Lidocaine

Centralized Core Laboratory - Akron General Medical Center : 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. 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

While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Through a combination of revolutionary treatments and extraordinary patient experiences, our care does more than heal. It brings the entire family together for emotional support and understanding across multiple locations to reach you in the community where you live. Learn more...

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Lidocaine

Centralized Core Laboratory - Akron General Medical Center : Send Out

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