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Laboratory and Specimen Collection Centre Licensing Act

R.R.O. 1990, REGULATION 682

LABORATORIES

Consolidation Period: From August 27, 2015 to the e-Laws currency date.

Last amendment: O. Reg. 260/15.

This is the English version of a bilingual regulation.

1. In this Regulation,

“fiscal year” means the 12-month period beginning on April 1; (“exercice”)

“laboratory director” means a person who is responsible for the administration of the scientific and technical operation of a laboratory including the supervision of tests and the reporting of the results of the tests; (“directeur de laboratoire”)

“laboratory supervisor” means a person who under the general supervision of a laboratory director supervises laboratory personnel and who may perform tests requiring special scientific skills; (“superviseur de laboratoire”)

“laboratory technician” means a person who under direct supervision performs laboratory tests which require limited technical skill and responsibilities; (“technicien de laboratoire”)

“laboratory technologist” means a person who under general supervision performs tests which require the exercise of independent judgment; (“technologiste de laboratoire”)

“relevant” means appropriate to the classes of tests for which the laboratory is licensed; (“pertinent”)

“spouse” means,

(a) a spouse as defined in section 1 of the Family Law Act, or

(b) either of two persons who live together in a conjugal relationship outside marriage; (“conjoint”)

“technical director” has the same meaning as “laboratory supervisor”. (“directeur technique”)  R.R.O. 1990, Reg. 682, s. 1; O. Reg. 352/98, s. 1; O. Reg. 68/00, s. 1; O. Reg. 331/05, s. 1; O. Reg. 324/07, s. 1.

2. The following classes of tests are prescribed for the purposes of the Act and this Regulation:

1. Bacteriology.

2. Virology.

3. Mycology.

4. Parasitology.

5. Immunology.

6. Serology HIV Antibody.

7. Hematology.

8. Biochemistry.

9. Cytology.

10. Immunoassays.

11. Histology (Pathology).

12. Immunohematology.

13. Cytogenetics.

14. Molecular Genetics.

15. Genetics.

R.R.O. 1990, Reg. 682, s. 2; O. Reg. 536/98, s. 1; O. Reg. 239/04, s. 1; O. Reg. 324/07, s. 2.

3. (1) An application for a licence, or a provisional licence, to establish, operate or maintain a laboratory, or renewal thereof, shall be submitted to the Director.  R.R.O. 1990, Reg. 682, s. 3 (1).

(2) The fee for the issuance or renewal of a licence is $1,262 plus an additional $200 for each test that the licensee is authorized to perform under the licence that is not listed as a service in the schedule of laboratory benefits.  O. Reg. 358/02, s. 1.

(3) The fee for the issuance or renewal of a provisional licence is $631 plus an additional $100 for each test that the licensee is authorized to perform under the licence that is not listed as a service in the schedule of laboratory benefits.  O. Reg. 358/02, s. 1.

(3.1) In subsections (2) and (3),

“schedule of laboratory benefits” means the schedule of laboratory benefits as defined in subsection 1 (1) of Regulation 552 of the Revised Regulations of Ontario, 1990 made under the Health Insurance Act.  O. Reg. 17/01, s. 1.

(4) The operator of a licensed laboratory shall post the licence in a conspicuous place in the laboratory.  R.R.O. 1990, Reg. 682, s. 3 (4).

(5) The operator of a licensed laboratory shall post the accreditation certificate issued by the agency designated under section 14 in a conspicuous place in the laboratory.  O. Reg. 25/08, s. 1.

4. (1) A licence or renewal thereof that is issued to establish, operate or maintain a laboratory is subject to the following conditions:

1. That the operator and owner engage the services of a laboratory director.

2. That the operator and owner only engage the services of a person as laboratory director, laboratory supervisor, technical director, laboratory technologist or laboratory technician who meets the qualifications prescribed by section 6 or who is otherwise exempted under section 7.

3. That the management and operation of the laboratory is at the address set out in the licence for the laboratory.

4. That an Alphafetoprotein screen, HCG or Estriol, Inhibin or Pregnancy Associated Plasma Protein type A (PAPP-A) test or any combination of them not be performed if the person requesting the test indicates that the test is for a fetal assessment.

