We are experiencing exceptionally high volumes in our emergency rooms.
Every patient is important to us, and we are doing all we can to provide care quickly and efficiently.

Topiramate

Centralized Core Laboratory : Chemistry

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. Topiramate
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

TOPIR MAYO

Specimen Type:

Blood

Tube Type:

Red top

Collection Volume:

2.5 mL (minimum 1.5 mL)

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Enzyme-Multiplied Immunoassay Technique (EMIT)

Special Instructions:

Serum must be separated from cells within 2 hours of drawing

Lab/Phone:

330-543-8418

TAT:

1-2 days

Additional Info:

Reference range Depends on Clinical use:

Anticonvulsant: 5.0-20.0 mcg/mL

Psychiatric: 2.0-8.0 mcg/mL

CPT Code:

80201

Synonyms:

Topamax

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