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escreen specimen result certificate (2)

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65 views1 page

escreen specimen result certificate (2)

Uploaded by

markdarrenhamric
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Specimen Result Certificate

Report printed on 06/06/2024 9:36:13 PM


To: Verification Date
YUZUO ZHANG
06/06/2024 01:16 PM

1232 TERRY ROAD Labcorp


RONKONKOMA, NY 11779 Medical Review Officer:
Dr. Stephen Kracht
1723 E 12TH ST
BROOKLYN, NY 11229
718-975-8678

Donor Name: Donor SSN:


ZHANG, YUZUO XXX-XX-8635
Date Of Test: Other ID:
06/06/2024 09:36 AM CST
ID Number: Donor Status:
3532890006 Pre-employment
Lab Spiceman Type:
Labcorp Urine

Drugs Tested Test Type:


Non-DOT
Marijuana, Cocaine, Amphetamines, Opiates, PCP

Final Result Disposition: Negative

TO BE COMPLETED BY THE MEDICAL REVIEW OFFICER


I have reviewed the laboratory results for the specimen identified by this form in accordance with applicable Federal requirements. My determination/verification is:

Negative Positive Test Cancelled Refusal to test because


Dilute Adulterated Substituted

REMARKS:

Dr. Stephen Kracht 6/06/2024 1:16 PM


(PRINT) Medical Review Officer's Name Signature of Medical Review Officer Date (Mo./Day/Yr.)

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