Download Laboratory - Quest Laboratories

CONTENT
PAGE
SECTION 1: General Information
Ordering Test…………………………………………………………………………………………………….
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Dispatch Services……………………………………………………………………………..........................
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Request Form Requirements……..……………………………………………………………………………
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Add Test Requests…………………………………………………………………………………………...…
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Dispatch of Test Results……………………………………………………………………………………….
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Supplies…………………………………………………………………….…….………………………………
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Payment……………………………………………………………………………………………..…………..
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SECTION 2: Laboratory Requests Overview
Scheduled Procedures………………………………………………………………………….………………
Referred Laboratory Tests……………………………………………………………………….………..……
Urgent Requests………………………………………………………………………………….………….….
Notifiable Diseases…………………………………………………………………………….……………..…
Chain of Custody………………………………………………………………………………….…………….
SECTION 3: General Specimen Collection Guidelines
Blood Collection Procedure…………………………………………………………………………………….
Important Considerations for Blood Collection
Use Appropriate Blood Collection Tubes
Unacceptable Blood Specimens
Urine Collection Procedure……………………………………………………………………………………..
Random
Timed
24 hour Urine
CSF and Other Body Fluids Collection Procedure………………………….…………..……….…………..
SECTION 4: Requirements by Specific Departments and Tests
Biochemistry ………….……………………………………………………….………………………………...
Glucose Tolerance Test
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Molecular Diagnostics……………………………………………………….………………………………….. 14
Chlamydia & Gonorrhoea PCR
HBV DNA
HPV DNA
HSV PCR
VPIII (Vaginitis Screen)
Serology……………………………………………………………………………………………………….…
TB-Quantiferon
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Immunology……………………………………………………………………………………………….……..
Homocysteine
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Microbiology…………………………………………………………………………………………….……….
Specimen Collection and Transportation
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Cytology…………………………………………………………………………………………….……………
Gynaecological Smear
Non-Gynaecological Smear and Fluids
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Histopathology………………………………………………………………………………….……………….
Contact Us…………………………………………………………………………………..………………..….
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SECTION 1: GENERAL INFORMATION
ORDERING TESTS
Please refer to Quest Laboratories Services Guide for the comprehensive list of laboratory examinations offered
by Quest.
DISPATCH SERVICES
Quest will provide dispatch service to collect specimens from your clinic. Please call our collection hotlines at
6277-0222 or 6277-0221. Our traffic controller will arrange dispatch service for you. The collection hotlines are
open during the following hours:
Mon – Fri : 8:30 am – 4:30 pm
Sat – Sun : 8:30 am – 12:30 pm
To facilitate prompt collection of specimens within the designated time period, please contact us for specimen
collection as early as possible.
REQUEST FORM REQUIREMENTS
To ensure optimal specimen collection for the most accurate test results, please refer to the respective sections
before collecting specimen from a patient. Clearly indicate special requirements and special instructions.
Request forms and specimen containers must be labelled correctly to prevent errors in results reporting.
Request forms must include the following information:
1. Full name of patient
2. Patient’s identification number (NRIC or Passport No.)
3. Date of birth
4. Sex (male or female)
5. Source of specimen (if not blood)
6. Initial/signature of requesting doctor
7. Date and time of collection
8. Name of the patient’s attending Doctor/Consultant
9. Other relevant information, e.g. I.V. drugs administered
On the request forms, please indicate clearly the required test(s) to facilitate prompt processing of the
specimen(s).
Labelling of specimen container
Label specimen containers clearly and legibly with two unique identifiers (Name/NRIC/DOB/etc.). Confirm the
identity of the patient prior to specimen collection. The information on the request form(s) and the specimen
container(s) must match. Unlabelled or mislabelled specimens will cause unnecessary delay and may
result in specimen being rejected by the laboratory.
Please include the following information in the request form for the below tests:
Microbiology
1.
2.
3.
4.
Relevant clinical presentation
Intended antimicrobial use (laboratory will adopt a recommended list)
Specimen source or site
Please state the test required (e.g. culture, direct smear, gram stain etc)
Gynaecological Cytology (Pap Smear)
1. Origin of site (cervical, endocervical, vaginal, vault)
2. Last menstrual period (LMP)
3. Hormonal status (e.g. post-menopausal, pregnant, post-natal)
4. Exogenous hormone therapy (including birth control pills, treatment for endocrine-responsive malignancy,
oestrogen creams)
5. Use of intrauterine contraceptive device (IUCD)
6. Diethylstilbesterol (DES) exposure
7. History of abnormal cytology and gynaecological disorders
8. Date of last pap smear, if any.
9. Other relevant clinical findings or Patient concerns (e.g. discharge, itch, foul smell, bleeding, pain)
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Guidelines for HIV Testing
“Samples reactive for HIV screening test must be repeated and repeated reactive samples and those with
equivocal results must be referred to the National HIV Reference Laboratory, Department of Pathology, and
Singapore General Hospital for confirmation. The reactive results of the HIV screening test are not to be released
to the patient or the referring doctor before they are confirmed by the National HIV Reference Laboratory.
Laboratories shall also ensure that a sufficient amount of blood is taken for the HIV screening test so that there
is a sufficient amount of the blood sample (at least 1.5cc of serum/plasma) to be sent to the National HIV
Reference Laboratory for confirmatory tests should the HIV screening test produce reactive results.”
(Doc No. MH71:03/09 02-01/96 (HV), Vol. 9)
In light of the directive from the Ministry of Health, clinical laboratories must ensure that a sufficient amount of
blood is received for the HIV screening test. A minimum of 4ml blood must be received by the laboratory to
conduct the HIV screening test, repeats and the confirmatory test at the National HIV Reference Laboratory for
reactive cases.
The Health Ministry guidelines in regard to HIV screening by an accredited laboratory stipulate all HIV reactive
cases MUST be sent to the National HIV Reference laboratory at Singapore General Hospital (SGH) for the
confirmatory test. The confirmatory test is free of charge if the patient falls into one of the following categories:
 Singapore citizen or Singapore permanent resident
 Foreign national residing in Singapore and holding a work permit, employment pass, long-term social
visit pass or student pass.
 Foreign national who is applying for a work permit, employment pass, long term social visit pass, student
pass or permanent residency.
The HIV confirmatory test is chargeable under all other circumstances based on SGH’s prevailing rate for the
test.
Due to obvious medico-legal reasons, the following conditions must be met when obtaining specimens for HIV
testing:
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Ask to see the National Registration Identity Card (NRIC) or Passport or Work Permit (WP).
Confirm patient’s identity, including name, identification number, race, nationality and other relevant
information.
Verify patient’s physical appearance against the photograph on his/her NRIC or passport.
Indicate the name of the requesting doctor or the doctor-in-charge of the patient.
Signature of requesting doctor.
ADD TEST REQUESTS
Examined samples are stored for a stipulated period of time according to internal protocols. Additional test
requests are to be made to Quest Client Services Department. Please note that all additional tests are subject
to the stability of the samples and suitability of the requested tests.
DISPATCH OF TEST RESULTS
