Text extracted via OCR from the original document. May contain errors from the scanning process.
.
10(24/20168:08:55PM
TO
LABCORP
Page 1 of 12
r
TO:
Sebastian Lig
LatiCsarp
SeemnimNundm
292-401- 3880-0
Nina
hImmlWmibee
10416405675
AomumNurdso
31981645
.
Rome
68
Psemtlasiblum
Epstein
AccovoAddren
Sebastian Lighvani MD
PMemlbruNsme
Jeffrey
PuiembtAlleNur
lanbane
npubame
Age (YAM)
63/08/28
Defter/Bibb
Sex
01/20/53
M
Sudo&
Yes
lbseeaA&Imn
9 E 71ST ST
NEW YORK NY 10021
Adobwmfledansem
WPM: 812269
DassidnmeCoUftW
10/:8/16 17:56 I
I
DmeNeaW
10/16/16 I
I
DeeaSTimeRaipmed
10/24/16 20:06ET
Physician Name
LIGHVANI , S
NM
:407879885
AysicuoW
LabCorp Raritan
69 First Avenue
TeanekdalW
CBC/Diff Ambiguous Default; Pneumococca: Ab (23 Serotype); Immmnoglobulins A/G/M On, Ser;
Tetanus/Diphtheria Ab; Complement C4, Serum; TSR; Tryptase; Vitamin D, 25-Hydroxy; C/ Esterase
Inhibitor, Punt; Histamine, Plasma; TSH Rfx on Abnormal to Pree T4; Antinuclear Antibodies
Direct; Sedimentation Rate-Hestergron; Thyroid Antibodies; Vitamin 612; C-Reactive Protein,
Want; Venipuncture
TESTS
CBC/Diff Ambiguous Default
NBC
BBC
Macrocytes present.
Marked anisocytosis.
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
Platelets
Neutrophils
Lymph&
Monocytes
Eos
Basos
Neutrophils (Absolute)
Lymphs (Absolute)
Monocytes(Absolute)
Boa (Absolute)
Baso (Absolute)
Immature Granulocytes
Immature Grans (Abs)
Hematology Comments:
Verified by microscopic
A hand-written panel/profile was received from your office. In
accordance with the LabCorp Ambiguous Test Code Policy dated July
2003, we have assigned CBC with Differential/Platelet, Test Code
4005009 to this request. If this is not the testing you wished to
receive on this specimen, please contact the LabCorp client Inquiry/
RESULT
FLAG
UNITS
LAB
6.5
xl0E3/uL
3.4 - 10.8
01
4.96
xl0E6/uL
4.14 - 5.80
01
14.6
g/dL
12.6
17.7
01
41.3
%
37.5
51.0
01
83
fL
79
97
01
29.4
pg
26.6
33.0
01
35.4
g/dL
31.5
35.7
01
14.1
%
12.3
15.4
01
247
x10E3/uL
150
379
01
47
%
01
39
%
01
8
%
01
5
%
01
1
%
01
3.1
x10£3/uL
1.4 - 7.0
01
2.5
x10E3/uL
0.7 - 3.1
01
0.5
xl0E3/uL
0.1 - 0.9
01
0.4
x10E3/uL
0.0 - 0.4
01
0.0
x10E3/uL
0.0 - 0.2
01
0
%
01
0.0
x10£3/uL
0.0 - 0.1
01
Note:
01
examination.
Epstein, Jeffrey
292-401-3880-0
Seq N 0393
10/24/16 20:06 ET
FINAL REPORT
This elccument contains mint and el:cadential health Informanon peotecled by state and federal law
Dyes hat teceived this dcostrent in en.
please call
Page 1 of 4
O2004-16 labontosy Corporatien of America m Holdings
AI I Km,hts Item bed
DOC
I Vex. 1.49
EFTA_R1_00010947
EFTA01733964
10/24/2016 8:06:55 PM
LABCORP
TO:
Sebastian Lighvani M
Page 2 of 12
r
Labggarp
PabeolNume
Epstein, Jeffrey
SronsoramS
292-401-3880-0
Account bombe:
31981645
➢ara ID
°so: Number
10416405675
Dafi acdTine Cobard
10/10/16 17:56
Date Recoiled
10/24/16
Sa
14
Are(YI740)
63/08/28
Due of Binb
01/20/53
LabCorp Raritan
69 Brat Avenue
Raritan.
