LESSON 8: NATURE OF THE CLINICAL LABORATORY
The Clinical Laboratory
It is an essential component of health institutions
Main Task: To provide accurate, reliable information to medical doctors for the diagnosis,
prognosis, treatment, and management of diseases.
70%
Decisions performed by medical doctors are based on laboratory test results.
MLS plays a very significant role in the performance of laboratory testing and ensuring the
reliability of laboratory results.
MANUAL LESS LABORIOUS
TAXING SHORTENED TURNAROUND
TIME
LABOR- INTENSIVE PRODUCE MORE
TIME-CONSUMING RELIABLE RESULTS
It also actively involved in
Research
Community outreach programs
Surveillance
Infection control in the hospital and community settings
Information dissemination
Evaluation of applicability of current and innovative diagnostic technologies
CLASSIFICATIONS OF CLINICAL LABORATORY
ACCORDING TO FUNCTION
Clinical Pathology
Concerned with the diagnosis and treatment of diseases performed through laboratory testing
of blood and other body fluids.
Anatomic Pathology
Concerned with the diagnosis of diseases through microscopic examination of tissues and
organs.
ACCORDING TO INSTITUTIONAL CHARACTERISTICS
Institution-based
A clinical laboratory that operates within the premises or part of an institution.
Free-standing
A laboratory that is not part of an established institutions.
ACCORDING TO OWNERSHIP
Government Owned
Clinical laboratories owned by national or local government units.
Privately-Owned
Clinical laboratories are owned, established and operated by an individual, corporation,
institution, association, or an organization.
ACCORDING TO SERVICE CAPABILITY
Primary Category
Licensed to perform: Basic to routine laboratory testing.
Routine urinalysis, routine stool examination, routine hematology or complete blood count that
includes hemoglobin, hematocrit, WBC and RBC count, WBC differential count and qualitative
platelet count, blood typing and Gram staining (if hospital—based)
Equipments: Microscope, Centrifuge, Hematocrit Centrifuge
Space Requirement: At least 10 square meters
Secondary Category
License to perform: All tests done by Primary Category + Routine Clinical Chemistry, Gram Stain
(HB), KOH Mount (HB), Crossmatching (HB)
Blood glucose concentration, blood urea nitrogen, blood uric acid, blood creatinine, cholesterol
determination.
Equipments: Microscope, Centrifuge, Hematocrit Centrifuge, Semi-automated chemistry
analyzers, autoclave, incubator, oven.
Space Requirement: At least 20 square meters
Tertiary Category
Licensed to perform: All test done by Secondary Category Plus
Immunology and Serology
Microbiology, Bacteriology, Mycology
Special Clinical Chemistry
Immunohematology and Blood Banking
Equipments: All equipment in Secondary + Automated Chemistry Analyzer, Biosafety Cabinet
Class 2, Serofuge
Space Requirement: At least 60 square meters
Immunology and serology
NS1-Ag for dengue, rapid plasma reagin, Treponema-pallidum particle agglutination test
Microbiology, Bacteriology, Mycology
Differential staining techniques, culture and identification of bacteria and fungi from specimens,
anti-microbial susceptibility testing
Special Clinical Chemistry
Clinical enzymology, therapeutic drug monitoring, markers for certain diseases.
Special Hematology
Bone marrow studies, special staining for abnormal blood cells, red cell morphology
Immunohematology and Blood Banking
Blood donation program, antibody screening, and identification preparation of blood
components.
National Reference Laboratory
Laboratory in a government hospital designated by the DOH to provide special diagnostic
functions and services for certain disease.
FUNCTIONS:
Referral Services
Provision of confirmatory testing
Assistance of research activities
Implementation of external quality assurance program
Resolution of conflicts regarding test results
Training of medical technologists on certain specialized procedures
5 NRL-EQAS (National Reference Laboratory- External Quality Assessment Services)
National Kidney and Transplant Institute (NKTI)
Hematology and Coagulation
Research Institute of Tropical Medicine (RITM)
Microbiology
(Identification and antibiotic susceptibility testing)
Parasitology
(Identification of ova and quantitation of malaria)
Lung Center of the Philippines
Clinical Chemistry
(For testing 10 analytes, namely glucose, creatinine, total protein, albumin, blood urea nitrogen,
uric acid, cholesterol, sodium, potassium and chloride)
East Avenue Medical Center (EAMC)
Drugs of abuse (methamphetamine acid and cannabinoids)
San Lazaro Hospital STD-AIDS Cooperative Center Laboratory (SACCL)
Infectious immunology hepatitis B surface antigen (HBsAg), human immunodefiency virus (HIV),
hepatitis C virus (HCV)
