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theophylline
Synonyms: Aminophylline 
Computer Code: THEO
Specimen Collection: 3 mL blood (red top tube). 
Minimum Volume: 0.5 mL 
Handling Instructions for Offsite Areas: Allow to clot, centrifuge for 20 minutes, remove serum, refrigerate. 
Reference Values: 8-15 mcg/mL (draw sample one hour or less before next dose)  
Lab Code: CC 
Requisition: TOXI
Test Frequency: Daily 
Routine TAT: 2 hr 
Stat TAT: 60 min 
CPT Code(s): 80198 
LCD or NCD:  
Methodology Used: 27
See Addendum XVII

Albany Medical Center
43 New Scotland Avenue
Albany, NY, 12208
Date: 04/19/2014
Time: 11:08:28 (24hr)