08869-1
TESTS
RESULT
FLAG
UNITS
LAS
Technical Services Department to clarify the test order.
appreciate your business.
Pneumococcal Ab (23 Serotype)
Pneumo Ab Type 1*
Pneumo Ab
Pneumo Ab
Type
Type
3*
4*
Pneumo Ab Type 8e
Pneumo Ab Type 9 (98)*
Pneumo Ab Type 12 (12F)*
Pneumo Ab Type 14*
Pneumo Ab Type 17 (17F)*
Pneumo Ab Type 19 (19F)*
Pneumo Ab Type 2*
Pneumo Ab Type 20*
Pneumo Ab Type 22 (22F)*
Pneumo Ab Type 23 (23P)*
Pneumo Ab Type 26 (6B)*
Pneumo Ab Type 34 (10A)*
Pneumo Ab Type 43 (12A)*
Pneumo Ab Type 5*
Pneumo Ab Type 51 (7F)*
Pneumo Ab Type 54 (258)*
Pneumo Ab Type 56 (18C)*
Pneumo Ab Type 57 (19A)*
Pneumo Ab Type 68 (9V)*
Pneumo Ab Type 70 (33F)*
0.8
Low
0.6
Low
0.8
Low
0.5
Low
Low
cit, Low
Low
<0.1
Low
0.2
Low
0.9
Low
C0 7)
0.7
Low
C61r
Low
Low
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
U
/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/ML
ug/mL
ug/mL
ug/mL
ug/mL
*This test was developed and
performance
characteristics determined by Viracor-I8T Laboratories. It
has not been cleared or approved by the U.S. Food and Drug
Administration.
we
immunoglobuline A/O/N,
Immunoglobulin G, Qn,
Immunoglobulin A, Qn,
Immunoglobulin 8, Qn,
Qn, Ser
Serum
Serum
Serum
Tetanus/Diphtheria Ab
Tetanus Antitoxoid IgG Ab
994.7
216t/
41LX'
mg/dL
mg/dL
mg/dL
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>2.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
>1.3
700 - 1600
61 - 437
20 - 172
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
02
01
01
01
2.0: v
IU/mL
<0.10
03
Interpretation:
Non-Protective
<0.10
Protective
>=0.10
Results for this test are for research purposes
only by the assay's manufacturer. The performance
characteristics of this product have not been
established. Results should not be used as a
diagnostic procedure without confirmation of the
Epstein, Jeffrey
292-401-3880-0
scqsa393
10/24/16 20:06 ET
FINAL REPORT
This document contains pins and confidential health naformatton 'erected try state and retinal law.
If you have received this doctunent 1n ma. please c
Page 2 of 4
O200916 Laboratory Corpantica of America W Holdinpn
All Rie,hts Reserved
DOC1 Vet: 1A9
EFTA_R1_00010948
EFTA01733965
10/24/2016 8:06:55 PM FROM: LABCORP LCLS BULK
TO:
LABCORP
TO:
Sebastian Ligh,P.
Pap 3 of 12
r
Epstein, Jeffrey
occeout Mmbet
31981645
TESTS
LabCorp Raritan
69 First Avenue
Raritan, NJ 08869-1800
Phone
PreenNum
Spe
292-401-3880-0
Rem D
Control tOrn:Wt
Dew sodOme Collected
Dee Mowed
Scz
Ate(aM/D)
Doe of Birtb
10416405675
10/18/16 17:56
10/24/16
63/08/28
_
01/20/53
RESULT
FLAG
UNITS
LLB
diagnosis by another medically established diagnostic
product or procedury
Diphtheria Antitoxoid Ab
0.15 o
Complement C4, Serum
ESN
Tryptase
For research use only.
