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One of the main causes is the autoimmune condition pernicious anaemia

This insenstivity means that you might have to do the test many times before getting a positive though

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Not optional, not recommended, but required for maintaining the 28-day beyond-use date and preventing bacterial colonization

The purchaser and handling laboratory assume full responsibility for proper handling, storage, use, and regulatory compliance in accordance with all applicable local, state, and federal regulations

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