5. That a Hepatitis B surface antigen test not be performed if the person requesting the test indicates that the test is for a prenatal assessment.

6. That the Newborn Screening Test for amino acidopathies, fatty acid oxidation defects, organic acidemias, endocrinopathies, hemoglobinopathies, biotinidase, galactosemia, cystic fibrosis or severe combined immune deficiency not be performed if the person requesting the test indicates that the test is for newborn screening.

7. That the ColonCancerCheck FOBT not be performed.

8. That no payment or consideration of any kind be provided or offered to any donor of blood or blood constituents in return for the donation, whether directly or indirectly.

9. That no compensation for any expenditure of any kind or for time, travel or commitment be made to any donor of blood or blood constituents, whether directly or indirectly.

R.R.O. 1990, Reg. 682, s. 4; O. Reg. 399/93, s. 1 (1); O. Reg. 239/04, s. 2; O. Reg. 421/06, s. 1 (1); O. Reg. 25/08, s. 2; O. Reg. 51/08, s. 1 (1); O. Reg. 165/13, s. 1; O. Reg. 65/14, s. 1.

(2) A laboratory is exempt from the condition in paragraph 4 of subsection (1) if it is operated by any of the following:

1. Children’s Hospital of Eastern Ontario.

2. Credit Valley Hospital.

3. North York General Hospital (General site).

4. Lakeridge Health Corporation (Oshawa site).

5. Sudbury Regional Hospital (St. Joseph’s Health Centre Site).

6. Mount Sinai Hospital.

7. London Health Sciences Centre (South Street Campus).  O. Reg. 399/93, s. 1 (2); O. Reg. 564/00, s. 1.

(3) A laboratory is exempt from the condition in paragraph 5 of subsection (1) if it is operated by,

(a) a public hospital; or

(b) the Ontario Agency for Health Protection and Promotion.  O. Reg. 446/08, s. 1.

(4) A laboratory operated by the Children’s Hospital of Eastern Ontario is exempt from the condition in paragraph 6 of subsection (1).  O. Reg. 421/06, s. 1 (2).

(5) A laboratory is exempt from the condition in paragraph 7 of subsection (1) if it has entered into a Participation Agreement with the Ministry.  O. Reg. 51/08, s. 1 (2).

(6) In subsection (5),

“Participation Agreement” means an agreement between a laboratory and the Ministry under the Laboratory Services Funding Framework Agreement for the Colorectal Cancer Screening Program in which the laboratory agrees to conditions in respect of their participation in the program, including conditions that the laboratory will,

(a) use the ColonCancerCheck FOBT kit for the purposes of the program,

(b) distribute the ColonCancerCheck FOBT kits to,

(i) legally qualified medical practitioners,

(ii) registered nurses who hold an extended certificate of registration under the Nursing Act, 1991, and

(iii) pharmacies,

(c) provide the ColonCancerCheck FOBT kits to participants accessing the program through Telehealth Ontario,

(d) report on the distribution and provision of the ColonCancerCheck FOBT kits under clauses (b) and (c) to Cancer Care Ontario for the purposes of the Ontario Cancer Screening Registry, and

(e) participate in a quality assurance program that is designed for the program.  O. Reg. 51/08, s. 1 (2); O. Reg. 142/11, s. 1.

4.1 (1) No owner or operator of a laboratory shall, directly or indirectly, confer a benefit, or permit another person to confer a benefit on his or her behalf, on,

(a) a health professional at whose request the laboratory examines specimens;

(b) a member of the family of a health professional referred to in clause (a); or

(c) a corporation that is owned or controlled by a health professional referred to in clause (a), by a member of the health professional’s family or by another corporation that is owned or controlled by the health professional or a member of his or her family.  O. Reg. 206/96, s. 1.

(2) For the purposes of subsection (1), an owner or operator of a laboratory confers a benefit on a person referred to in clause (1) (a), (b) or (c) by giving the person a gift, benefit or advantage of any kind, and, without limiting the generality of the foregoing,

(a) by providing goods or services to the person at a cost that is less than the fair market value of the goods or services;

(b) by paying all or part of the person’s debts or financial obligations;

(c) by lending the person money; or

(d) by extending credit for goods and services to the person unless,

(i) the credit is normally extended to persons in the ordinary course of business,

(ii) the credit is extended under a written agreement that fixes the term for which the credit is extended and the rate of interest, and

(iii) the term for which the credit is extended and the rate of interest at which the credit is extended are comparable to the terms and rates prevailing in the market at the time the credit is advanced.  O. Reg. 206/96, s. 1.

