General Lab Questions
We are unable to suggest, recommend, or direct patients on what testing should be ordered. You should consult your physician who is trained to take into consideration your symptoms and other factors to determine the best testing in order to provide the best diagnostic information. At best, we can describe the tests, how they work, and what results the tests may show.
Fry Laboratories, L.L.C. specializes in the detection and identification of blood-borne pathogens including (but not limited to) Borrelia, Bartonella, Ehrlichia, Anaplasma, Rickettsia, Babesia, Toxoplasma, Plasmodium (Malaria), Trypanosoma, other infectious protozoa or bacteria, biofilm forming organisms, and new or emerging diseases. Additionally, we offer DNA sequencing tests to provide the widest microbial detection capability possible based on the genomes of organisms directly.
Unfortunately, some of the information on the internet is not accurate or is misconstrued. The best place to find information regarding tick-borne, vector-borne, or infectious diseases is through your healthcare provider and regulated governmental sources, like the CDC. The internet contains incomplete, inaccurate, or misleading information regarding diagnosis, treatment, and testing; therefore, be wary of information from online sources and consult a healthcare provider. Furthermore, there are also online sources that report information regarding the ongoing research projects at Fry Laboratories, LLC. Please note that information regarding the research performed by Fry Laboratories, LLC is included within the Resources section of our website. Official information about Fry Laboratories, LLC will be released by us or through official press releases in partnership with 3rd party companies.
Please visit your healthcare provider for appropriate medical care, test selection, and treatment advice.
Specific Test Questions
Many of our tests are direct microscopic examinations of blood smears. The term hemobartonella and, often used interchangeably – epierythrozoan, are descriptions of the behavior of an organism(s) that is observed (meaning the organism sticks to red blood cells). Except in a few cases, it is generally not possible to determine the species of bacteria observed by microscopy as they are indistinguishable. Bacteria generally appear as spherical, rod, or slightly irregular shaped cells. Organisms that adhere to the surfaces of cells have the physical characteristics consistent with epierythrozoan, or red blood cell adhering, bacteria. It is now known that Bartonella species are not the only type of organism to display these characteristics. In summary, as new species of blood-borne bacteria have been discovered it has become clear that microbes identified by microscopy that are found inside or adherent to red blood cells are not necessarily Bartonella species and as such the general terms ‘hemobartonella’ and ‘epierythrozoan’ are replaced with the term ‘epierythrocytic bacteria’. Fry Laboratories, LLC offers targeted serologic and DNA sequencing to confirm and identify a microbe observed by microscopy.
IgG and IgM are two types of antibodies that are found in the blood. Antibodies are part of the bodies immune system that is used to identify, neutralize, and destroy foreign objects and organisms, such as bacteria, parasites, and viruses. At a basic level, IgM antibodies usually are associated with the early onset phase of an infection (acute), while IgG is generally associated with long-term immunity or reactivity towards a pathogen (chronic or prior infection).
Fry Laboratories, LLC uses several tests to assist in the detection of Bartonella species and related organisms. A common method is by the utilization of immunofluorescent microscopy that can detect both IgG and IgM antibodies. This test is a qualitative measure of the hosts immune reaction to the pathogen. The second method is direct microscopic visualization of a blood sample. Typically, Bartonella species may be found adherent to the outside of red blood cells, but in some cases may be inside of the cells as well. Lastly, DNA sequencing may aid in the detection of Bartonella species by detecting and identifying the organism’s DNA in a patient sample.
The spirochetes that cause Lyme Disease, named Borrelia burgdorferi, can be seen on a stained smear and can be observed by our laboratory. Generally, it is considered difficult to detect Borrelia by microscopy. The absence of spirochetes by microscopic examination does not necessarily mean the patient does not have Lyme Disease. Therefore, in addition to the stained smear Fry Laboratories, LLC offers an Immuno-blot and DNA sequencing that can also detect Borrelia burgdorferi.
We can detect abnormalities with red cells and white cells, as well as organisms, or biofilm-like structures that are visible within the portion of the sample we are observing. The pictures found in text-books of parasites and blood infections usually are Giemsa or May-Grunwald stains, the same stains used in the Stained Smear / Special Stains test.
No. Do not freeze the blood sample. Freezing whole blood destroys the cells and testing cannot be performed. Samples that have evidence of freezing will be discarded when they arrive in the laboratory. The provided small ice pack (or large freezer pack in the tissue kit) with the kit should be frozen and be placed with the sample in the styrofoam box.
The Advanced Stain test is based on fluorescent DNA staining technology. The fluorescent DNA stain is used to visualize DNA positive structures in a wet-mount preparation of a sample. A photomicrograph is obtained and included within the report.
The Mosaic Stain test uses a fluorescent fungal stain in addition to a fluorescent DNA stain to dual-label the sample. Suspect fungal and DNA positive structures are observed in a wet-mount preparation of a sample. A photomicrograph is obtained and included within the report.