Test reports will be dispatched to clinics by our dispatch riders. Clinics will receive two (2) copies of test report:
one for patient and the other for clinician’s records.
All “Urgent” or “STAT” tests or request forms with “Fax Results” will receive immediate attention. We will contact
you as soon as the results are ready.
SUPPLIES
Selected supplies such as specimen containers, syringes, needles, formalin (histopathology specimens),
spatula, fixative (cytology) and request forms are supplied free of charge.
PAYMENT
1. Quest will bill clinics at the end of each month for specimens collected by our dispatch service or patients
sent to our laboratories.
2. Cheque payments must be made to: “QUEST LABORATORIES PTE LTD”
3. Payments for walk-in patients may be made by cash, VISA or Mastercard.
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SECTION 2: LABORATORY REQUESTS OVERVIEW
Scheduled Procedures
Appointments for scheduled procedures such as Frozen Sections are required 24 hours in advance. Please
contact Quest Anatomical Pathology Department at 6277 0210/11/12 when such procedures are required.
Referred Laboratory Tests
Some tests not performed in-house at Quest laboratories are being referred to our approved list of reference
laboratories. These specimens are processed Monday through Friday except public holidays. Request that
missed the courier pick up will be sent on the following working day.
Urgent Requests
Urgent requests shall be ordered using a Quest pink request form to facilitate prompt identification and testing.
Quest appreciates your co-operation to ensure urgent specimens are given the due priority it deserves. You can
help us maintain the level of service required of urgent requests by ordering such tests only when needed.
NOTIFIABLE DISEASES
The following information will be required for the filing of notifiable diseases.
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Full name of patient
Sex (male or female)
Date of birth
Ethnic group (Chinese, Indian, Malay, Others)
Residential status (resident or non-resident)
Nationality (Indonesian, Malaysian, Thai, Others)
Occupation
Residential address
Telephone number (home and office)
Place of work or school
Physician’s medical council registration number (MCR No.)
List of notifiable disease are as listed below:
(1) Acquired Immune Deficiency Syndrome.
(2) Chickenpox.
(3) Cholera.
(4) Dengue.
(5) Dengue Haemorrhagic Fever.
(6) Diphtheria.
(7) Encephalitis.
(8) Human Immunodeficiency Virus Infection.
(9) Leprosy.
(10) Malaria.
(11) Measles.
(12) Mumps.
(13) Paratyphoid.
(14) Plague.
(15) Poliomyelitis.
(16) Rubella.
(17) Typhoid.
(18) Tuberculosis.
(19) Venereal disease —
(a) Chancroid.
(b) Gonorrhea.
(c) Non specific urethritis.
(d) Syphilis.
(20) Viral Hepatitis.
(21) Yellow Fever.
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CHAIN OF CUSTODY
If a patient has a condition which may have medico-legal significance, specimen (s) may be obtained using
Chain-of-Custody procedures and sent to a reference laboratory authorized to perform chain-of-custody work
or forensic analysis (e.g. analytical or forensic science laboratories belonging to the Health Sciences Authority).
Conditions associated with potential medico-legal ramifications include:
1. Motor vehicle crashes and traffic-related injuries
2. Employment-related (on-the-job) injuries
3. Workers compensation proceedings
4. Employee insurance programs
5. Pre-employment screening and evaluations
6. Employee (work place) drug screening
7. Incidents related to loss of professional certification or license
8. Alcoholism treatment programs
9. Cases involving the medical examiner or coroner system
The following information is required for Chain-of-Custody procedures:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
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12.
13.
14.
Donor identification information (identity card number, case number, etc.)
Name of agency or person requesting the test
Contact person to whom the report will be released
Test(s) requested
Specimen identification number
Laboratory accession number
Date and time of collection
Date and time of specimen receipt in the lab
Specimen condition and type used (e.g. blood, plasma, serum, urine, etc.)
Names of all persons involved with:
a) Witness of specimen collection
b) Transfer of chain of custody
c) Physical possession of specimen
Analytical method and name of analyst
Date and time of analysis and test results (units defined)
Date and time of report
Other pertinent information or qualifying comments:
a) Condition of seals on container and specimen tubes
b) Miscellaneous tests performed to determine adulteration of sample (e.g. urine specific gravity, urine
gravity, etc.)
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SECTION 3: GENERAL SPECIMEN COLLECTION GUIDELINES
TYPES OF SPECIMENS
(A) Blood
(B) Urine
(C) CSF and Other Body Fluids
(A) BLOOD COLLECTION PROCEDURE
Blood is used most frequently for laboratory analysis. Blood may be obtained by:
o Skin puncture
o Venous puncture
Proper collection technique is critical to maintaining the integrity of the specimens.
Also note that the composition of capillary and venous blood differ in important aspects.
Skin Puncture
Skin puncture is recommended only for paediatric patients or adults with extreme obesity, severe burns or
thrombotic tendencies. The following technique for skin puncture is recommended:
1.
2.
3.
4.
5.
6.
7.
Select an appropriate puncture site – lateral or medial plantar heel surface in infants or palmar surface of
the last digit of the 2nd, 3rd or 4th finger of an adult.
Swab the puncture site with 70% isopropyl alcohol. Allow area to air dry.
Make a puncture with a sterile lancet with a single deliberate motion nearly perpendicular to the skin surface.
For heel punctures, the blade should be <2.4 mm to avoid injury to the heel bone.
Discard the first drop of blood by wiping it away with a sterile pad.
Regulate further blood flow by thumb pressure. Do NOT milk the puncture site as this may haemolyse the
specimen and introduce excess tissue fluid.
Collect the blood in microtainer(s), with the appropriate additive(s).
Dispose all material used in the collection in a safe manner.
Venous Puncture
The following technique for venous puncture is recommended:
1.
2.
3.
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6.
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11.
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14.
Identify the patient by checking identification against labels and requisition forms. Ask the patient his/her full
name and NRIC/birth date for further verification. Do NOT draw any specimens without properly identifying
the patient and ensure tubes are labelled correctly.
Confirm that the fasting order has been followed if a fasting specimen is required.
Reassure the patient and position him/her properly for easy, comfortable phlebotomy.
Assemble equipment and supplies, including vacutainers and other blood tubes, alcohol swabs, sterile
gauze or cotton ball, tourniquet, syringes, needles and needle holders.
Ask the patient to make a fist to make the veins more palpable. Select a suitable vein for puncture. Veins
of the antecubital fossa (median cubital and cephalic veins) are preferred.
Swab the puncture site with 70% isopropyl alcohol. Allow area to air dry.
Apply a tourniquet several inches above the puncture site. Never leave it in place for > 1 minute.
Perform the venipuncture. The needle should enter the skin at a ~15o angle with the bevel of the needle up.
Release the tourniquet when the blood begins to flow.
After sufficient blood has been drawn, have the patient relax his/her fist. Do NOT allow the patient to pump
the hand.
Place a clean sterile cotton ball/gauze over the site. Withdraw the needle, and then apply pressure to the
site. Place a plaster over the venipuncture wound.
Mix the blood gently with the anticoagulants by inverting the blood collection tube several times and send
the specimens to the laboratory immediately.
For blood collected in a yellow top SST vacutainer, please perform 5 smooth inversions for complete mixing
of blood specimen.
Dispose all material used in the collection in a safe manner.
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IMPORTANT CONSIDERATIONS FOR BLOOD COLLECTION