(3) For the purposes of subsection (1), an owner or operator of a laboratory confers a benefit on a health professional referred to in clause (1) (a) by purchasing services from the health professional or paying a third party for services provided by the health professional unless,

(a) the services are paid for under a written contract;

(b) the services are of a kind ordinarily provided by the health professional; and

(c) the amount paid for the services is not excessive having regard to the nature of the services.  O. Reg. 206/96, s. 1.

(4) Despite subsections (1), (2) and (3), the owner or operator of a laboratory may employ the spouse or a member of the family of a health professional referred to in clause (1) (a), if the remuneration of the employee is reasonable given the nature of the employee’s duties, the amount of time for which the employee is paid and his or her performance at work.  O. Reg. 206/96, s. 1; O. Reg. 68/00, s. 2; O. Reg. 331/05, s. 2.

(5) Despite subsections (1), (2) and (3), the owner or operator of a laboratory may provide supplies and equipment to a health professional referred to in clause (1) (a), with or without charge, if the supplies or equipment are to be used exclusively for the procurement or maintenance of specimens to be sent to the laboratory or for the reporting of the results of laboratory tests.  O. Reg. 206/96, s. 1.

4.2 (1) No owner or operator of a laboratory shall enter into an agreement to rent premises to or from a person referred to in clause 4.1 (1) (a), (b) or (c), or permit another person to enter into such an agreement on his or her behalf, unless the amount of rent payable under the agreement is comparable to the amount of rent paid for similar premises in the same geographic area.  O. Reg. 206/96, s. 1.

(2) No owner or operator of a laboratory shall enter into an agreement to rent premises to or from a person referred to in clause 4.1 (1) (a), (b) or (c), or permit another person to enter into such an agreement on his or her behalf, if the agreement provides for an amount of rent that varies in accordance with the number of services, or the monetary value of services, that are referred to the laboratory by the health professional referred to in clause 4.1 (1) (a), (b) or (c), as the case may be.  O. Reg. 206/96, s. 1.

4.3 (1) Sections 4.1 and 4.2 do not apply if the benefit is conferred on, or the rental agreement provides that premises be rented to or from,

(a) a health professional who holds at least a 50 per cent ownership interest in the laboratory or who is a member of the family of a person who holds at least a 50 per cent ownership interest in the laboratory;

(b) a member of the family of a health professional who holds at least a 50 per cent ownership interest in the laboratory;

(c) two or more health professionals who jointly hold at least a 50 per cent ownership interest in the laboratory; or

(d) a corporation that is owned or controlled by a person referred to in clauses (a) or (b) or that is jointly owned or controlled by two or more health professionals referred to in clause (c).  O. Reg. 206/96, s. 1.

(2) For the purposes of subsection (1), a person holds at least a 50 per cent ownership interest in a laboratory that is a corporation if the person holds 50 per cent or more of the issued shares of the corporation.  O. Reg. 206/96, s. 1.

4.4 (1) In sections 4.1, 4.2 and 4.3,

“health professional” means a member of a College of a health profession referred to in Schedule 1 of the Regulated Health Professions Act, 1991.  O. Reg. 206/96, s. 1.

(2) For the purposes of sections 4.1, 4.2 and 4.3, a person is a member of another person’s family if,

(a) the person is the child or direct descendant of the other or is the brother or sister of the other;

(b) the person is married to the other or to a person who is the child, the descendant, the brother or sister of the other; or

(c) the person is the child of the brother or sister of the other.  O. Reg. 206/96, s. 1.

(3) In subsection (2),

“child” includes, with respect to any person, any other person with whom the person stands in the role of a parent.  O. Reg. 206/96, s. 1.

5. An applicant for a licence to establish, operate or maintain a laboratory shall,

(a) have adequate laboratory staff who are qualified to perform the classes of tests for which the licence is sought; and

(b) have equipment and premises that are suitable for the performance of the tests for which the licence is sought.  R.R.O. 1990, Reg. 682, s. 5.

