Centralized Core Laboratory - Mayo Clinic Laboratories :
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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. Rufinamide, Serum
2.
3.
4.
5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
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)
Rufinamide, Serum
Test ID/Workstation :
RUFIS
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)
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