LabCorp Patient Report

Specimen ID: Acct #: 17452095 Phone: (800) 539-6119 Rte: 00

Control ID: Walk-In Lab, LLC
1645 Tiffany Lane
Mandeville
• •••• •• LA
• 70448
••• • ••• •• ••••• • ••• ••• •• • ••• ••••

Patient Details Specimen Details Physician Details

DOB: Date collected: Ordering: J EDELSTEIN
Age(y/m/d): Date received: Referring:
Gender: SSN: Date entered: ID: E39315
Patient ID: Date reported: NPI: 1114927506
General Comments & Additional Information
Clinical Info: SRC:FE
Alternate Control Number: Alternate Patient ID: Not Provided
Total Volume: Not Provided Fasting: U
Ordered Items
Occult Blood, Fecal, IA
TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
Occult Blood, Fecal, IA Negative Negative 01

01 PDLCA LabCorp Phoenix Dir: Brian Poirier, MD

5005 S 40th Street Ste 1200, Phoenix, AZ 85040-2969
For inquiries, the physician may contact Branch: 504-828-2666 Lab: 800-788-9743

Date Issued: 04/13/17 1212 ET FINAL REPORT Page 1 of 1

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