6. (1) The qualifications for a laboratory director are that the person,

(a) is a legally qualified medical practitioner who has been certified by the Royal College of Physicians and Surgeons of Canada in a branch of laboratory medicine; or

(b) is a legally qualified medical practitioner who has two years of post-graduate training in a clinical laboratory or laboratories approved by the Director; or

(c) has obtained from a university approved by the Director an academic doctorate degree with a relevant chemical, physical or biological science as a major subject and has two post-graduate years of laboratory training and experience in a laboratory or laboratories approved by the Director; or

(d) has obtained from a university approved by the Director a master’s degree with a relevant chemical, physical or biological science as a major subject and has five post-graduate years of laboratory training and experience in a laboratory or laboratories approved by the Director.  R.R.O. 1990, Reg. 682, s. 6 (1).

(2) The qualifications for a laboratory supervisor or technical director are that the person,

(a) is a legally qualified medical practitioner who has one post-graduate year of experience in a relevant laboratory specialty in a laboratory or laboratories approved by the Director; or

(b) has obtained from a university approved by the Director an academic doctorate degree with a relevant chemical, physical or biological science as a major subject and has one post-graduate year of experience in a relevant laboratory specialty in a laboratory or laboratories approved by the Director; or

(c) has obtained from a university approved by the Director a master’s degree with a relevant chemical, physical or biological science as a major subject and has two post-graduate years of relevant laboratory training and experience in a laboratory or laboratories approved by the Director; or

(d) has obtained from a university approved by the Director a bachelor’s degree with a relevant chemical, physical or biological science as a major subject and has a minimum of three post-graduate years of relevant laboratory training and experience of which at least two years shall have been in a laboratory or laboratories approved by the Director; or

(e) is qualified as a laboratory technologist, and,

(i) has at least six years of relevant laboratory experience approved by the Director, or

(ii) has successfully completed relevant courses that together with experience are acceptable to the Director as equivalent to the experience referred to in subclause (i).  R.R.O. 1990, Reg. 682, s. 6 (2).

(3) The qualifications for a laboratory technologist are that the person,

(a) has obtained from a university approved by the Director a bachelor’s degree with a relevant chemical, physical or biological science as a major subject and has been employed for a minimum of one year as a laboratory technician in a laboratory approved by the Director; or

(b) is recognized as a technologist by a technologist society in Canada, Great Britain or the United States, whose courses of study are approved by the Director; or

(c) has obtained a diploma as a laboratory technologist from an Ontario Community College; or

(d) has education or experience or both that is approved by the Director as equivalent to the standards prescribed in clause (a), (b) or (c).  R.R.O. 1990, Reg. 682, s. 6 (3).

(4) The qualifications for a laboratory technician are that the person,

(a) has obtained an Ontario Secondary School Graduation Diploma or is able to produce evidence of equivalent standing that is approved by the Director and has served two years as a technical trainee in a laboratory approved by the Director; or

(b) has obtained an Ontario Secondary School Graduation Diploma or is able to produce evidence of equivalent standing that is approved by the Director and has successfully completed relevant courses which together with experience are in the opinion of the Director equivalent to the standards prescribed in clause (a).  R.R.O. 1990, Reg. 682, s. 6 (4).

7. Where a person is unable to meet the qualifications listed in section 6 for any particular category of employment, the person is exempted from the requirements of the said section in so far as they relate to that category of employment if he or she was employed in a laboratory on the 1st day of November, 1972, as a,

(a) laboratory director;

(b) laboratory supervisor or technical director;

(c) laboratory technologist; or

(d) laboratory technician,

and has submitted evidence to the Director sufficient to satisfy the Director as to his or her competence and ability to adequately perform the duties of his or her office.  R.R.O. 1990, Reg. 682, s. 7.

8. (1) No laboratory director shall work or be employed as a laboratory director or laboratory supervisor in more than two laboratories unless the Director approves on the basis of need in the area or areas in which the laboratories are situated.  R.R.O. 1990, Reg. 682, s. 8 (1).

