Overview: The Standard USCIS Laboratory Panel

The USCIS immigration medical examination requires a standard laboratory panel for all eligible applicants. These tests are mandated by the Centers for Disease Control and Prevention (CDC) Technical Instructions for Civil Surgeons and must be performed by a USCIS-designated Civil Surgeon.

The three core required tests are: (1) Syphilis serology using the RPR method, required for applicants age 15 and older; (2) Gonorrhea testing using NAAT, required for all applicants; and (3) Tuberculosis screening using an IGRA blood test (QuantiFERON-TB Gold), required for all applicants.

Syphilis Testing (RPR)

The Rapid Plasma Reagin (RPR) test is a non-treponemal screening test for syphilis. It is required for all immigration medical exam applicants age 15 and older. A reactive (positive) RPR result requires confirmatory testing using a treponemal test such as the FTA-ABS or TP-PA. Results are documented in Part 4 of Form I-693. A confirmed positive syphilis result is a Class B condition and requires treatment documentation.

• Required for applicants age 15 and older
• Reactive results require confirmatory treponemal testing
• Documented in Part 4 of Form I-693
• Treated syphilis with documented cure does not prevent green card approval

Gonorrhea Testing (NAAT)

Gonorrhea testing using Nucleic Acid Amplification Testing (NAAT) is required for all immigration medical exam applicants. NAAT is the most sensitive and specific method for gonorrhea detection. A positive result requires treatment before Form I-693 can be completed. Gonorrhea is a Class A communicable disease of public health significance, and active untreated gonorrhea is a ground of inadmissibility.

• Required for all applicants regardless of age
• NAAT method — most sensitive available
• Positive results require treatment before I-693 completion
• Active untreated gonorrhea is a ground of inadmissibility

Tuberculosis Testing (QuantiFERON-TB Gold)

The QuantiFERON-TB Gold (QFT) test is an Interferon-Gamma Release Assay (IGRA) blood test and is the preferred method for TB screening in the immigration medical examination. It requires a single blood draw and does not require a return visit for reading, unlike the tuberculin skin test (TST).

A positive QFT result indicates TB infection and requires a chest X-ray to evaluate for active TB disease. Latent TB infection (LTBI) without active disease is not a ground of inadmissibility, but active TB disease is a Class A condition.

Additional Testing That May Be Ordered

Based on your medical history, physical examination findings, or country of origin, your Civil Surgeon may order additional laboratory tests. These may include a chest X-ray for TB evaluation, additional blood work, or other diagnostic tests. If additional testing is required, our staff will explain what is needed and why.

How Lab Results Are Documented on Form I-693

Your Civil Surgeon documents all laboratory results directly on Form I-693 in the designated sections. Results are categorized as normal, abnormal, or requiring follow-up. The completed form is sealed and submitted to USCIS — you will receive a copy for your records. Lab results from outside providers cannot be used; all testing must be performed as part of the official immigration medical exam.

Turnaround Time and Processing

All standard laboratory tests are performed on-site at our Costa Mesa clinic on the day of your appointment. Results are typically available within 1 to 2 business days. Your completed sealed Form I-693 will be ready within 2 to 3 business days. Expedited processing is available if you have an urgent USCIS deadline.