EFTA Document EFTA01735428

4 --. 1 Quest • r; , v Report Status: Final EPSTEIN, JEFFREY Patient Information Specimen Information Client information EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 63 Gender: M Phone: NG Patient ID: 19530120MJE Specimen: KP992835A Requisition: 0841963 Collected: 11/11/2016 / 11:59 EST Received: 11/14/2016 / 13:56 EST Reported: 11/18/2016 / 07:44 EST Client #: 78300020 MA1L992 MOSKOWITZ, BRUCE W BRUCE MOSKOWITZ, BRUCE MD Attn: APAL NATIONWIDE ACT 1411 N FLAGLER DR STE 7100 WEST PALM BEACH, FL 33401-3418 SUMMARY OF REPORT CHANGES Please refer to the body of the reported for complete information Test Name => REVISED: Change in test result(s) URINALYSIS, COMPLETE CALCIUM OXALATE CRYSTALS In Range Out Of Range Reference Range NONE OR FEW /HPF Please refer to the body of the report PLEASE REFER TO THE BODY OF REPORT(S) FOR THE FOLLOWING CHANGE(S): e> ADDENDUM: New or added Information CULTURE, URINE, ROUTINE PLEASE DISREGARD PREVIOUSLY REPORTED INFORMATION BELOW: ORIGINALLY REPORTED ON 1I/I4/2016 at 2:48 PM EST URINALYSIS, COMPLETE CALCIUM OXALATE CRYSTALS CLIENT SERVICES: 866.697.8378 NONE OR FEW /HPF CALCIUM OXALATE CRYSTALS IDENTIFIED SPECIMEN: KP992835A PAGE I OF 2 Quest. Quest Diagnostics, the associated toga and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. EFTA_R1_00018821 EFTA01735428 41) Quest Report Status: Final EPSTEIN, JEFFREY Patient Information Specimen Information Client Information EPSTEIN, JEFFREY DOB: 01/20/1953 ACE: 63 Gender: M Phone: NG Patient ID: 19530120MJE Specimen: KP992835A Requisition: 0841963 Collected: 11/11/2016 / 11:59 EST Received: 11/14/2016 / 13:56 EST Reported: 11/18/2016 / 07:44 EST Client #: 78300020 MA1L992 MOSKOWITZ, BRUCE W BRUCE MOSKOWITZ, BRUCE MD Ann: APAL NATIONWIDE ACT 1411 N FLAGLER DR STE 7100 WEST PALM BEACH, FL 33401-3418 Test Name URINALYSIS, COMPLETE COLOR APPEARANCE SPECIFIC GRAVITY PH GLUCOSE BILIRUBIN KETONES OCCULT BLOOD PROTEIN NITRITE LEUKOCYTE ESTERASE WBC RBC SQUAMOUS EPITHELIAL CELLS BACTERIA => CALCIUM OXALATE CRYSTALS URIC ACID CRYSTALS HYALINE CAST NOTE Uric Acids NONE SEEN In Range YELLOW 1.028 5.5 NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NONE SEEN NONE SEEN NONE SEEN NONE SEEN Out Of Range CLOUDY Reference Range YELLOW CLEAR 1.001-1.035 5.0-8.0 NEGATIVE NEGATIVE NEGATIVE TRACE NEGATIVE NEGATIVE NEGATIVE NEGATIVE < OR = 5 /HPF < OR = 2 /HPF < OR = 5 /HPF NONE SEEN /HPF NONE OR FEW /HPF Calcium Oxalate Crystals Identified NONE OR FEW /HPF crystals identified NONE SEEN /LPF PERFORMING LABORATORY QUEST DIAGNOSTICS ONE MALCOLM AVENUE TETERBORO, NJ. 07608 LABORATORY DIRECTOR: LAWRENCE TSAO, M.D. CLIE NO: 31D0696246 This urine was analyzed for the presence of WBC, RBC, bacteria, casts, and other formed elements. Only those elements seen were reported. CULTURE, URINE, ROUTINE MICRO NUMBER: =>TEST STATUS: SPECIMEN SOURCE: =>SPECIMEN QUALITY: =>RESULT: INFORMATION 61024207 ADDENDUM - FINAL URINE ADEQUATE No Growth PERFORMING SITE: QHO QUEST DIAGNOSTICS HOR-SHAM, 900 BUSINESS CENTER DRIVE.. HORSHAM. PA 190444412 Latoraincy [Arca°, ANDREA% S DUMAN, MD PHD, CLIA. PH/0201404 CLIENT SERVICES: 866.697.8378 SPEC1MEN:KP992835A Quest. Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks orQuest Diagnostics. Lab QHO QHO PAGE2OF2 EFTA_R1_00018822 EFTA01735429