Phenobarbital
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Phenobarbital | |
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| SPECIMEN INFO |
| Collection Date & Time: |
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Test ID :
PHNO
Test Workstation :
MACH3
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Collection Volume:
500 uL microtainer; 1.5 mL macrotainer
Minimum Volume:
500 uL microtainer; 1.5 mL macrotainer
Preferred Volume:
500 uL microtainer; 1.5 mL macrotainer
Storage:
Shipping: Send Refrigerated; Storage: Refrigerated: 7 days; Room Temperature: 7 days; Frozen: 1 year
Availability:
24 Hours/day, 7 days/week
Methodology:
Roche-Kinetic (KIMS)
Special Instructions:
For therapeutic monitoring, draw peak levels 2 hours postIV injection or 12 hours postoral ingestion and trough levels immediately prior to next dose. Please indicate whether the specimen is a peak, trough, or random level.
Lab/Phone:
330-746-9623
TAT:
1 hour
Additional Info:
Therapeutic range: 15-40 ug/mL
CPT Code:
80184
