2,3]. While food-specific IgE test results may contribute to that evaluation, they cannot replace it. In this regard, detection of food-specific IgE in serum provides evidence of IgE sensitization, but a history of clinical reactivity to the food of concern, is required to make a diagnosis of IgE-mediated food allergy. Moreover, several forms of food hypersensitivity are not associated with the presence of food-specific IgE in serum. Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay (IA) Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Alternative Name(s) ImmunoCAP®

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

PHOSPHORUS TEST   What are the other names for this test? Phosphate in the blood test, P, PO4, Phosphorus serum What is a phosphorus test? A phosphorus test helps to determine phosphorus levels in your blood. Phosphorus is a mineral that often mixes with other substances to develop organic and inorganic phosphate compounds. Phosphorus and phosphate words often replace each other in testing. A serum phosphorus/phosphate test measures the amount of inorganic phosphate in your blood. Phosphates are necessary for bone development, energy production, and nerve and muscle function. They also help to maintain the acid-base balance of your body. Most phosphorus comes from the foods you eat. Phosphorus is present in many foods, and your digestive system absorbs it. Foods that contain high phosphate include eggs, beef, fish, chicken, cereals, beans, peas, and nuts. Your blood possesses about 1% of phosphorus amount. Most phosphates of your body work with calcium to build teeth and bones. Few amounts are available in your muscle and nerve tissue. The remaining is present in your body cells to keep energy. Your body helps to maintain phosphorus levels by releasing extra into the kidneys, and enough of it absorbs from the intestines. Phosphorus deficiencies may happen due to malnutrition, acid-base disorder, malabsorption, high calcium levels, and problems that lead to kidney failure. High phosphorus may develop due to low calcium levels, high intake of phosphorus, and kidney disorders. What is the purpose of this test? A phosphorus test helps to see abnormal phosphorus levels in your blood. This test often performs other tests, such as calcium, vitamin D, and parathyroid hormone (PTH). A phosphorus test may use to:   Diagnose conditions that lead to calcium and phosphorus imbalances.  Diagnose and observe kidney and bone disease Determine parathyroid disorders. The parathyroid glands are located in your neck and help to produce hormones, which control calcium levels in the blood. If the gland develops high or low hormones, this leads to severe complications for your health. Monitor calcium and phosphorus levels if you are taking their supplements. When do I need to take this test? Your healthcare provider may order a phosphorus test if you see a symptom of kidney disease or parathyroid disorder. You may need this test if you have phosphorus disorders that may lead to symptoms similar to abnormal calcium levels, including   Fatigue Bone pain Weakness Muscle cramps Confusion Most people do not see symptoms of these problems. Your healthcare provider may ask for a phosphorus test if you are at risk of developing kidney disease. Your provider also observes your medical history and calcium test results. If you have abnormal calcium levels, this also means you have abnormal phosphorus levels. You may need to place an online order for this test if you have difficulty controlling your diabetes. What is the procedure for this test? A phosphorus test is a blood test that often requires your blood sample. The following are the steps for this test after visiting the laboratory.   Sit in front of your provider. Be relaxed and stay in a fixed position. It is difficult for your provider to collect a blood sample if you do the muscle movement. Remove the portion of your cloth from the arm. A small needle will inject into a vein in your arm.  