Identify Patient and Specimen Correctly
Ask the patient to identify himself/herself verbally. Label the specimen in the patient’s presence. Use the
patient’s sticky label or write the patient’s name and identification number on the specimen container legibly.
It is also important to note the date and time of specimen so that every specimen may be accounted for if
there are serial draws.
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Ensure Patient Fasts if Required
Some tests require patient fast for at least 8 -12 hours without food and/or beverages except plain water
before the test. These tests include PTH-Intact, Gastrin, fasting blood glucose, lipid profile and C-Peptide.
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Discourage Prolonged Fasting
Prolonged fasting may cause increase in serum bilirubin.
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Avoid Haemolysis
Tests such as potassium, magnesium, CK, AST, ALT, ACP and LDH are affected by haemolysis from
haemolytic anaemia or venipuncture. Haemolysis from traumatic venipuncture may be associated with the
release of thromboplastins, which may invalidate coagulation results. Haemolysis will also mask
haemolysing antibodies in the antibody screen. Haemolysis may be avoided by careful blood taking
techniques. Avoid venous stasis by leaving the tourniquet on the arm for extended time, forcing blood from
the syringe into a tube or vigorous shaking of a blood specimen.
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Ensure Optimal Anticoagulant Effect(s)
For tests requiring anticoagulated blood, completely fill the vacutainers until the vacuum is exhausted.
Correct proportion of blood to anticoagulant or preservatives is necessary for optimal test results. For
example, it is very important that the ratio of blood to anticoagulant be 9:1 in Coagulation Studies. Mix the
tubes immediately after the blood is collected to ensure complete action with the additive, i.e. to prevent
clotting of anticoagulated blood samples and to hasten clotting in the plain tubes with clot activators.
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Protect Photosensitive Specimen from Light
Some specimens, for example, Folate, Vitamin B12, Bilirubin and Porphyrin, are photolabile. Such
specimens should be protected from light by wrapping with an aluminum foil wrap or an equivalent.
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Send for Prompt Specimen Processing
Send the blood specimens to the laboratory as soon as possible for prompt processing of specimens. Serum
or plasma should be physically separated from contact with cells as soon as possible so that the values of
the analytes reflect the "true" value of the biological specimen. A maximum limit of 4 hours from the time of
collection is recommended.
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Use Appropriate Blood Collection Tube(s)
After determining what tests to order, select the vacutainers with the appropriate additives. To minimise carry
over of tube additives that interfere with analysis, draw multiple tubes in the following order:
Description
Tube content
Laboratory use
Sodium Citrate
- Coagulation Test
Tube Inversion
3-4 times
Blue
Clot Activator
(Plain)
Red
Clot Activator
(Plain with Gel)
Gold
SST II
- Lipid Profile
- HIV
- Virology
- Antibody Identification
- Cold Agglutinin Test
- Biochemical
- Virology
- Immunology Tests
- Protein Electrophoresis
- Troponin T
- Stat K
5 times
5 times
8-10 times
Lithium Heparin
Green
K2 EDTA
Lavender
Sodium Fluoride
Grey
K2 EDTA
Trace Element
Royal Blue
Free tube
Plain Tube
Trace Element
Royal Blue
Free tube
- Direct Anti-globulin Test
- Antibody Identification
- Hb Electrophoresis
- Full Blood Count
- Hba1c
- Lactate
- Glucose
- GTT
- Blood Lead
- Blood Arsenic
- Blood Cadmium
- Blood Manganese
- Blood Mercury
- Serum Zinc
- Serum Copper
- Serum Aluminium
- Serum Selenium
- Blood Mercury
8-10 times
8-10 times
8-10 times
8-10 times
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Chill Specimen if Required
Some analytes such as Homocysteine, Lactate, ACTH, Ammonia, Gastrin, Lactate, IGF-1, PTH-Intact and
Renin require chilling at 2oC to 8oC to inhibit the metabolism of blood cells and stabilise certain thermolabile
constituents. To chill a specimen, immediately place it in either crushed ice, a mixture of ice and water. The
coolant must cover the specimen level in the tube. Transport the specimens to the laboratory immediately
on ice.
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Other Considerations
Specimens for LDH isoenzymes should be kept at room temperature and must NOT be chilled. In addition
to chilling, anaerobic conditions should be maintained for specimens for ammonia. ACTH specimens should
be collected in a non-glass container.
UNACCEPTABLE BLOOD SPECIMENS
Incorrectly collected specimens and inappropriate specimen volumes cause erroneous laboratory results, and
therefore, will not be processed. Errors that can occur during collection and handling of specimens include the
following:
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Incorrect Identification of Patients or Specimen
In order to reduce the number of errors in patient and specimen identification, always ask for the patient’s
name and identification number or date of birth and verify the information against the request form.
Additionally, check the requisition form label against the patient’s identification card. Label the specimen in
the patient’s presence with the patient’s sticky label. Do not leave the room where the specimen was
collected with unlabelled samples.
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Clotted Blood Specimens
Some tests, e.g. coagulation studies and FBC, require plasma or whole blood. Do not take too much time
drawing such blood samples as clotting can happen before it is adequately mixed with the anticoagulant.
Blood specimens must be mixed gently with the anticoagulant within one minute to prevent it from clotting.
Invert the tubes 10 to 15 times.
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Insufficient Quantity
A minimum specimen volume is required to complete a test analysis. For coagulation testing (PT, APTT),
correct proportion of blood to anticoagulant is necessary. The vacuum must be completely exhausted but
the tube must NOT be overfilled by forcing more blood into the tube as this will affect test results.
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Use of Dated Supplies
Always check the expiration date before using the container for collecting specimens. Results may be
compromised if expired collection supplies are used, for example, tubes with expired anticoagulants can
cause whole blood to clot.
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Contaminated Specimens
Specimen contamination can be due to therapeutic drugs (e.g. heparin) and intravenous (IV) fluids (e.g.
saline, glucose, Ringer’s lactate). Heparin causes positive results for Lupus Anticoagulant studies while IV
solutions may affect many chemistries, e.g. glucose and electrolytes.
Contamination can also occur due to carry over of tube additives if blood is not drawn into multiple tubes in
the correct order during phlebotomy, i.e. plain tube(s) followed sequentially by tubes containing citrate,
heparin, EDTA and oxalate.
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Use of Incorrect Blood Tubes
The blood tube to be used is dependent on the test procedure. Blood tubes are colour coded by the colour
of the stopper. Transfer of blood from one tube to another is also strongly discouraged as different tubes
have different anticoagulant.
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(B) URINE COLLECTION PROCEDURE
Proper collection and preservation of urine are necessary to ensure valid results. There are three (3) kind of
urine specimens:
(1) Random Urine Specimen
(2) Timed Urine Specimen
(3) 24-hour Urine Collection
Random Urine Specimens
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Random urine specimens may be collected at any time. Collect random urine specimens in leak-proof nonsterile screw-capped containers obtainable from laboratory.
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Send specimens to the Laboratory as soon as possible. It is particularly important to use freshly voided urine
to test for bilirubin, RBCs and WBCs as these undergo decomposition upon standing at room temperature.
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Ensure that urine container lids are tightly secured and the bottle is correctly labelled with the patient’s name,
identification number and date of collection prior to submission for analysis.
Timed Urine Specimens
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Timed urine specimens are obtained at designated intervals, starting from “time zero”. For example, in
glucose tolerance test, collections are made at 0 and 120 minutes.
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Note the time of collection on each specimen container, in addition to the patient’s name, identification
number and date of collection.
24 Hour Urine Collection
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24-hour urine specimens are collected in special urine containers available from Quest Client Services
Department. To obtain the containers with preservatives for different tests, please call Quest Client Services.