Our Pan-Bacterial DNA analysis test uses Next Generation DNA Sequencing technology to detect bacteria and archaea (not protozoa, fungi, or viruses). We isolate DNA from the patient sample (blood, tissue, urine etc.) and using an amplification technique known as Polymerase Chain Reaction (PCR), that amplifies DNA specific to bacteria. The amplified DNA is then sequenced and compared to all bacteria and archaea published in Genbank. For more detailed information, click here for our sequencing information page.
Our Pan-Eukaryotic DNA analysis test uses Next Generation DNA Sequencing technology to detect and identify fungi, protozoa, amoeba, and algae (not bacteria or viruses). We isolate DNA from the patient sample (blood, tissue, urine etc.) and using an amplification technique known as Polymerase Chain Reaction (PCR), that amplifies DNA specific to protozoa and fungi. The amplified DNA is then sequenced and compared to all fungi and protozoa published in Genbank. For more detailed information, click here for our sequencing information page.
Many of our tests have indicated warnings about potential interference of results due to medications. Generally, antibiotics are recommended to be discontinued two (2) weeks prior to the blood sample draw to allow for the most reliable results. However, as with all treatments please consult your physician or health care professional regarding this as it is a medical decision. It is critical that the choice to start or stop any medication should be done with consultation from your healthcare provider.
There are subtle and sometimes significant differences between similar tests from different testing laboratories. Fry Laboratories, LLC does not comment on the performance characteristics of other laboratories’ tests. Please check with your healthcare provider when selecting tests as they are best equipped to identify and select the most appropriate test for your case, sample type, and suspected organism(s). Fry Laboratories, LLC encourages questions regarding how the various tests work, what they test for, and how they can be used; however, that should not be interpretation as a recommendation for a particular test(s).
Questions Regarding Patient Results
We email or mail the results to your ordering physician when completed. A faxed copy of the results may be faxed to the ordering physician’s office at the request of the ordering physician. The physician is expected to contact and follow up with the patient once results have been received.
The results should be discussed with your ordering physician or health care professional. Fry Laboratories, LLC is not permitted to discuss, interpret, or release patient results with anyone other than the ordering physician.
Our processing time for testing depends on the tests that are ordered. Expected turn-around-times may be found in the most recent Services Handbook (found in the Forms Section). Extended times may occur if DNA Analysis testing is ordered and results require verification. While results may be available earlier than this time, please allow a few extra days if the results are reported by mail. Physicians who use the email reporting system are sent results the day they are released.
Unfortunately, we do not email, mail, or fax results to anyone other than the ordering physician or health care professional. Copies of these results may be obtained from the ordering physician directly. If the healthcare provider has elected to receive paper copies of the test results duplicate printed copies of all test reports are sent to the healthcare provider; therefore, a copy may be provided to the patient. If the healthcare provider receives the test results via encrypted email, then they can print out a copy for you or forward digital copies to you.
At this time, Fry Laboratories, LLC is enrolled in Medicare and some Medicaid programs. We do not accept private insurance and are not contracted with any private insurance company. For a complete list of all enrolled insurance programs please call the Billing Department at (480) 292-8457. For all other testing, our patients pay for the testing at the time of service out of pocket. Fry Laboratories, LLC provides a paid invoice several weeks after processing payment and sample completion. To submit claims, patients need to retrieve a claim form from their insurance company, complete the form, and submit it for evaluation along with their paid invoice. Private insurance may require treatment records or doctor’s notes to assist in the claims process. It is important to check with your insurance company prior to any testing to understand your coverage and insurance benefits.
No. You will need to get all insurance forms and claim instructions directly from your insurance company.
Fry Laboratories is contracted with Medicare. Patients with Medicare must submit a completed Advanced Beneficiary Notice of Noncoverage (ABN) form with each sample. The ABN form as well as instructions for the ABN are located in the “Forms – Other Documents” section of the website. Please read the ABN instructions as it has valuable information regarding our billing process for Medicare patients. In some instances Medicare will assign payment responsibility to the patient; therefore, the patient will be charged the amount assigned by Medicare. When mailing in your specimen, please include a signed copy of your ABN form, front and back copies of your Medicare ID card, and your completed requisition (test order form) with a credit card included in the “payment” section. For additional questions please call our billing office at (480)292-8457.
Invoices are mailed several weeks after payment processing and test completion. We understand that paying for testing services at the time of service is an inconvenience and we do not bill all insurance carriers. Fry Laboratories, LLC process payments and mails invoices as rapidly as possible to assist in claim submission for reimbursement. To improve efficiency and reduce overhead costs our invoices are mailed in periodic batches. If there is a special circumstance in which a receipt is immediately required, please call our Billing Office at (480) 292-8457.