A small amount of blood will collect in a test tube. Blood samples will store in the laboratory for examination of an allergy. You can go home for regular activities. This test finishes within five minutes. You may also need a urine sample for a phosphorus test. Your provider may recommend a 24-hour urine or random urine test. For a 24-hour urine test, the steps include Starting urine in a toilet in the morning without collecting it. Note the time of urinating Put your urine in the container for the next 24 hours Store that urine in a refrigerator or at a cool place  Give your container with urine to the lab care as per the guidelines For a random or spot urine sample, your healthcare provider will instruct you to collect all urine at any time. How do I need to prepare for a phosphorus test? This test may require fasting from midnight before the test. You can consult with a verified doctor about specific preparation. You can inform your provider about medicines, vitamins, and supplements you use. You should not avoid taking the medication without the consent of your doctor. Are there any risks involved in this test? A phosphorus test does not have high risks when you give a blood sample. You may experience low risks when the needle injects into your vein include   Infection Bruising Hematoma (Deposition of blood under the skin) Extreme Bleeding Slight pain What do the test results indicate? The phosphorus test results depend on many factors, such as age, gender, and medical history. The test results may also slightly differ among laboratories. It is because each lab may use different methods for examination. The reference range for phosphorus is between 2.7 to 4.6 mg/dL (milligrams per deciliter). The recommended value for phosphorus may change. Low or high phosphorus values may indicate kidney problems. You can consult a healthcare provider here to know about your phosphorus levels. Children generally have higher phosphate levels than adults due to the increasing growth of bones. Low phosphate levels in children may prevent bone growth, while high phosphate levels may indicate health conditions that disturb the mineral balance in your body. High phosphorus levels in the blood, known as hyperphosphatemia, may develop due to the following reasons:   Liver disease High phosphorus intake in the diet due to phosphate supplementation. Kidney failure Hypoparathyroidism - A condition in which your parathyroid glands do not develop the required parathyroid hormone. Diabetes ketoacidosis - a group of complications of diabetes that leads to life danger situations. Low phosphorus levels in the blood, known as hypophosphatemia, may occur due to the following reasons:   High calcium levels in the blood, also known as hypercalcemia, often develop due to hyperparathyroidism. Low blood potassium (hypokalemia) Excess use of diuretics Malnutrition Use of alcohol Rickets and osteomalacia happen due to vitamin D deficiencies. Osteomalacia - a condition that softens your bones and disturbs the bone structure. If this condition develops in children, it is called rickets. Hypothyroidism (an underactive thyroid) Excess use of antacid Extreme burns See your phosphorus levels after placing an online test. What factors may affect the test results? If your phosphorus test shows abnormal results, this does not always indicate a medical problem. Some medications and medical processes, like dialysis, may also affect your test results. Some specific foods and drinks that contain high phosphorus levels may change your test result include   Fish Cola Cheese Different beans Chocolate Beer Pre-packaged food Phosphorus blood and urine levels may be altered by enemas and laxatives containing sodium phosphate and high vitamin D supplements. What additional tests do I need along with this test? Your healthcare provider may ask for other tests, specifically calcium tests, if you do not have symptoms of abnormal phosphorus levels. The calcium test is a routine test included in a comprehensive metabolic panel (CMP) and a basic metabolic panel (BMP). Your provider often observes your phosphorus levels in the blood if you have low or high calcium levels. You may also need a phosphorus urine test with this test. What else do I need to know about this test? Abnormal high phosphorus levels may result in organ damage due to calcification, and calcium phosphate accumulation in the tissues, which is less common. High phosphorus levels often lead to cardiovascular disease or osteoporosis (bone disease).

