Updated September 2026
Respiratory Virus Testing
Cleveland Clinic Laboratories offers several respiratory testing services to healthcare organizations & providers.
SARS-CoV-2 (COVID-19), influenza A/B, and respiratory syncytial virus (RSV) testing is available for the qualitative detection of these viruses in respiratory specimens from individuals with appropriate signs, symptoms, and risk factors.
All three viruses will continue to be in circulation during the 2026-2027 respiratory virus season.
Respiratory Virus Testing Overview
Test Name
COVID, Influenza A/B, & RSV NAAT, Routine (CVFLRS)
Turnaround Time
24 hours from the time of receipt by the laboratory*
Testing is performed 24 hours a day, 7 days a week
Specimen Requirements – Upper Respiratory
Type:
(1) Nasopharyngeal (NP) Swab – preferred
Volume:
3 mL
Specimen Container:
Universal Transport Media (UTM)
Accepted Alternatives
Type:
• (1) Nasopharyngeal (NP) swab
• (1) Nasal (anterior nares) swab
Volume:
Swab
Transport Media:
• Universal Transport Media (UTM)
• eSwab
• Saline (sterile)
• Viral Transport Media (VTM), including M4RT, M5, or M6
Specimen Requirements – Lower Respiratory
Type:
• Aspirate, tracheal
• Bronchoalveolar Lavage (BAL)
• Sputum
Volume:
1 mL
Transport Container:
Sterile container
Transport Temperature
Refrigerated; transport to the laboratories on cold packs or wet ice.
Stability
Ambient:
Unacceptable
Refrigerated (2-8ºC):
96 hours
Frozen:
Up to 30 days
Rejection Criteria
Swabs used for Group A Strep testing are not acceptable.
Expanded Respiratory Pathogen Panel Test Overview
This test is for immunocompromised patients, severely ill adults who will be hospitalized and have evidence of a lower respiratory tract infection the etiology of which has not been determined, and children who are going to be admitted that are being evaluated for a suspected respiratory viral infection.
This panel should rarely be ordered in the outpatient setting, and if ordered, preauthorization should be strongly considered. The test is very expensive and if not covered by insurance the patient will incur a substantial charge.
Test Name
Expanded Respiratory Pathogen Panel by PCR (with COVID), Routine (RPPCR)
Turnaround Time
2 – 3 days
Specimen Requirements – Upper Respiratory
Type:
(1) Nasopharyngeal (NP) Swab – preferred
Volume:
3 mL
Specimen Container:
Universal Transport Media (UTM)
Accepted Alternatives
Type:
• (1) Nasopharyngeal (NP) swab
• (1) Nasal (anterior nares) swab
Volume:
Swab
Transport Media:
• Universal Transport Media (UTM)
• eSwab
• Saline (sterile)
• Viral Transport Media (VTM), including M4RT, M5, or M6
Specimen Requirements – Lower Respiratory
Type:
• Aspirate, tracheal
• Bronchoalveolar Lavage (BAL)
• Sputum
Volume:
1 mL
Transport Container:
Sterile container
If aliquotting is necessary, sterile aliquot tubes must be used. Do not dilute with UTM or VTM.
Transport Temperature
Refrigerated; transport to the laboratories on cold packs or wet ice.
Stability, Upper Resp.
Ambient:
Unacceptable
Refrigerated (2-8ºC):
3 days
Frozen:
Up to 30 days
Stability, Lower Resp.
Ambient:
Unacceptable
Refrigerated (2-8ºC):
7 days
Frozen:
Up to 30 days
Rejection Criteria
Swabs used for Group A Strep testing are not acceptable.
Ready to Place an Order?
Download and complete a Respiratory Virus Testing Requisition (required).
Need to Set Up an Account?
Request support from a regional Sales Manager or contact Laboratory Customer Service for general inquiries.
Specimen Collection Instructions
You will need:
• Personal protective equipment (PPE)
• (1) tube of transport medium
– Universal Transport Media (UTM)
– Viral Transport Media (VTM)
– Saline solution
• (1) swab
• Patient identification labels
Before you begin:
• Confirm the patient’s name and date of birth.
• Wash your hands, then put on personal protective equipment, including gloves.
If you are having difficulties obtaining appropriate COVID-19 specimen collection and transport supplies, please contact your CCL Account Manager.
Nasopharyngeal (NP) Swabs
Step 1:
Carefully remove the swab from the packaging without touching the tip.
Step 2a – for nasopharyngeal (NP) swabs:
– Gently insert the NP swab along the nasal septum just above the floor of the passage to the nasopharynx until resistance is met.
– Rotate the swab gently against the nasopharyngeal mucosa for 10 – 15 seconds, then remove.
Step 3:
Remove the cap from the tube, then insert the swab all the way to the bottom of the vial.
Step 4:
While holding the tube away from your face, bend the swab in the vial at a 180-degree angle to break at the marked breakpoint.
Step 5:
Close the tube tightly. If possible, wrap the cap with Parafilm.
Any leaking specimens will be rejected.
Step 6:
Label specimen with the printed label or write the patient’s first & last name, date of birth, and the date, time, and site of collection (e.g., NP) on the tube.
Step 7:
Double-bag the specimen, place on wet ice, then refrigerate.
Step 8:
Complete a Respiratory Virus Test Requisition.
Step 9:
Place the completed requisition in the pocket of the specimen bag.
Do not place any paperwork in the part of the bag containing the specimen.
Step 10:
For the fastest turnaround time, deliver the specimen directly to the Main Campus LL Building Specimen Receiving Area:
Cleveland Clinic Laboratories
10300 Carnegie Avenue
Cleveland, OH 44106
Need a Respiratory Virus Test Requisition?
Contact your CCL Sales Manager or Laboratory Customer Service.
Nasal (Anterior Nares) Swabs
Specimen Collection:
Step 1:Carefully remove the swab from the packaging without touching the tip.
Step 2:
Position the patient’s head slightly back, then insert the swab into their LEFT nostril (less than one inch) and gently push until a slight resistance is met.
Step 3:
Rotate the swab against the inside of the patient’s nostril four times for 10-15 seconds.
Step 4:
Remove the swab, then repeat Steps 2 & 3 in the RIGHT nostril with the same swab.
Remove the swab from the patient’s nose when finished.
Preparing for Transport:
Step 5:
While holding the swab, open the tube and set the cap down with the threads facing up.
Insert the swab into the tube until the breakpoint is level with the tube opening.
Step 6:
While holding the tube away from your face, bend the swab until it snaps at the break point.
You may need to gently rotate the swab shaft to complete the breakage.
Step 7:
After discarding the remaining swab shaft into an approved disposal container, screw the cap back onto the tube.
Apply the test label or write the patient’s information onto the tube.
Step 8:
Place the specimen into a biohazard bag, then insert any lab paperwork into the outside pouch.
Refrigerate the specimen during storage and transport to the lab.
Resources
COVID-19 Resources
Influenza Resources
RSV Resources
If you have any questions, please contact your CCL Sales Manager or Laboratory Customer Service for assistance.
