Last Modified: 9/22/2021 2:27:50 PM

Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements:

10.0 mL Whole Blood in a Yellow Top Tube - ACD

Collection Instructions:

Collect only Monday through Thursday 

Must be to testing facility with in 24 hours of collection

Minimum Volume: 1.0 mL Whole Blood
Transport & Storage: Temperature/Stability: 72 hours Ambient
Rejection Criteria: Hemolysis • Li Heparin
Reference Range: A positive result indicates the presence of HLA-DR4 antigen which is associated with an increased risk of an adverse reaction to vaccination with Lyme disease vaccine
Critical Ranges:  
Test Comments:  
Methodology: Flow Cytometry (FC)
Clinical Significance: Testing for the presence of HLA-DR4 antigen in a patient is used to determine the potential risk of developing of lyme arthritis from infection with Borrelia burgdorferi or vaccination with lyme vaccine.
Custom Panel: No


Turn Around Time: 3 to 4 days
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Quest - Chantilly to San Juan Capistrano
PHL Test Code: MSOT
EPIC Test Code:
Send Out Test Code: 104548
Alternate Test Names: HLA-DR4, Flow Cytometry
Included Tests:  
CPT Coding: 00913333

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