Verbally instruct the patient on how to obtain the 24 hour urine specimen. Please stress to patient the
importance of proper urine collection. Ask the patient to repeat the instructions to determine he/she has
understood the following steps:
Discard the first morning urine. The 24 hour collection begins after this void.
Record the date and time on the provided urine container (e.g. 8 a.m., Aug. 8).
Collect all urine for the next 24 hours.
When there is a need to defecate, the bladder should be emptied first to avoid any urine loss and faecal
contamination of the urine.
The next morning, at exactly the same time recorded on the container, e.g. 8 a.m., void urine into the bottle.
This is the final urine collection for the 24 hour period.
Send the urine specimen to the laboratory as soon as possible.
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2.
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5.
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Emphasize to patient that accuracy and precision of collection are important, especially for creatinine
clearance test.
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Unpreserved urine specimens should preferably be refrigerated during the period of collection to prevent
microbiologic decomposition and chemical changes.
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If preservatives are required, it is important to include the designated preservatives in the urine collection
container at the start of the collection. Patient should be cautioned that the preservatives may be toxic and
caustic, and not to spill or discard the preservatives.

It should be noted that some urinary constituents such as VMA, Na, K, Cl and Ca vary greatly with diet. For
VMA, dietary restriction prior to urine collection includes vanilla, chocolate, coffee, bananas, citrus fruit, salt,
aspirin and hypertensive drugs.

Remember to label the urine container appropriately with the patient's name, NRIC number, clinic’s name
and date of collection.
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Detailed Procedures for 24 hour Urine Collection
24 Hour Urine Collection for Protein, Creatinine, Calcium, Phosphate, Uric Acid, Urea, Magnesium &
Electrolytes: No Preservative added
This procedure checks the function of the kidneys or measures certain by-products in the urine. For accurate
results, it is important to collect all the urine for exactly 24 hours.
Instructions
1.
2.
3.
4.
5.
6.
7.
8.
Before the collection, a urine collection container will be given. Your patient may need more than one urine
container to contain all of his/her urine for the 24 hour period.
Label the patient’s name, NRIC number & clinic name on the urine containers.
For 24 hours Creatinine Clearance Test, indicate patient’s height and weight on the urine container and the
request form.
Choose a day when it is convenient for your patient to collect his/her urine for 24 hours.
When the patient wakes up that morning, empty his/her bladder into the toilet as usual. That specimen is
not collected for testing.
From then on, please collect all the urine in the container for the remainder of the day and night including
the first specimen the following morning. For example, if he/she wakes up at 8 a.m. on Sunday morning,
empty the bladder into the toilet. Then, save all of their urine for the rest of the day and night including the
first specimen on Monday morning.
For accuracy, he/she must collect all of their urine during the time period because the amount and the
content of the urine will be measured and be used to calculate the test results.
When there is a need to defecate, the bladder should be emptied first to avoid any urine loss and
contamination of the urine.
24 Hour Urine Collection for Catecholamines, 5-Hydroxy Indole Acetic Acid, VMA: 15mL 50%HCl added
Catecholamines
1.
2.
Patient should abstain from the following at least 2 days prior to and during urine specimen collection:
chocolates, coffee, bananas, food containing vanilla, citrus fruits and where medically possible, drug such
as aspirin, methyldopa, isoproterenol, labetalol, mandelamine and metoclopromide.
The procedures for collection are as per 24 hour urine collection.
5-hydroxy indole acetic acid (5-HIAA)
1.
2.
Patient’s diet should be free from chocolates, walnuts, avocados, bananas, nuts, plums, pineapples,
tomatoes, eggplant, vegetables and where medically possible, drug such as reserpine, phenacetin,
acetanilide, nicotine, chlorphenylalanine, isoniazid, L-dopa, methyldopa and MAO inhibitors for 1 day prior
to and during specimen collection.
The procedures for collection are as per 24 hour urine collection for urine protein.
Vanillylmandelic Acid (VMA)
1.
2.
Patient’s diet should be free from chocolate, coffee, tea, citrus fruits and food containing vanilla for 1 day
prior to and during specimen collection. Where medically allowable, drug such as aspirin, drugs containing
gentisic and homogentisic acid, antihypertensive drugs, methyldopa, glyceryl trinitrate, chlorpromazine, Ldopa, epinephrine, norepinephrine, prochlorperazine, reserpine, disulfiram, guanethidine, imipramine, MAO
inhibitors, radiographic dyes should be withheld for 1 day prior to and during specimen collection.
The procedures for collection are as per 24 hour urine collection.
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24 Hour Urine Collection for Trace Metals
Patient Preparation
Various medications or supplements taken by the patient may have an impact on the results of the test. Birth
control pills often produce elevated levels of copper in the blood. Drugs taken for high blood pressure frequently
contain diuretics which increase the amount of liquid discharged and dilute the urine. The intake of Vitamin C
should be discontinued for 3 days before the test. It is also recommended that use of iron and trace element
supplements be stopped for a few days before the test.
Additional Preparation for the following Trace Metal Tests
Arsenic
Patient must avoid all seafood for 72 hours prior to specimen collection. Seafood and seaweed consumption
can markedly elevated levels of total arsenic in urine.
Cadmium
Patients should refrain from eating shellfish for at least three (3) days prior to specimen collection.
Chromium
If medically feasible, patient should refrain from taking vitamins or mineral supplements at least one week prior
to collection.
Copper
Birth control pills often produce elevated levels of copper in blood. It is recommended to stop birth control
medications for a few days before the test.
Mercury
Avoid seafood and seaweed three (3) days prior to the collection.
Aluminum
Abstain from fruit juice and tea one (1) day prior to the collection.
Arsenic
Abstain from seaweed for three (3) days prior to the collection.
(C) CSF AND OTHER BODY FLUIDS COLLECTION