(2) A laboratory supervisor shall not work or be employed as a laboratory supervisor in more than two laboratories unless the Director approves on the basis of need in the area or areas in which the laboratories are situated.  R.R.O. 1990, Reg. 682, s. 8 (2).

9. (1) The owner and the operator of a laboratory shall ensure that the staff of the laboratory,

(a) examine specimens from humans only,

(i) at the request of a legally qualified medical practitioner or a dentist,

(ii) at the request of a midwife, in respect of a test specified in Appendix B,

(ii.1) at the request of a person who lawfully practises a health profession in a jurisdiction outside Ontario, if in that jurisdiction a laboratory may lawfully examine specimens at the request of that person,

(iii) at the request of an insurer or an agent within the meaning of the Insurance Act, in respect of HIV Antibody testing,

(iv) at the request of a registered nurse who holds an extended certificate of registration under the Nursing Act, 1991,

(v) at the request of a person who is a participant in the provincial colorectal cancer screening program, in respect of a test or tests for the purposes of the program, or

(vi) at the request of a member of the College of Naturopaths of Ontario, in respect of a test specified in Appendix C;

(a.1) report the results of tests performed as part of the provincial colorectal cancer screening program to Cancer Care Ontario for the purposes of the Ontario Cancer Screening Registry;

(b) except in the case of a person described under subclause (a) (v), report the results of a test directly to the person who requested it and include in the report the name of the laboratory that received the specimen and the name and address of the laboratory in which the test was performed;

(b.1) in the case of a person described under subclause (a) (v), report the results to Cancer Care Ontario for the purposes of the Ontario Cancer Screening Registry but not to the person;

(c) report all positive laboratory findings that indicate the presumptive presence or presence of any reportable disease within the meaning of the Health Protection and Promotion Act to the medical officer of health of the health unit in which the person who gives rise to the case resides within 24 hours after the test is conducted, unless section 5.1 of Regulation 569 of the Revised Regulations of Ontario, 1990 (Reports) made under that Act applies;

(d) establish a quality control program that is acceptable to the Director;

(e) maintain such records and submit such reports as the Director may require and produce such records and reports as are considered necessary for purposes of this Regulation to the Director for inspection at all reasonable times;

(f) analyze and report upon test samples submitted to the laboratory by the Director.  R.R.O. 1990, Reg. 682, s. 9; O. Reg. 795/93, s. 1; O. Reg. 206/96, s. 2 (1); O. Reg. 46/98, s. 1; O. Reg. 324/07, s. 3; O. Reg. 65/08, s. 1; O. Reg. 142/11, s. 2; O. Reg. 215/11, s. 1; O. Reg. 142/15,  s. 1; O. Reg. 169/15, s. 1.

(1.1) For the purposes of assisting staff of a laboratory to perform their duties in examining a specimen from an individual, the owner and the operator of the laboratory may collect personal health information about the individual indirectly from the person referred to in subclause (1) (a) (ii.1) or (iii) who makes the request for the examination.  O. Reg. 336/04, s. 1.

(2) In this section,

“health profession” means a health profession referred to in Schedule 1 to the Regulated Health Professions Act, 1991.  O. Reg. 206/96, s. 2 (2).

10. The owner or operator of a laboratory may notify,

(a) legally qualified medical practitioners;

(b) laboratory owners or directors of licensed laboratories, or both; and

(c) the Director,

respecting the information set out in subsection 15 (1) of the Act.  R.R.O. 1990, Reg. 682, s. 10.

11. Laboratories operated by a ministry of the Crown in right of the Province of Ontario and every blood donor clinic of the Canadian Blood Services are exempt from the provisions of sections 5 to 16 of the Act and from the provisions of this Regulation.  R.R.O. 1990, Reg. 682, s. 11; O. Reg. 239/04, s. 3, O. Reg. 169/15, s. 2.

12. All pharmacies and all pharmaceutical chemists employed in a pharmacy are exempt from the provisions of sections 5 to 16 of the Act and from the provisions of this Regulation with respect only to the performance of immunologic tests for pregnancy.  R.R.O. 1990, Reg. 682, s. 12; O. Reg. 169/15, s. 2.

