Laboratory Requirements for OIE-FAVN test
MWD Lackland Test Request
Public Health Command Region - South
ATTN: Diagnostic Laboratory
2899 Schofield Road, Suite 2630
Ft Sam Houston TX 78234-7583
Phone (210) 295-4605/4010/4387 Fax: (210) 270-2559
Website: vetlab.army.mil
Print/type all information. Check test requested.
| |FAVN-OIE Rabies Antibody Test (only) | |Procurement (FAVN, Tick Disease Panel) |
| |Tickborne Disease Panel | |Canine anaplasmosis IFA |
| |Babesia canis IFA | |Brucella canis agglutination and IFA |
| |Ehrlichia canis IFA | |Heartworm antigen ELISA |
| |RMSF IFA | |Leishmania IFA |
| |Lyme Disease IFA and Western Blot | |Trypanosoma cruzi IFA |
| |Australia Panel: (Ehrlichia, Leptospirosis, Brucella, Leishmania) | |Leptospirosis MAT (7 serovar screen) |
|Clinical History: |
| |
|Dog’s Name: |Tattoo: |Procurement: |
|Breed: |Age: |Sex: |
|Color Markings: |Microchip: |
|DOD Military Dog Veterinary Services |Clinic Code: 1370-00 |
|1219 Knight Street, Bldg 7595 |Date Serum Drawn: ___________ |
|Lackland AFB, TX 78236-5519 | |
| |Phone: 210-671-3391 |
| |Fax: 210-671-2308 |
|Name of Veterinarian: _______________________________________ |
|Signature: |
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Date/Time Received
Lab Accession Number
Laboratory Test Results:
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