The laboratory performs a variety of testing on CSF, other body fluids and drainages. Ensure that the
specimen is properly collected and avoid any contamination. For example, a bloody spinal tap may render
the specimen unsuitable for analysis.

Collect the fluids in sterile, leak-proof, screw-capped containers obtainable from the laboratory. Ensure that
the caps are tightly secured.

If CSF is collected for multiple analyses and collected in more than one container, earmark the first container
for biochemistry, the second for microbiology and the last container for cytology.
12
SECTION 4: REQUIREMENTS BY SPECIFIC DEPARTMENTS AND TESTS
BIOCHEMISTRY DEPARTMENT
Glucose Tolerance Test
1.
2.
3.
4.
5.
6.
7.
8.
Glucose Tolerance test to be performed only in the morning.
Three (3) days prior to the test, patient must ensure a diet containing more than 150g of carbohydrates
daily.
Drug therapy should be stopped on the morning of the test.
Patient is required to fast for at least 8 to 12 hours without food and/or beverages except plain water
before the test.
Collect 2ml blood (use fluoride tube) before administering carbonated glucose drink.
Label blood specimen as fasting sample and indicate the time of blood collection.
Administer 75g of the carbonated glucose drink orally over the course of 5 minutes. Patient should
refrain from strenuous exercise, smoke or eat after carbonated glucose drink is administered orally
After 2 hours, collect 2ml of blood (use fluoride tube). Label blood specimens as 2 nd hour post-prandial
sample and indicate the time of blood collection.
MOLECULAR DIAGNOSTICS DEPARTMENT
Chlamydia & Gonorrhoea PCR: Mid-stream urine collected in a sterile container or a sterile swab is required.
Specimen requirements:
a)
Urine (preferred samples for male patient):
Collect 15 - 20ml of morning first voided urine in a preservative-free sterile container.
OR
Urethral swab (male patient): Use aluminium Invasive sterile collection dry swab (Red Top). Send swab in
container.
b)
Endocervical swab/High vaginal swab (female patient):
Use only Invasive sterile collection dry swab (Red Top). Send swab in the container without any media.
c)
Rectal, conjunctival and throat swab (for suspected infections at these sites):
Collect using Invasive sterile collection dry swab (Red Top). Send swab in the container without any media.
d)
Semen:
Collect semen in an empty sterile container for male patients
Storage & transportation:
Refrigerate sample until transfer to laboratory. Do not freeze. Send sample at 2°C - 8°C (with ice-pack) and
sample must reach lab within 24 hours after collection.
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HBV DNA: 3 mL EDTA Blood tube to be collected for HBV DNA only to avoid contamination.
ABBOTT REALTIME HIGH RISK-HPV DNA PCR: Collect sample with HPV swab or Thin prep vial (If ordered
with Thin Prep Pap test)
1.
2.
3.
General Instructions (Abbott Cervi-Collect Specimen Collection Kit)
Prepare patient in lithotomy position.
If observed, remove excess mucus or abnormal excudate from the cervical os and surrounding
ectocervix.
4. Insert the Abbott Cervi-Collect swab into os of the cervix until only bottom-most bristles are exposed.
5. Slowly rotate the brush 3 full turns in one direction. Do not over-rotate.
6. Withdraw the brush carefully. Avoid touching the brush bristles to the outside of the Transport Tube or
to any other object.
7. Handle the Transport Tube and cap carefully to avoid contamination.
8. Unscrew the Transport Tube cap and immediately place the Cervical Brush into the Transport Tube so
that the brush bristles are immersed in the buffer.
9. Rinse the Cervical Brush in the Specimen Transport Buffer by rotating the Cervical Brush in the buffer
(10) times while pushing it against the wall of the Transport Tube. Swirl the Cervical Brush vigorously
to further release material. Discard the Cervical Brush.
10. Recap the Transport Tube. Ensure the cap seals tightly.
11. Label the Transport Tube with sample identification information, including date of collection using an
adhesive label.
General Instructions (Thin Prep Vial)
1.
2.
3.
4.
5.
Follow the same advice for patient preparation as for cervical smear.
Obtain an adequate sampling from the cervix using the cytobrush. Insert the central bristles of the brush
into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix. Push
gently, and rotate the brush in a clockwise direction five times
Rinse the brush into the PreservCyt® solution vial by pushing the brush into the bottom of the vial 10
times, forcing the bristles apart. As a final step, swirl the brush vigorously to further release the bristle
apart. Discard the cytobrush.
Tighten the cap so that the torque line on the cap passes the torque line on the vial
Label the vial with the patient’s name
REAL TIME HSV PCR:
Specimens: Genital swab or Oral swabs collected from mouth, tongue, lips, pharynx and/or eyes using
plain sterile swab (Red cap)
VPIII (Vaginitis Screen)
Specimens: Swabs of vaginal fluid specimens from patients with symptoms of vaginitis/vaginosis.
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SEROLOGY DEPARTMENT
SPECIMEN COLLECTION AND HANDLING
TB Quantiferon (QFT) uses the following collection tubes:
1. Nil Control (Grey Cap)
2. TB Antigen (Red Cap)
3. Mitogen Control (Purple Cap)
Antigens have been dried onto the inner wall of the blood collection tubes so it is essential that the contents of
the tubes are thoroughly mixed with the blood. The tubes must be transferred to a 37°C incubator as soon as
possible and within 16 hours of collection.
1.
2.
For each patient, collect 1mL of blood by venepuncture directly into each of the QFT blood collection
tubes.
Immediately after filling tubes, shake them ten times just firmly enough to ensure the entire inner surface of
the tube is coated with blood, to solubilize antigens on tube walls.
Points to note:
a.
b.
3.
Tube should be between 17°C -25°C at the time of blood filling.
Vigorous shaking may cause gel disruption and could lead to aberrant result.
The tubes must be transferred to a 37°C±1°C incubator as soon as possible and within 16 hours of
collection. Do not refrigerate or freeze the blood samples
IMMUNOLOGY DEPARTMENT
Homocysteine
Specimen requirements
- 3ml EDTA blood required. Fasting sample is required.
- Keep cool with ice/ice pack during transportation. Avoid haemolysis (avoid direct contact with ice pack) and
send immediately to the laboratory.
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MICROBIOLOGY DEPARTMENT
Microbiological culture employs conventional methods with current advances to isolate the causative agent of
infection. Thus specimens must be collected appropriately and transported correctly in transit to the laboratory.
Specimens that are collected and/or transported poorly may result in the failure to recover the pathogens or
result in growth of contaminants or commensals leading to inappropriate treatment. Often, direct smears may
be used as a tool for rapid information in diagnosis and treatment when correlated to the patient’s clinical
presentation. It can also be used to determine the quality of the specimen collected for culture.
SPECIMEN COLLECTION AND TRANSPORTATION
1. Whenever possible, specimen must be collected before administering antimicrobials.
2. Proper collection is vital to avoid contamination from indigenous flora.
3. Use appropriate collection devices intended for the pathogen suspected. Collection must be done
aseptically.
4. Specimen container must be labelled with the patient’s details.
5. If culture is required only for a particular pathogen, please state it on the request form.
6. Please do NOT forward specimen collected in a syringe to the laboratory. The specimen should be
transferred into a sterile container for transit.
7. Prompt delivery of the specimen to the laboratory ensures that viability of the pathogen is not compromised
due to its fastidious nature.
8. If a delay is unavoidable due to circumstances, the specimen should be stored at 2 – 8 ºC except for blood.
Anaerobic cultures, specimens for Trichomonas vaginalis and Neisseria species, and cerebrospinal fluids.
9. If Neisseria gonorrhea is suspected, it should be submitted on a charcoal swab (Black cap).