13. Every legally qualified medical practitioner who performs laboratory tests for the exclusive purpose of diagnosing or treating his or her own patients in the course of his or her medical practice is exempted from the provisions of sections 5 to 16 of the Act and from the provisions of this Regulation.  R.R.O. 1990, Reg. 682, s. 13; O. Reg. 169/15, s. 2.

13.1 Every member of the College of Naturopaths of Ontario who performs laboratory tests in his or her own office, in the course of his or her naturopathic practice, for the exclusive purposes of diagnosing or treating his or her own patients is exempted from the provisions of sections 5 to 16 of the Act and from the provisions of this Regulation with respect to the performance of the tests set out in Appendix D.  O. Reg. 169/15, s. 3.

14. Institute for Quality Management in Healthcare is designated as an agency to carry out a quality management program.  O. Reg. 260/15, s. 1.

15. For the purposes of clause 9 (14) (c) of the Act, the fees set out in Column 2 of the Table to this section are prescribed for the classes of tests set out opposite those fees in Column 1.

TABLE

 

Item

Column 1

Column 2

1.

Bacteriology

$1,055

2.

Biochemistry

1,319

3.

Cytogenetics

747

4.

Cytology

747

5.

Hematology

1,187

6.

Immunoassays

737

7.

Immuno-hematology

978

8.

Immunology

755

9.

Mycology

879

10.

Parasitology

1,033

11.

Histology (Pathology)

650

12.

Serology HIV Antibody

524

O. Reg. 358/02, s. 2; O. Reg. 239/04, s. 4.

Appendix A Revoked:  O. Reg. 324/07, s. 5.

APPENDIX B
Tests that a Midwife may Request

1. Bilirubin — Total.

2. Bilirubin — conjugated.

3. Glucose.

4. Urinalysis — routine (includes microscopic).

5. Estriol.

6. HCG.

7. Hepatitis Associated Antigen or Antibody Immunoassay.

8. Newborn Screening Test for amino acidopathies, fatty acid oxidation defects, organic acidemias, endocrinopathies, hemoglobinopathies, biotinidase, galactosemia, cystic fibrosis or severe combined immune deficiency.

9. Alphafetoprotein Screen.

10. Albumin quantitative.

11. Serum Ferritin.

12. Serum Folate.

13.-16. Revoked:  O. Reg. 71/07, s. 1 (1).

17. Sickle cell solubility test (screen).

18. Kleihauer.

19. Antibody Identification.

20. Antibody Screen.

21. Blood group — ABO and Rho (D).

22. Blood group — per antigen.

23. Direct Anti-human globulin test.

24. Cervicovaginal specimens.

25. Revoked:  O. Reg. 71/07, s. 1 (1).

26. Chlamydia.

27. Culture — cervical, vaginal (includes GC).

28. Culture — other swabs or pus.

29. Culture — urine.

30. Virus isolation.

31. Wet preparation (for fungus, trichomonas, parasites).

32. Strep B rapid screen.

33. Pregnancy Test.

34. Virus antibodies — hemagglutination inhibition or ELISA technique (Rubella).

35. Non-cultural, indirect antibody or antigen assays by fluorescence, agglutination or ELISA technique (Toxoplasmosis).

36. Serology HIV Antibody.

37. VDRL.

38. Glucose tolerance test in pregnancy.

39. Revoked:  O. Reg. 71/07, s. 1 (1).

40. Inhibin.

41. Pregnancy Associated Plasma Protein type A (PAPP-A).

42. Complete blood count (any method).

43. Smear only, Gram or Papanicolaou stain.

O. Reg. 536/98, s. 2; O. Reg. 239/04, s. 5; O. Reg. 421/06, s. 2; O. Reg. 71/07, s. 1; O. Reg. 25/08, s. 3; O. Reg. 165/13, s. 2.

APPENDIX C
Tests that a Naturopath may Request

Tests Performed on Blood

1. 17-OH-Progesterone.

2. 5α-dihydrotestosterone (DHT).

