Felbamate

Centralized Core Laboratory - Cleveland Clinic Laboratories : Send Out

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. Felbamate
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

FELBA

Test Workstation :

CLEVE

Specimen Type:

Blood

Tube Type:

Green top (lithium or sodium heparin) tube

Alternate Tube Type:

SST/Red

Collection Volume:

5.0 mL

Minimum Volume:

1.5 mL

Storage:

Refrigerated

Availability:

Sent to Reference Laboratory: Monday-Friday

Methodology:

High Performance Liquid Chromatography (HPLC)

Lab/Phone:

330-543-8418

TAT:

1-8 days

Additional Info:

No therapeutic range has been established. From limited clinical studies, a target range of 30 to 60 ug/mL is suggested. Severity of toxicity is related to age and concomitant treatment.

CPT Code:

80167

Synonyms:

Felbatol

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Felbamate

Centralized Core Laboratory - Cleveland Clinic Laboratories : Send Out

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