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Akron Children's > For Healthcare Professionals > Lab Tests : Akron | Mahoning Valley

Clobazam and metabolite, S

PATIENT INFO
Patient Name:
Medical Record #:
BD:       /      /         Sex:   F   M

PHYSICIAN INFO
Physician Name :
Address:
Ph: (      )      -          Fax: (      )      -       
Additional Report to:
Ph: (      )      -          Fax: (      )      -       

TESTS REQUESTED
Test Name: ICD9 Code: (required)
1. Clobazam and metabolite, S  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CLBZS
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
1.3 mL
Minimum Volume:
1.0 mL
Cause for Rejection:
Collected in a gel tube
Storage:
Refrigerated
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Lab/Phone:
330-543-8418
TAT:
1-5 days
Additional Info:
Reference Range: Clobazam
  • Therapeutic Range: 30-300 ng/mL
  • Norclobazam
  • Therapeutic Range: 300-3,000 ng/mL
  • CPT Code:
    80339

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