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Patient's Address Line 1
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Address Line 2
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City, state and zipcode
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LABS
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Cardio CRP
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Cardio IQ Lipoprotein Ion Mobility
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CBC
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CMP
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DHEA Sulfate
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Dihydrotestosterone
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Estradiol level
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Fasting glucose
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Fasting insulin
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Fasting Insuline level
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Free T3
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Free T4
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Free testosterone level
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FSH
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Hemoglobin A1c
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Homocysteine cardio
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IGF-1
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LH
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Lipid Panel
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NMR Lipoprotein Panel
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NMR Lipoprotein Profile
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Omega 3/6 Fatty Acid
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Progesterone level
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Prolactin Level
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Serum Cortisol level
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Serum Free PSA
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Serum total PSA
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Thyroglobulin Antibody
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Thyroid Peroxidase Antibody
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Total Testosterone level
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TSH
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Urine Ntx
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Urine Ntx (N-Telopeptide)
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Vitamin B12
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Vitamin D 25 Hydroxy
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Vitamin D 25 HYDROXY
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ANA
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ANCA
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Anti Cardiolipin Ab
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Anti DNA-DS
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Anti Hu
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Anti Parietal Cell Ab
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Anti Thrombin III
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Anti Yo
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Autoimmune Panel: ANA; Anti SSA/SSB; Actin Ab Ig
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Basic metabolic panel
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Campylobact. jejuni titer
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Carbamazepine level
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CBC with diff
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Ceruloplasmin
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Complement C3 C4
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Complement CH50
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Comp metabolic panel
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CPK
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CRP
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Cryoglobulin
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Dlta amino levulenic acid 24 hr
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Dlta amino levulenic acid Rnd
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Electrolyte panel
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Factor V Leiden
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Folate
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Glucose fasting
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Glucose tolerance test 2hr
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Glucose tolerance test 3hr
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Heavy metals random or 24 hr
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Hepatic function panel
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Hepatitis panel
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HgBA1C
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HIV-1 RNA PCR quantitative
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HIV-1/2 SCR w/RFX WB confirm
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Homocysteine
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Hypercoagulation Panel
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Immunofixation serum
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Immunologic Indicated Panel
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Infectious Disease Panel
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Infectious Neuropathies Panel
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Intrinsic factor Ab
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Iron (tot) IBC % sat
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Iron total
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Lambert-Eaton syndrome Ab
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Lamotrigine level
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Levetiracetam level
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Lipid panel
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Lupus anticoagulant
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Lyme disease titer
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Magnesium
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Methylmalonic acid
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Myasthenia Gravis Panel
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Myopathy Panel
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Mysoline
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Neuropathic Toxins Panel
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Phenobarbitol level
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Phenytoin level
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Porphobilinogen 24 hr
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Porphobilinogen random
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Porphyrins 24 hr
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Porphyrins random
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Pregnancy HCG total qual serum
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Pregnancy HCG total quant
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Prolactin
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Protein C func.
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Protein electrophoresis w/ TP
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Protein S func.
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PSA
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PT + INR
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PTT
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Rheumatoid factor
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RPR w/RFX titer (monitoring)
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RPR w/ RFX titer/FTA (diagnostic)
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Sed rate (Westergreen)
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Serum copper
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T3 uptake
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T4
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T4 free
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Triglycerides
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TSH ultra sensitive
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UA complete RFX cult
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Urine Test: Valproic acid level
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Urine Test: VDRL
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Urine Test: Vimpat level
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Urine Test: Vitamin B1
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Urine Test: Vitamin B6
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Urine Test: Vitamin B12
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Urine Test: Vitamin D 1-25 hydroxy
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Urine Test: Vitamin E
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Urine Test: Vitamin A
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Urine Test: VMA 24 hr
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Urine Test: VMA random
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Additional Labs
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X-Ray Requested
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Diagnosis for X-Ray Request
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