Every option, one place.

Almost every nursing program, medical program, and clinical rotation requires TB (tuberculosis) screening. The requirement is standard. The confusion is about which test to get — and finding one provider who can actually help you with every path.

We're that provider. We're the only online lab service that offers all three TB testing options: two-step PPD skin test, QuantiFERON / T-Spot blood tests, and chest X-ray referrals for anyone with a positive result or a program that requires it. Most competitors will sell you a blood test and send you elsewhere for the rest. If your program's requirements change midway, or your first test comes back positive and you need follow-up, you don't have to start over with a new vendor.

Here's how the three options compare and how to pick the right one.

The three tests

1. Two-step PPD skin test (Mantoux)

The classic test. A small amount of tuberculin protein is injected just under the skin on your forearm. You come back 48-72 hours later so a nurse can measure the reaction. If your school requires the two-step version (most do), you repeat the whole process 1-3 weeks later. That's four visits total.

Pros: Cheap on paper. Widely available at any occupational health clinic, pharmacy that does TB testing, or student health office. Most schools accept it.

Cons: Four visits. Two waiting periods. False positives if you've had a BCG vaccine or certain infections. And you need to actually show up on time for the reading — miss the 48-72 hour window and you start over from scratch. If you don't come back for the reading, there are no refunds. That warning applies at almost every clinic that offers PPD, including ours. The test only counts if a nurse reads it in the window.

Best for: Students whose program specifically requires a skin test, who have a predictable schedule for four visits over three weeks, and who haven't had a BCG vaccine.

Skip it if: You've had BCG, you travel a lot, your schedule is unpredictable, or you're already stressed about deadlines. In those cases the blood test is worth the extra money.

2. QuantiFERON-TB Gold Plus (blood test)

A single blood draw. Your blood is exposed to TB antigens in the lab, and the lab measures your immune system's response. One visit, one result.

Pros: One appointment. Not affected by prior BCG vaccination. Results in a few days. Most nursing and health programs accept it as equivalent to a skin test.

Cons: More expensive than a skin test. Requires the blood tube to reach the lab within a specific time window, so some rural or remote draw sites don't offer it.

Best for: Anyone who's had a BCG vaccine (common for students born or raised outside the US), anyone whose schedule doesn't accommodate four visits over three weeks, and anyone whose program accepts blood-based TB screening.

3. T-Spot.TB (blood test)

Another blood-based TB test, similar in principle to QuantiFERON but using a different lab methodology. Both are called "interferon-gamma release assays" (IGRAs) in the medical literature.

Pros: Same one-visit convenience as QuantiFERON. Some studies suggest it's slightly more sensitive in specific patient populations.

Cons: Availability is spottier than QuantiFERON. Not every LabCorp or Quest location can process the sample. Usually the same price range as QuantiFERON.

Best for: Situations where your program specifically requires T-Spot (some do), or where QuantiFERON isn't available at your local draw site.

Which one should you actually get?

Read your program's compliance email carefully. The answer is usually spelled out:

• "PPD" or "tuberculin skin test" — get the two-step skin test.
• "IGRA," "QuantiFERON," or "TB blood test" — get QuantiFERON.
• "T-Spot" specifically named — get T-Spot.
• "Any of the above" or unspecified — for most people we lean toward the blood test. It's one visit, it works around BCG, and you're not risking a wasted skin-test appointment if life gets in the way of the reading.

There's no universally "better" test. They all work when the right patient gets the right one. But when we get to pick freely, we usually recommend the blood test — not because it's what we sell, but because most of the frustrated calls we get about TB testing are from people who lost their skin test to a missed reading, or got a false positive from BCG they didn't know still mattered.

About the BCG vaccine question

If you grew up outside the US, especially in India, China, Latin America, parts of Africa, or parts of Europe, you probably received a BCG vaccine as an infant. BCG protects against severe forms of TB in children but doesn't reliably prevent adult TB infection. It also means a PPD skin test will show a positive reaction whether or not you actually have TB.

This causes a lot of unnecessary panic. Students who received BCG show up for a skin test, get a positive result, and end up in the middle of chest X-rays and follow-up appointments they didn't need. If you had BCG, don't get a skin test. Get a QuantiFERON or T-Spot blood test instead — it distinguishes actual TB infection from BCG immunity, so a positive result actually means something.

This is the single biggest reason we exist for TB testing specifically. The occupational health clinic down the street can do a PPD, but they can't always help you when BCG throws it off. A blood test cuts through the confusion.

Where to get each test through us

This is where we're different from other online lab services. Most only sell you a blood test. We handle the full range:

PPD skin test: Order through us and we route you to a partner occupational clinic or pharmacy that can do both the injection and the reading. You get one point of contact for the whole two-step process instead of having to coordinate multiple providers yourself.

QuantiFERON or T-Spot blood test: Order through us and we send you a physician-signed lab order for LabCorp, Quest, or a partner clinic. One draw, results back in a few days.

Chest X-ray: If your program requires a chest X-ray (some do as a baseline), or if your TB screening came back positive and you need imaging for follow-up, we can route you to a partner imaging center for that too. Not many online lab services offer this — most will send you back to your PCP.

Browse everything at our TB Test Options collection.

What if your result is positive?

A positive QuantiFERON, T-Spot, or PPD skin test means your immune system has been exposed to TB — either an active infection, a past infection, or (rarely) a false positive. It does not mean you have contagious tuberculosis.

Follow-up steps typically include:

• A chest X-ray to rule out active pulmonary TB. We offer this as a direct add-on — you don't have to go find another provider. Most competitors will refer you elsewhere at this step.
• A visit with your student health office or a public health clinic to discuss whether latent TB infection (LTBI) treatment is appropriate. In the US, latent TB is usually treated with a course of medication that takes 3-9 months depending on the regimen chosen.
• Documentation for your school. Positive TB screening does not automatically disqualify you from a health program. Programs deal with latent TB regularly. The important thing is completing the follow-up steps.

Having all three steps — blood test, skin test, and chest X-ray — available through one provider matters more than people realize. Especially during clinical rotation deadlines, when adding a second vendor to hunt down an X-ray order is exactly the friction you don't need.

What customers say about the blood-test path

We hear from customers most often when they've already tried the traditional route and hit a wall — usually because of BCG, insurance not covering the blood test, or an occupational health clinic that couldn't process QuantiFERON.

"Tuberculosis blood testing can be very expensive and I am allergic to the skin test. LabReqs provided the test for a reasonable price and fast turn around time with results. I will definitely use again in the future." — Jennifer C.

"I needed a Quantiferon Gold TB test for work but had to arrange it on my own. LabReqs offered the best price and partners with LabCorp so there are several locations to choose from all over the country." — Anonymous, TB Blood Test - Quantiferon Gold

"Fast and easy process! Needed a TB test for my nursing school and I've ordered from LabReqs in the past. Process was super simple, got my lab order in a day." — esmeralda infante

About cost

Prices vary by lab and region. Skin tests are almost always the cheapest option. QuantiFERON and T-Spot run more, but the one-visit convenience is worth it for people whose schedules can't handle four skin-test visits. If cost is your only concern and your program accepts PPD, go with a skin test at whatever clinic is closest and cheapest.

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Whatever test your program requires — skin, blood, or X-ray — we handle it. Browse our TB Test Options.

Confused by the compliance email? Send it to us. We'll tell you which test the wording actually calls for, and we'll almost always have the option you need in stock.