Rufinamide, Serum
| PATIENT INFO |
| Patient Name: |
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| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Rufinamide, Serum | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
RUFIS
Test Workstation :
MAYO
Specimen Type:
Blood
Tube Type:
Red Top Tube(no anticoagulant)
Collection Volume:
2.5mL(minimum 1.5mL)
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Draw blood immediately before next scheduled dose. For sustainedrelease formulations ONLY, draw blood a minimum of 12 hours after last dose. Spin down within 2 hours of draw.
Lab/Phone:
330-543-8418
TAT:
3-5 days
Additional Info:
Reference range available on patient report
CPT Code:
80210
Synonyms:
Rufinamide(Banzel)
Banzel(Rufinamide)
