Here we present a low cost, 3D printed optical reader which is compatible with a disposable, finger actuated chip which can be used for rapid CD4+ enumeration. This portable and widely autonomous device provides the next step in a workflow which can meet the WHO ASSURED requirements for assessment of HIV status in resource-poor settings. The reader is composed of 3D printed parts where the microfluidic chip can be moved along the optical axis of the objective lens for focusing using a screw adapted from a masonry bolt. Performance of the reader shows good agreement with measurements made using a conventional inverted microscope.