123 Test Street

Louisville,KY 40253

Phone #: (555) 555-1212

Fax: (555) 555-1212

Confidential for Exclusive use by Test Client ABC   123 Test Street, 74135,   Louisville, KY 40253   (555) 555-1212

	Information Provided Applicant Name: TESTER, JOHNNY   Date of Birth: xx/xx/xxxx   Social Security #: xxx-xx-1532   Internal Code:   Sub Code:   Client Request #:   State of Employer: OK

Order Date:  3/17/2011 3:29:53 PM  Eastern	Order #: 6645

Drug Test Report		OK

Drug Test DONOR PRIMARY ID: XXXXXXX DONOR SECONDARY ID: TESTER, JOHNNY REASON FOR TEST: PRE-EMPLOYMENT CLIENT #: 60066460 CLIENT NAME: Test Client ABC CLIENT ATTN: ACCOUNT DESCRIPTION: SAP SPECIMEN: 8044432 UNIQUE SPECIMEN ID: 8044432814775TKS Results RESULT: NEGATIVE RESULT TYPE: A SOURCE: AMPHETAMINES (1000 ng/mL SCREEN) DESCRIPTION: AMP UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: BARBITURATES DESCRIPTION: BARB UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: BENZODIAZEPINES DESCRIPTION: BENZ UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: COCAINE METABOLITES DESCRIPTION: COC UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: MARIJUANA METABOLITES, (50 ng/mL SCREEN) DESCRIPTION: T50 UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: METHADONE DESCRIPTION: METD UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: METHAQUALONE DESCRIPTION: METQ UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: OPIATES (2000 NG/ML SCREEN) DESCRIPTION: OPI2K UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: PHENCYCLIDINE DESCRIPTION: PCP UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: NEGATIVE RESULT TYPE: A SOURCE: PROPOXYPHENE DESCRIPTION: PROP UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT: 167.7 RESULT TYPE: N SOURCE: CREATININE DESCRIPTION: CREAR UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT VALUE: 167.7 UNIT OF MEASURE: mg/dL RANGE LOW: >/= 20 mg/dL RANGE HIGH: RESULT: 5.4 RESULT TYPE: N SOURCE: pH DESCRIPTION: PHR UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE RESULT VALUE: 5.4 UNIT OF MEASURE: RANGE LOW: 4.5-8.9 RANGE HIGH: RESULT: NEGATIVE RESULT TYPE: A SOURCE: OXIDIZING ADULTERANTS DESCRIPTION: NITRQL UNIT CODE NAME: 35190N UNIT CODE NUMBER: 735190 NAME: SUBSTANCE ABUSE PANEL 10- TYPE: 50 GC/MS W/NITRITE Collection Information COLLECTION DATE: 20110317 COLLECTION TIME: 1531 SPECIMEN DATE: 20110319 SPECIMEN TIME: 0435 COLLECTION SITE NAME: National Occupational Health Sevices,L SITE ID: OK590 ADDRESS: 5906 E. 31 Tulsa OK 74135 QUEST LAB NAME: Quest Diagnostics-Lenexa LAB ID: KS CERTIFIED SCIENTIST: Stuerke,Aaron ADDRESS: 10101 Renner Blvd Lenexa KS 66219 MRO CLIENT CLIENT NAME: DR AMBROSE SOLANO CLIENT NUMBER: 60067675 ADDRESS: 5906 E 31ST ST, TULSA OK 74135

Entered by:	DTU
Comments:
Completed Date:	3/24/2011 4:52:06 PM
Received Date:
Printed Date:	3/25/2011 8:54:26 AM,admin1
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