3. Adrenocorticotropic Hormone ACTH.

4. Alanine Transaminase (ALT, SGPT).

5. Albumin, qualitative.

6. Aldosterone.

7. Allergen Specific IgG Antibody.

8. Allergy testing (ELISA).

9. Allergy testing (IgE specific, RAST).

10. Alpha tocopherol – Vitamin E.

11. Amino Acids – Total Fractionation.

12. Ammonia.

13. Amylase.

14. Androstenedione.

15. Antibody Screening Food IgG.

16. Antibody Screening IgA.

17. Antibody Screening IgM.

18. Antigen Leukocyte Antibody.

19. Anti-Müllerian Hormone (AMH).

20. Anti-Nuclear Antibody.

21. Anti-Parietal Cell Antibody.

22. Anti-Reticulin Antibodies.

23. Apolipoprotein A1.

24. Apolipoprotein B.

25. Ascorbic Acid (ascorbate) Vitamin C.

26. Aspartate Transaminase.

27. Beta-Carotene (Carotene).

28. Bilirubin (total, total conjugated, unconjugated, direct and indirect).

29. Blood Group ABO and RhD.

30. Blood Urea Nitrogen (BUN).

31. Bun / Creatinine Ratio.

32. CA125.

33. CA15-3.

34. Calcium, Calcium ionized.

35. Candida Antibodies (IgM, IgG, IgA).

36. Carbon Dioxide Bicarbonate.

37. Carcinoembryonic Antigen.

38. Ceruloplasmin.

39. Chloride.

40. Cholinesterase, pseudo or true.

41. Coenzyme Q10.

42. Complement proteins – C3 (B1C) and Complement proteins – C4 (B1E).

43. Complete Blood Count.

44. Copper.

45. Cortisol – bound and unbound, no differentiation.

46. C-peptide immunoreactivity.

47. C-Reactive Protein (CRP).

48. C-Reactive Protein – High Sensitivity.

49. Creatine Phosphokinase.

50. Creatinine.

51. Creatinine Clearance.

52. Cystathionine.

53. Dehydroepiandrosterone sulphate (DHEAS).

54. Digitalis purpurea (digoxin).

55. Electrophoresis – including total protein.

56. Endomysial Antibody.

57. Erythrocyte Sedimentation Rate (ESR) (Sedimentation Rate).

58. Estradiol.

59. Estriol.

60. Estrogen.

61. Estrone.

62. Fatty acids, free.

63. Ferritin.

64. Fibrinogen semi-quantitative and quantitative.

65. Folate.

66. FSH.

67. Galectin 3.

68. Gamma-glutamyl Transferase (GGT) / GG transpeptidase (GGTP).

69. Gliadin Antibodies (IgG, IgA).

70. Glomerular Filtration Rate (GFR).

71. Glucose-6-Phosphate Dehydrogenase (G-6-PD).

72. Glucose, quantitative.

73. Glucose Tolerance Test.

74. Glutathione.

75. Hemoglobin – A1C.

76. Homocysteine.

77. Histocompatibility Testing – HLA 27 typing.

78. Immunoglobulin (globulin).

79. Insulin, Fasting and Non-fasting.

80. Insulin-Like Growth Factor 1.

81. Intrinsic Factor Blocking Antibody.

82. Iron, total – with iron binding capacity and per cent saturation.

83. Islet Cell Cytoplasmic Autoantibody.

84. Lactate dehydrogenase.

85. Lactate, Lactic Acid.

86. Lead.

87. Leptin.

88. Lipase.

89. Luteinizing Hormone.

90. Lyme Disease Antibodies.

91. Magnesium.

92. Memory Lymphocyte Immuno-Stimulation Assay (MELISA Test).

93. Mercury.

94. Mononuclear Heterophile Antibodies (Monospot).

95. Natriuretic Peptide – Brain (BNP).

96. Parathyroid hormone.

97. PCB (polychlorinated biphenyls).

98. Phosphatase, alkaline.

99. Phosphorus (inorganic phosphate).

100. Potassium.

101. Pregnenolone.

102. Progesterone.

103. Prolactin.

104. Protein, Total (albumin / globulin ratio).

105. Prothrombin time and International Normalized Ratio (INR).

106. PSA, Ratio.

107. Reticulocyte count.

108. Retinol, Vitamin A.

109. Reverse T3.

110. Rheumatoid factor.

111. S-adenosylhomocysteine.

112. S-adenosyl methionine.

113. Sex Hormone Binding Globulin (SHBG).

114. Sodium.

115. Testosterone.

116. Testosterone, free.

117. Thyroglobulin.

118. Thyroid Peroxidase Antibody.

119. Thyroid Stimulating Immunoglobulin (TSI).

120. Thyroxine Free (FT4).

121. Total Cholesterol panel – HDL / LDL / lipoprotein phenotyping (includes sample appearance, cholesterol, triglycerides, Lipopro VLDL cholesterol [calculated estimate]).