Blood Culture
Blood culture specimen must be collected using sterile techniques to reduce the chance of contamination.
BacT/ALERT®PF Plus (Biomerieux) for pediatric blood Culture bottle:
Although lower sample volumes can be used, recovery may be improved using sample volume closer to the
recommended 4ml. Volumes greater than 4ml do not maintain the optimal blood to medium ratio.
BacT/ALERT® FA Plus (Biomerieux) Aerobic and /or BacT/ALERT® FN Plus (Biomerieux) Anaerobe
Culture bottle(s):
Although lower sample volumes can be used, recovery may be improved using sample volume closer to the
recommended 10ml. Volumes greater than 10ml do not maintain the optimal blood to medium ratio.
The inoculated BacT/ALERT blood cultured bottle(s) should be transported to the laboratory as quickly as
possible.
Two to three sets of cultures per patient collected by separate venipuncture sites are recommended by Clinical
and Laboratory Standards Institute (CSLI).
 Body Fluids
The examination of body fluids is an important tool with valuable diagnostic information for various medical
conditions. The various fluids vary in formation, function and complexity. Thus several general observations are
made for all body fluids. Gross examination, cell counts, morphological examination, and chemical analysis are
usually done. All body fluids are usually done STAT on arriving at the laboratory. It is advisable to let the
laboratory know that there is intention to send such specimens so that a senior staff member will be present for
the analysis.
Aspirate from the site in question should be sent to the laboratory in a sterile container. If there is any delay in
transportation, the specimen should be refrigerated between 2 – 8 ºC except for cerebrospinal fluids.
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 Gastrointestinal Specimens
Culture and sensitivity for stool specimens are routinely investigated for Salmonella, Shigella and Vibrio. If there
are indications that the laboratory should look for pathogenic Escherichia coli in patients who are more than two
years old, this should be stated clearly on the request form.
If transport delay is anticipated, the specimen should be refrigerated between 2 – 8 ºC.
If rectal swab is used to obtain anal material for the culture of Neisseria gonorrhoea, it should be submitted on a
charcoal swab (black cap). Please call laboratory for supply arrangements prior to specimen collection from
patient.
1)
2)
For stool specimen: Patient should pass stool sample directly into a clean sterile container. Stool specimen
sent in other forms e.g. toilet tissue, plastic bag will be rejected.
For rectal swab specimens, the tip of the sterile swab should be passed about 2.5cm beyond the anal
sphincter and rotated gently for a good collection.
 Urine
Mid stream urine (50ml) collected into a sterile container is required.
1)
2)
Never submit specimens collected from a bedpan or urinal.
24 hours urine sample are not suitable for culture.
Urine Collection Procedure:
o






Female Patients
Clean the urethral opening and vaginal vestibule prior to collection.
Disinfectants are not recommended for cleaning. Soaps will be sufficient.
Dry after cleaning.
Patient should wash hands and dry.
Hold labia apart during voiding of urine.
Collect only mid stream urine.
o
Male Patients
Wash hands and dry.
Clean penis, retract the foreskin for uncircumcised patients, wash with soapy water and then dry.
Keep foreskin retracted and collect mid stream urine.



If there is any delay in transportation, the specimen should be refrigerated at the clinic. Urine specimens
must be processed within 4 hours of collection. Do not freeze!

