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Lab-Req-Standard-Alt-V15

Lab-Req-Standard-Alt-V15 2025

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The document is a standard lab requisition form for MicroGen, formerly Pathogenius Laboratory, detailing the process for submitting specimens for various diagnostic tests. It includes sections for patient and physician information, specimen details, insurance and diagnostic information, and consent signatures. The form outlines multiple testing panels available, such as ENT/Pulmonary, Gastrointestinal, Respiratory, and others, along with associated organisms and common ICD-10 codes. It emphasizes the use of advanced DNA technology for microbial diagnostics and provides payment options.

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