26
1.740 L/e/
5.0
IU/mL
<0.10
Interpretation:
Non-Protective
<0.10
Protective
>=0.10
mg/dL
uI13/mL
ug/L
Vitamin D, 25-Hydroxy
31.07
ng/mL
Vitamin D deficiency has been defined by the Institute of
Medicine and an Endocrine Society practice guideline as a
level of serum 25-0H vitamin D less than 20 ng/mL (1,2).
The Endocrine Society went on to further define vitamin D
insufficiency as a level between 21 and 29 ng/r1 (2).
1. ION (Institute of Medicine). 2010. Dietary reference
intakes for calcium and D. Washington DC: The
National Academies Press.
2. Holick MF, Hinkley NC, Bischoff-Ferrari HA, et al.
Evaluation, treatment, and prevention of vitamin D
deficiency:
an Endocrine Society clinical
practice
guideline.
JCEM. 2011 Jul; 96(7):1911-30.
Cl Esterase Inhibitor, rune
Cl Est.Inhib.Funct.
:09
Histamine, Plasma
Results for this test are f
manufacturer. The performance
not been established. Results
procedure without confirmation
established diagnostic product
%mean normal
Abnormal
Equivocal
Normal
:4
0.450
2.2
30.0
03
-
44
01
- 4.500
0:
- 13.2
03
- 100.0
0:
<41
41 - 67
>67
03
High ,_V
<1.00
03
earch p
oses only by the assay's
characteristics of this product have
should not be used as a diagnostic
of the diagnosis by another medically
or procedure.
TSN Rfx on Abnormal to Free T4
TSH
1.700 V .
u:U/ML
0.450 - 4.500
01
Epstein, Jeffrey
10/24/16 20:06 ET
FINAL REPORT
This documentcontains pints and confidential health thfonnation otorled by dm and federal law.
If you have received dal dec.unent w arcs. please cal
292-401-3880-0 f swim-3
Page 3 of 4
02004-16 Lab:eatery Corponflon of America E lictehngs
AU Rights Reserved
DOC1 Vc: 1.49
EFTA_R1_00010949
EFTA01733966
.
10/24/2016 8:06:55 PM
LASCORP
TO:
Sebastian Lighvan
Page 4 of 12
r
Lallov
Nths Name
Epstein, Jeffrey
Smonsc :tea
292-401-3880-0
Account Swam
31981645
Padeu M
crape Numbet
10416405675
Demand rime Named
10/18/16 17:56
Due Repotted
10/24/16
Sex
M
AteNaMM
63/08/28
Dm of Bum
01/20/53
LabCorp Raritan
69 First Avenue
liarLan NJ 08869-18tH!
Phone
TESTS
RESULT
UNITS
LAB
Antinuclear Antibodies Direct
ANA Direct
Sedimentation Rate -Westergren
Thyroid Antibodies
Thyroid Peroxidase (TP0)
Thyroglobulin Antibody
Negative
Negative
20
mm/hr
0
Ab
8
IU/mL
0
<1.0
IU/mL
0.0
Thyroglobulin Antibody measured by Beckman
Vitamin B12
C-Reactive Protein,
Coulter Methodology
755
pg/mL
211
Quant
1.7 v"
mg/L
0.0
01
RN
LabCorp Raritan
69 First Avenue, Raritan, NJ 08869-1800
02
NEWXW Viracor 1ST Laboratories Inc
1001 NW Technology Drive, Lees Summit, HO
03
BN
LabCorp Burlington
For inquiries, the physician may contact Branche
1447 York Court, Burlington, NC 272111
Labs
Dir: Aracell B Reyes, MD
Dir: Michelle Altrich, PhD
64086-5603
Dir: William F Hancock, MD
01
- 30
01
- 34
- 0.9
- 946
- 4.9
01
01
01
01
292-401-3880-0
Scq N 0393
Epstein, Jeffrey
10/24/16 20:06 ET
FINAL REPORT
Ibis document cameos pdva lc and confidential health inform/
sled by slam and fetal law.
If you ban received des doormenlin error. plea= call
Page 4 of 4
02004-.16 Laboratory Corporation of America 0 'folding,
All Rights Sesame
DOCI Vet: 1.49
EFTA_R1_00010950
EFTA01733967