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

PLATELET COUNT Any other names for this test? This test is also known as a platelet test, thrombocyte count, platelet function test, platelet function assay, and platelet aggregation studies.   What is a platelet count lab test? A platelet count test calculates the number of platelets in your blood. Platelets, also known as thrombocytes, are tiny blood cells that help in the clotting process. Clotting is the procedure through which you prevent bleeding after an injury. If your platelet count is below the average, this can indicate thrombocytopenia. A condition that causes you to bleed excessively after a cut or other type of bleeding injury. If your platelet count is higher than the average, it is a sign of thrombocytosis. A condition that makes your blood clot more than is necessary. Due to their ability to block blood flow, blood clots can be harmful. What is the purpose of a platelet count test? This test is often used to screen for conditions that cause excessive bleeding and excessive clotting. It is used to Analyze specific platelet illnesses. During difficult surgical operations, such as cardiac bypass and trauma surgery, check platelet function. There is a higher chance of bleeding during these operations. If a patient has a personal or family history of bleeding issues, you should ask them before surgery. People who take blood thinners should be monitored. If a person is at risk for a heart attack or stroke, these medications may be given to reduce clotting.   Why do doctors ask for a platelet count test? Your doctor might order this test as part of your regular physical checkup. He may also ask for this if he thinks you have these particular conditions:   Thrombocytosis (high platelet count). Thrombocytopenia (low platelet count).   Why do I need a platelet count test? Your healthcare provider may ask for this test if you show symptoms of too few or too many platelets. Symptoms of too few platelets are: Excessive bleeding after a small cut or injury Heavy or long menstrual cycles Bleeding of the nose or gums Blood in urine or stool unknown cause of bruising Petechiae are little red patches that appear on the skin. Purpura, or purple blotches on the skin. Symptoms of too-high platelets are: Weakness Feeling daisy Headache Numb feet and hands    If you have any of the symptoms listed above, schedule a platelet count test.   How can I get ready for a platelet count examination? No special treatment is essential for this test. However, let your healthcare provider know about any medicine or supplement you are taking. These factors might affect your test outcome. Among the medications that may have an impact are: Ibuprofen Aspirin What happens during a platelet count test? A blood sample is used to conduct this test. Your doctor will draw a blood sample by performing the steps below: Your medical expert will first clean the puncture site with an antibiotic. Then, to force blood into the vein, he will wrap the top of the hand in an elastic band. He is now going to inject a small needle into the vein. Blood taken with the needle will be placed in a test container for examination. The blood test process is now complete. The process of drawing blood has now been completed. Your medical team member will remove the elastic band.   Any risks to this test? Blood testing poses a small risk to them. Because of the needle's in and out motion, you may experience a pinch of pain and bruise in the area where the needle was put. How long does a platelet count test take? A platelet count test does not take very long since it is a simple blood test. The test is often done in less than five minutes. However, your healthcare provider might take a few seconds to find a vein in your hand. What do the results of a platelet count test mean? The average platelet count range is 150,000–450,000 platelets per L. If your results are below the normal range, you suffer from thrombocytopenia (low platelet count). If your results are higher than the average range, it indicates you have thrombocytosis (higher platelet count). These reference ranges differ between laboratories. Book a platelet count test to learn about your platelet count. What does a low platelet count result mean? The low platelet count (thrombocytopenia) may indicate: Blood cancer such as lymphoma or leukemia. A viral illness, such as mononucleosis, hepatitis, or measles An autoimmune illness occurs when the body attacks its healthy tissues, which may include platelets. A bone marrow infection or injury Vitamin B12 deficiency Cirrhosis Gestational thrombocytopenia is a frequent but moderate low-platelet disease that affects pregnant women. However, this condition does not harm a woman or the unborn child in any way. Studies show that it gets better during or after pregnancy.   What do high platelet count results mean? The high platelet count (thrombocytosis) may indicate: Lung cancer and breast cancer are two examples of cancers. Anemia Digestive system inflammation Rheumatoid arthritis is a type of arthritis. Infection from a bacterium or a virus  If you are unsure of your test results, see a doctor online. Anything else I should know about this test? Sometimes one or more of the following blood tests are combined with platelet testing:   The MPV blood test determines the size of your platelets. The partial thromboplastin time (PTT) test determines how long it takes for blood to clot. The prothrombin time and INR test assess the body's ability to create blood clots. Your healthcare provider may ask you to go through the above tests. It will help your doctor with your treatment.

Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature

Preferred Specimen(s) 0.3 mL serum Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay - Analyte Specific Reagents Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Alternative Name(s) ImmunoCAP®

Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days

Clinical Significance Alternative Names Specialized,Services,HIV Viral Load,PTxplnt,Txplnt,Quest Advanced Post-Transplant, HIV-1 RNA, Real-Time PCR, Plasma - This test is intended for use in conjunction with clinical presentation and other laboratory markers of disease progress for the clinical management of HIV-1 infected patients. The test can be used to assess patient prognosis by measuring the baseline HIV-1 RNA level or to monitor the effects of antiretroviral therapy by measuring changes in EDTA plasma HIV-1 RNA levels during the course of antiretroviral treatment. Reportable range is 20 to 10,000,000 copies/mL (1.30-7.00 Log copies/mL). Methodology Real-Time Polymerase Chain Reaction Reference Range(s) HIV 1 RNA, QN PCR    Not Detected    copies/mL HIV 1 RNA, QN PCR    Not Detected    Log copies/mL Preferred Specimen(s) 3 mL plasma collected in an EDTA (lavender-top) tube Minimum Volume 1 mL Collection Instructions For Shipper collection please see detailed instructions in Test Resources Transport Container Transport tube Transport Temperature Refrigerated (cold packs) Specimen Stability Room temperature: Unacceptable Refrigerated: 6 days Frozen: 84 days Reject Criteria Samples frozen in primary tube • Unspun whole blood samples >24 hours from collection • Samples collected in sodium or lithium heparin • Frozen whole blood