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

Clonazepam

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. Clonazepam  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
CLONO
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
3.0 mL
Minimum Volume:
1.5 mL
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Draw specimen immediately before next scheduled dose(minimum 12 hours after last dose) Serum must be separated from cells within 2 hours of draw. For Outpatients, test should only be drawn in outpatient locations within a Hospital (Akron or Beeghly).
Lab/Phone:
330-543-8418
TAT:
4-6 days
Additional Info:
Reference range available on patient report
CPT Code:
80346
Synonyms:
Klonopin Rivotril 7Aminoclonazepam

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