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 Results

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
 
Our Company is not responsible for the accuracy of information contained in public records from which we obtain information. The information provided will be an accurate account of information of record and available as of the time of the search. Our Company is not responsible for the accuracy of information reported to it from references, witnesses, current and / or previous employers, education institutions, credit bureaus, federal and / or state agencies unless our company has been asked to authenticate and / or corroborate the information. Human error in compiling this report is possible and it should not be the sole determination in evaluating this applicant.