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. Flecainide
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID :
FLEC
Test Workstation :
CLEVE
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Alternate Tube Type:
EDTA-Lav
Collection Volume:
5.0 mL
Minimum Volume:
1.5 mL
Cause for Rejection:
Collected in serum separator tube or gels of any kind
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Quantitative Liquid Chromatography - Tandem Mass Spectrometry
Special Instructions:
Do not use serum separator tubes. Remove serum from cells within 6 hours of collection and transfer into standard aliquot tube.
Predose(trough) draw at steady state concentration.
If collected at an offsite location, send by a STAT Courier to Hospital lab
Lab/Phone:
330-543-8418
TAT:
2-6 days
Additional Info:
Reference range: 0.20-1.00 mcg/mL
Toxic: >1.50 mcg/mL
CPT Code:
80181
Synonyms:
Almarytm; Apocard; Ecrinal; Tambocor
Flecainide
Test ID/Workstation :
FLEC
Specimen Type:
Blood
Tube Type:
Red top (no anticoagulant) tube
Collection Volume:
5.0 mL
Cause for Rejection:
Collected in serum separator tube or gels of any kind
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Quantitative Liquid Chromatography - Tandem Mass Spectrometry
Special Instructions:
Do not use serum separator tubes. Remove serum from cells within 6 hours of collection and transfer into standard aliquot tube.
Predose(trough) draw at steady state concentration.
If collected at an offsite location, send by a STAT Courier to Hospital lab
Lab/Phone:
330-543-8418
TAT:
2-6 days
Additional Info:
Reference range: 0.20-1.00 mcg/mL
Toxic: >1.50 mcg/mL
CPT Code:
80181
Synonyms:
Almarytm; Apocard; Ecrinal; Tambocor
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