LETTER OF MEDICAL NECESSITY
Infinite Allergy Labs FAST Panel
To Whom it May Concern,
I am the physician for the patient noted above and am writing to request coverage for the diagnostic
Food Allergy/Sensitivity Test performed by Infinite Allergy Labs for my patient. I consider this test a
medically necessary step in the diagnosis and treatment of my patient due to their medical history, and
there is no in-network laboratory in my area able to provide comparable testing.
Food sensitivities cause a range of illness and symptoms, including skin rashes and chronic intestinal
diseases. The Infinite Allergy Labs FAST Panel measures over 88 of the most common foods and
additives. This yields many benefits, including uncovering which foods are causing inflammation and
disease, developing a personalized nutritional guide, and improving a patient's state of health and
energy levels. The test is the most sensitive food test available methods that detect both IgG, IgG4, IgE,
and C3b/d antibodies and complement antigen together to determine the reactivity of each sample
against a wide variety of food antigens using the most up to date technology.
Food elimination based on the Infinite Allergy Labs FAST Panel results has been shown to significantly
reduce symptoms a patient is experiencing.
LABORATORY PERFORMING TEST:
Infinite Allergy Labs - a high complexity CLIA laboratory located at 3885 Crestwood Pkwy Suite 550
Duluth GA 30096.
CLIA ID#: 11D2142105, Phone: 1-833-FOODALLERGY www.infiniteallergyalabs.com