Other Specimens
All other specimens can either be sent in a sterile container or in a swab with transport medium. Do not send
specimen in dry swabs. Please state the source of specimen with clear instructions for the purpose of culture.
1)
2)
3)
4)
Use a sterile swab and swab onto the area in question.
Ensure that the swab is rotated at the tip when collecting the sample.
Insert the swab straight away into the transport gel.
If transport delay is anticipated, specimen should be refrigerated between 2 – 8 ºC except for blood,
anaerobic cultures, specimens for Trichomonas vaginalis and Neisseria species, and cerebrospinal fluids.
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CYTOLOGY DEPARTMENT
INTRODUCTION
Cytological examinations are generally used for the detection of malignancy. Other investigations may also be
requested e.g. detection of TB, fungi, etc.
CYTOLOGY: GYNAECOLOGICAL SMEAR
CERVICAL (PAP) SMEARS
The cervical (PAP) smear is a screening technique primarily for the detection of cervical intraepithelial lesions
and cancers as well as genital infections.
Both conventional slide PAP test and Liquid based cytology (ThinPrep) PAP tests are available in Quest.
Special Instructions on Specimen Collection and Handling












Patient Preparation: Proper patient preparation encompasses the following:
Ideal sampling date is two weeks after the first day of last menstrual period.
Discourage sampling during normal menses.
Avoid use of vaginal medication, vaginal contraceptives, or douches for 48 hours prior to examination.
Sampling for Conventional Smear
Endocervical smear is prepared by inserting spatula into canal.
Spread material onto a labelled glass slide.
Spray fix slides immediately with coating fixative (Cytospray), making sure the smear is adequately coated
with fixative.
Ectocervical scrape: With spatula thoroughly scrape the entire endocervix with emphasis on the squamocolumnar junction. Spread material onto a labelled glass slide and spray-fixed immediately with Cytospray.
Vaginal smear: If desired, obtain specimen by lightly scraping the posterior fornix with spatula. Spread the
material evenly onto a labelled glass slide and spray-fixed immediately with Cytospray
Write patient’s name and ID in pencil on the frosted end of the glass slide. Any unlabeled slide will be
rejected and discarded. The clinic will be informed before rejection of specimen.
Fixation: If more than one slide is immersed in fixation solution, attach a paper clip to each slide (on the
frosted end of the slide) to separate slides and allow for circulation of the fixative.
For adequate study of the female genital tract for malignancy, we suggest a well-collected and prepared smear
be taken from the ectocervix and the endocervix. If a quantitative maturation index is requested, a portion of the
specimen must be taken from the lateral vaginal wall and smeared onto a separate slide. It is also important to
label all slides and specimen containers with the patient's name and the site(s) of specimen collection.
Hormonal Evaluation
A separate slide must be taken from the lateral vaginal wall for optimal reliability.
This request should be clearly stated on the request form.
18







Sampling for Liquid based ThinPrep PAP Test
Obtain an adequate sampling from the cervix using a broom-like device.
Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles
to fully contact the extocervix.
Push gently, and rotate the broom in a clockwise direction five times.
Rinse the broom as quickly as possible into the PreservCyt solution vial by pushing the broom into the bottom
of the vial 10 times, forcing the bristles apart.
As a final step, swirl the broom vigorously to further release material into the solution.
Discard the collection device.
Tighten the cap so that the torque line on the cap passes the torque line on the vial.
Write the patient’s name and ID on the sticky label on the vial.
Write any relevant clinical information and medical history on the request form.
Any unlabeled vial will be rejected and discarded. A call will be made to the clinic before specimen is rejected.




Sampling Note:
Excessive use of lubricant during sampling may contaminate or obscure the PAP sample.
Lubricant should be applied sparingly to avoid an unsatisfactory report issued.
It is recommended that a water-based lubricant be used, e.g.; Astroglide, Surgilube and Crystelle.




