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Testing Results
IMPORTANT! Sites requesting testing must have approval from the appropriate state or local health department before submitting specimens. Approval must be sent to NPHL by email at or by calling (402) 559-9444.

A Special Microbiology Form must accompany the specimens. Some tests require additional forms and patient history. This will be listed below when applicable. When requested, testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406 for further clarification.


  Test: Borrelia burgdorferi Antibodies, Total 
  Synonym: Lyme Disease Antibodies 
  Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay 
  Availability: Test performed Daily, Results within 1-2 days 
  Specimen: Blood 
  Collection Device: 6.0 mL Clot (Red) or SST (Gold) tube
Specimen Labeling: Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms  
  Volume: 2.0 mL serum (Min: 0.1 mL)  
  Storage/Transport: Prior to and during shipment: Refrigerate; Separate serum from cells ASAP or within 2 h of collection
Shipping instructions, including specimen-handling requirements during transport:
Package and ship as Category B, Biological Substance, UN3373. See instructions and shipping address: in biohazard bag with absorbent material. Refrigerated specimen should be shipped on cold packs. Transport by NPHL ground courier (NPHL brown shipper not required). If courier not available, contact Client Services (866) 290-1406 to arrange pickup.  
  Unacceptable: CSF, severely lipemic, heat-inactivated, contaminated, or hemolyzed samples 
  Specimen Stability: After separation from cells: Ambient: 48 h; Refrigerated: 2 w; Frozen: 1 yr (avoid repeated freeze/thaw cycles) 
  Reference Interval: < 1.00 LIV: Negative - Antibody to Borrelia burgdorferi not detected.
1.00-1.20 LIV: Equivocal - Repeat testing in 10-14 days may be helpful.
> 1.20 LIV: Positive - Probable presence of antibody to Borrelia burgdorferi
  Reportable Disease: Lymes disease positive test is reportable within 7 days  
  Comments: Current CDC recommendations for the serologic diagnosis of Lyme disease are to screen with a polyvalent ELIA test and confirm equivocal and positive results with Immunoblot. Both IgM and IgG immunoblots should be performed on samples < four weeks after appearance of erythema migrans. Only IgG Immunoblot should be performed on samples > four weeks after the disease onset. Only IgG immunoblot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease. Please submit requests for appropriate immunoblot testing with 10 days.

Once this test is performed, if
a) Negative - no further testing is done,
b) Positive or equivocal - Western blot testing will be performed on the original sample upon receiving a request.
Sample will be held for 30 days only.  
  Revised: 12/11/2018 


If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406.