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

Lidocaine

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. Lidocaine  
2.  
3.  
4.  
5.  
6.  

SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
ZMSO
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Sodium or Lithium heparin (Green). Do not collect in a gel separator tube.
Alternate Tube Type:
No additive (Red) Do not collect in a gel separator tube.
Collection Volume:
3.0 mL
Minimum Volume:
1.0 mL
Cause for Rejection:
Do not collect in a gel separator tube.
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Homogenous Enzyme Immunoassay (HEIA)
Lab/Phone:
330-543-8418
TAT:
8 hours
Additional Info:
Therapeutic range: 1.5-5.0 mg/L
CPT Code:
80176

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