CYTOLOGY: NON-GYNAECOLOGICAL SMEAR AND FLUIDS
General Instructions
Smear Preparation
1. Write the patient's name in pencil on the frosted end of the slide.
2. Submit 1-4 slides of material from any source that can be evaluated cytologically
3. Fix slides immediately by immersing in 95% alcohol or by spraying sufficient spray fixative (cytospray),
making sure the smear is adequately coated with fixative.
4. If air-dried(unfixed) smears are also prepared for the same patient, differentiate the fixed and unfixed slides
by putting them in separate containers indicating A/D for the container of air-dried(unfixed) slides.
5. Indicate the site from where specimen was taken, as well as appropriate clinical information on request form
Fluid
1. Submit fresh fluid to the laboratory as soon as possible. If delay is anticipated, refrigerate between 2 – 8 ºC.
2. Place fluid in a tightly capped, appropriately labelled container.
3. For large amount of accumulated fluids, e.g. fluids from drainage containers, let fluid stand for 20 - 30
minutes then collect 50ml of sediment from bottom of container. Send only the 50ml of sediment fluid to the
laboratory.
(**Do not send drainage collection bags and drainage tubes to the laboratory.)
Specific Site Instructions
Breast Cyst Aspiration
If aspirate is scanty, fluid may be smeared one drop at a time on clean, dry slides and immediately fixed. If
aspirate is abundant, collect in a clean tube, indicate volume and send as soon as possible to the laboratory.
Breast Secretions (Nipple discharge)
Drops of fluid from the nipple are smeared directly on clean glass slides and fixed immediately with spray fixative
or immersed in 95% ethyl alcohol for 20 minutes. Whenever possible, submit multiple slides (2-4) half of which
should be left air-dried without fixative.
19
Bronchial, Oesophageal & Gastric Brushings
Roll brush over a clean dry slide and fix immediately with 95% alcohol or spray fixative.
Cerebrospinal Fluid
Collect in a sterile container and send fresh as a STAT test to the laboratory with appropriate indication of test
requested.
Effusions
Collect in a sterile container and send fresh as soon as possible to the laboratory. If a large volume of effusion
is collected, let it stand for 30 minutes, pour away top portion of fluid gently leaving 50 mL to be transferred into
a smaller sterile container.
Fine Needle Aspiration
1. Fix 2-4 slides immediately (within a few seconds) using cytology spray fixative or by immersing the slides in
95% ethyl alcohol for 20 minutes. Then leave the slides to dry after draining out excess alcohol fixative.
2. If fluid is also obtained with a needle pass, it should be expressed into a sterile container. Submit the liquid
specimen with the fixed slides (using one request form) promptly to the laboratory.
3. Clinical information is required for the Pathologist to render a diagnosis. Please indicate on the request form
the site of aspiration, clinical diagnosis, whether the lesion is solid or cystic and gross appearance of the
aspirate if applicable.
Pericardial, Peritoneal and Pleural Fluid
Collect in a sterile container and send as soon as possible to the laboratory.
(See General Instructions)
Sputum
Submit early morning deep-cough specimen prior to the ingestion of any food. Have the patient rinse mouth with
plain water first. Collect separate specimens on 3-5 consecutive mornings. Do not pool specimens. Send
specimens fresh as soon as possible to the laboratory. (See also Non-gynaecological smear and fluid - General
Instruction)
Urine
Avoid the first morning stream of urine. For voided sample, only collect the midstream urine. Submit all
specimens fresh in a sterile container. Mark on the request form: “Voided” or “Catheterised” as appropriate.
20
HISTOPATHOLOGY DEPARTMENT
Introduction
Surgical, anatomical and consultative pathology services are available through our Pathologists at Quest
Laboratories. Tests available include:
- Routine Surgical Specimens & Biopsies
- Frozen Sections|
The Histopathology Request Form
A request form should accompany all specimens. When more than one specimen is sent from the same patient
at the same operation, use only one form. Place a sticky label with the patient’s identification on every copy of
the request form. The request form must include:
1. Patient’s name, age, sex, identification number and race.
2. The clinic or ward and bed number if from an inpatient. This information will facilitate the dispatch of reports.
3. Examination required e.g. cytology, histology, frozen section etc.
4. Summary of clinical history.
5. Operative findings.
6. Type of specimen and anatomical site.
7. Provisional clinical diagnosis.
8. Name and signature of physician/surgeon in charge of case.
9. Previous biopsy number or date of previous operation, if any.
10. Include the date and time in which the specimen is taken.
Instructions for Specimen Collection and Handling
1.
Specimens should be sent in clean containers with 10% buffered formalin unless otherwise stated.
2.
Frozen sections will be done on-site in the hospital without fixation (i.e. on fresh specimens).
3.
Wherever possible, there should be one specimen per container. If multiple specimens are placed in one
container, they should be clearly indicated by size or suture marking.
4.
Multiple small specimens, such as gastrointestinal biopsies, should be mounted on a piece of filter paper,
and properly labelled. (Gastrointestinal biopsies from different segments of the GI tract are best separated
in different containers. Biopsies mounted on filter paper, although sometimes numbered, may still drop off
into the formalin fixation, thus the identity of the biopsies may be lost.)
5.
Large specimens such as colon should be opened, the contents cleaned out and specimen completely
immersed in formalin. Containers must be tightly secured.
6.
Do not crush specimens with forceps, haemostats or other instruments. Avoid using cautery.
7.
Do not force a large specimen into a small container. (Specimens harden after fixation and it may be difficult
to remove from the container.) Large specimens must be completely immersed in formalin for proper fixation.
8.
Label each container with the patient’s name, NRIC or admission number, the source of the specimen and
nature of specimen.
9.
If ziplock plastic bags are to be used, staple request form onto the top of the bag above the zipper seal.
10. “URGENT REPORT” request has to be clearly indicated on the request form; otherwise, they will be
processed as per normal.
11. For specimens where orientation is important, mark or tag the specimen, e.g. axillary tail of mastectomy
specimens, N2 lymph node of gastrectomy specimens, most proximal lymph node of colectomy specimens.
ROUTINE BIOPSY & SURGICAL SPECIMENS
Specimens submitted for routine histology are categorised below, with a separate charge for each category.
Please refer to Service Guide for full details of charges.
21
Categories of Specimens
1.
One Small uncomplicated specimen – H201 (up to 3 cm)
Appendix, breast lump, cervical biopsy (<1cm), fallopian tube (one), fibroid, ganglion cyst, lymph node,
cervical/endometrial polyp, POC (products of conception), tonsil (one side), uterine curetting, etc.
2.
Medium or small complicated specimens- H203 (3cm to 6cm)
Multiple breast lumps, fallopian tubes in same container, bone (<3cm), fibroid, perianal fistula, gall bladder,
lipoma, lymph node, ovarian cyst, ovarian biopsy, prostatic chips, synovium, thyroglossal cyst, perianal
abscess, POC – ectopic, skin, tonsils (bilateral), one testis, etc.
3.
Large specimens – H204 (>6cm)
Bone (3cm – 6cm), breast cancer – wide excision, fibroid, lung resection, ovarian cyst, two testes, thyroid,
uterus with or without ovaries or tubes, prostatic chips, etc.
4. Complex large specimens – H205 (>6cm)
Breast (mastectomy), bone (>6cm), colon, kidney, limbs, rectum, stomach, spleen, THBSO for cancer,
large cone biopsy of cervix, uterus & large ovarian cysts, Whipple's operation, etc.
5.
LEEP Cone Biopsies – H206
Leep cone biopsy & cervical biopsy >1cm
6.
Specialized biopsies – HSBX, HSBX1, HSBX2, HSBX3
GIT, respiratory tract, urinary tract, bladder biopsy, etc.
HSBX
1 to 6 pcs in 1 container
HSBX1
7 to 12 pcs in 1 container, or
2 containers of specimen with 6 or less pcs each
HSBX2
13 to 18 pcs in 1 container, or
3 containers of specimen with 6 or less pcs each
HSBX3
19 to 24 pcs in 1 container, or
4 containers of specimen with 6 or less pcs each
FROZEN SECTION
Appointment for Frozen Section has to make one day in advance. Please call the following numbers for advance
booking and information on charges and surcharges if any:
6277 0210, 6277 0211 & 6277 0212
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CONTACT US
Head, Sales and Marketing
Ms Clarice Long
67 Ubi Ave 1, #07-01 to 07, 09 &10
StarHub Green North Wing
Singapore 408942
DID: 6277 0243
Fax: 6277 0236
Head, Laboratory
Mr John Lee
67 Ubi Ave 1, #07-01 to 07, 09 &10
StarHub Green North Wing
Singapore 408942
DID: 6277 0208
Fax: 6277 0236
Deputy Head, Laboratory
Mr Low Chin Keong
67 Ubi Ave 1, #07-01 to 07, 09 &10
StarHub Green North Wing
Singapore 408942
DID: 6277 0207
Fax: 6277 0236
Head, Laboratory
Mr Yap Kwee Chuah
290 Orchard Road
#17-07, 08, 09 The Paragon
Singapore 238859
Tel: 6737 2788
Fax: 6887 3249
Billing & Test Charges
6277 0266
Results Tracing – Clinical
6275 5501 EXT '0'
Results Tracing - Histo/Cyto
6277 0211 / 6277 0212
Supplies Requisition
6277 0221 / 6277 0222
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Quest Laboratories Pte Ltd
_____________________________________________________________________
_____________________________________________________________________
www.questlabs.com.sg
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