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HLA DNA TEST ORDER FORM Version Indiana, Inc/ 3450 N. Meridian St. Indianapolis, IN 46208 Lab Phone: (317)9165260 FAX: (317)9165230 Email: hla@indianablood.org CIA# 15D2084361 ASH # 084IN061PLEASE

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How to fill out ibc hla-dna test order

01

Contact the lab or healthcare provider to request an IBC HLA-DNA test order form.

02

Complete the patient information section on the form including name, date of birth, contact information, and any relevant medical history.

03

Provide insurance information if applicable.

04

Follow any additional instructions provided on the form.

05

Submit the completed form to the lab or healthcare provider for processing.

Who needs ibc hla-dna test order?

01

Individuals who are being evaluated for organ or tissue transplantation.

02

Patients with suspected autoimmune diseases.

03

Individuals with a family history of certain genetic conditions.

04

People with a history of recurrent infections or immune system deficiencies.

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What is ibc hla-dna test order?

IBC HLA-DNA test order is a medical test order for Human Leukocyte Antigen (HLA) DNA testing for patients who are preparing for organ transplantation.

Who is required to file ibc hla-dna test order?

Healthcare professionals such as physicians and healthcare facilities are required to file the IBC HLA-DNA test order for their patients.

How to fill out ibc hla-dna test order?

The IBC HLA-DNA test order can be filled out by the healthcare provider with all the necessary patient information and test specifications.

What is the purpose of ibc hla-dna test order?

The purpose of the IBC HLA-DNA test order is to determine the compatibility between a donor and a recipient for organ transplantation.

What information must be reported on ibc hla-dna test order?

The IBC HLA-DNA test order must include patient's personal information, test specifications, healthcare provider details, and any other relevant information.

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