Stone Urinalysis Report Sample Page 4
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4DIANON
SYSTEMS
RTE: US!AFS
SEQ: W93U
F I N A L
840 Research Parkway, Oklahoma City, OK 73104-3699
VOICE (800) 634-9330 FAX (405) 290-4046
AH3500000
Page 4 of 4
Stone Urinalysis Report
Specimen:
Collection:
01/13/13
Bar Code:
006100000
WR93U01
Received:
01/15/13
Completed:
01/15/13
Report Date:
01/15/13
SAMPLE, PHYSICIAN, MD
Patient Information
DIANON SYSTEMS
Patient Name
SAMPLE, PATIENT
840 RESEARCH PARKWAY
Social Sec. No.
***-**-0000
Phone #
(000) 000-0000
OKLAHOMA CITY, OK 73104
Date of Birth:
07/00/1900
Age:
55 Yrs
Chart #:
Recommendations
Patient Management Plan
q
Increase Fluid Intake
q
24 Hour Urine
q
Blood Test
q
Reduce Animal Protein Intake
q
Calcium Load Test to Determine the source of Your Elevated urine Calcium
q
Low Salt Diet
q
Low Protein Diet
q
Thiazide Treatment
q
Sodium Cellulose Phosphate
q
Phosphate Supplement
q
Reduce Oxalate Intake
q
Calcium Supplement (for Enteric Hyperoxaluria)
Imaging Studies
q
IVP
q
KUB
q
Other _________________________________
o
Other _________________________________________
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