122. Trace Minerals.

123. Transferrin.

124. Transglutaminase IgA Antibody.

125. Trichlorobenzene.

126. Triiodothyronine Free (T3).

127. TSH (thyroid stimulating hormone).

128. Uric Acid (Urate).

129. Vitamin B (all tests).

130. Vitamin D 1,25-dihydroxy.

131. Vitamin D, 25-hydroxy.

132. Volatile solvents.

133. Zinc.

Tests Performed on Stool

134. Bacteria / yeast (microbiology profile).

135. Calprotectin Fecal.

136. Comprehensive Digestive Stool Analysis.

137. Elastase.

138. Fecal Fat.

139. Occult Blood.

140. Parasites and Ova.

Tests Performed on Urine

141. 5α-dihydrotestosterone (DHT).

142. Aldosterone.

143. Bilirubin (total, total conjugated, unconjugated, direct and indirect).

144. Bisphenol A.

145. Calcium, Calcium ionized.

146. Chlorinated pesticides.

147. Cortisol – bound and unbound, no differentiation.

148. Cortisol / Cortisone.

149. Creatinine Clearance.

150. Cultures – urine, screening, actual culture without identification.

151. Dehydroepiandrosterone sulphate (DHEAS).

152. Estradiol.

153. Estriol.

154. Estrogen.

155. Estrone.

156. Human Growth Hormone.

157. Luteinizing Hormone.

158. Melatonin.

159. Oxytocin.

160. Porphyrins, screen.

161. Progesterone.

162. Routine Urinalysis (glucose, blood, ketone, leukocytes, etc.)

163. Testosterone.

164. Testosterone, free.

165. Thyroid hormones.

166. Toxic Metals.

167. Uric acid (urate).

168. Urinary Organic Acid Test.

Tests Performed on Saliva

169. 17-OH-Progesterone.

170. 5α-dihydrotestosterone (DHT).

171. Aldosterone.

172. Androstenedione.

173. Cortisol – bound and unbound, no differentiation.

174. Dehydroepiandrosterone sulphate (DHEAS).

175. Esterol.

176. Estradiol.

177. Estriol.

178. Estrogen.

179. Estrone.

180. Melatonin.

181. Progesterone.

182. Testosterone.

183. Testosterone, free.

Tests Performed on Hair

184. Heavy Metal – hair element analysis.

Tests Performed on Tissue/Discharge/Sputum

185. Culture – throat swab for streptococcus screen only.

186. Culture and sensitivities (other swabs or pus – culture and smear [includes screening]).

187. Culture and sensitivities (sputum – culture and smear).

188. Nail and skin cultures.

189. Nasal swabs (other swabs or pus – culture and smear [includes screening]).

190. Pap smear (smear only, gram or Papanicolaou stain as sole procedure).

191. Seminal fluid examination (complete).

Tests Performed on Breath

192. Hydrogen breath test.

193. Intestinal permeability test.

194. Urea breath test for H. pylori.

O. Reg. 169/15, s. 5.

APPENDIX D
Tests that a Naturopath may Perform

1. Ascorbic acid (ascorbate) Vitamin C.

2. Blood Group – ABO and RhD.

3. BTA Bioterrain Assessment.

4. Fatty acids, free.

5. Glucose.

6. Hemoglobin – A1C.

7. Human Chorionic Gonadotropin – pregnancy test.

8. Indican.

9. Koenisberg.

10. Live blood cell analysis.

11. Mononuclear Heterophile Antibodies (monospot).

12. Oxidative testing.

13. Rapid Strep Test.

14. Routine urinalysis by dipstick.

15. Sulkowitch.

16. Vaginal pH.

O. Reg. 169/15, s. 5.

 

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