Which services for mycobacteria are performed by a Level II laboratory according to CAP guidelines?

The selection of services for mycobacteria performed by a Level II laboratory, as specified by CAP guidelines, includes acid-fast staining, inoculation, and referral.

Level II laboratories generally have the capabilities to conduct specific procedures that can facilitate the initial stages of mycobacterial analysis. Acid-fast staining is a crucial step in identifying mycobacteria, as it helps to visually confirm the presence of these organisms in clinical specimens. Inoculation is also performed to culture the organisms, which is vital for subsequent identification and testing. Additionally, referral services are important for more complex identification processes or for cases where specialized tests may be necessary, thus differentiating the capabilities of Level II labs from those of more advanced facilities that can perform definitive identification of all mycobacteria.

The other options suggest levels of service beyond what a Level II laboratory typically performs. For instance, isolation and identification of Mycobacterium tuberculosis pertains more to the capabilities of a Level III laboratory, which has advanced resources for comprehensive testing. Definitive identification of all mycobacteria would require extensive methods and expertise that usually fall under the purview of specialized reference laboratories. Therefore, the services delineated in the correct answer align well with the operational capacity defined for a Level II