Jessica Hansen
 
 
 08-11-2020 14:58 FROM- CWFMD 
 T-274 P0002/0013 F-256 
 02-11-2018 
 Jessica Hansen 
 COMPANION DX REFERENCE LAB-HAWAII, LLC 
 CompanionD, 
 THE QUEEN'S MEDICAL CENTER 
 FAX 808,691,5017 
 1301 PUNCHBOWL ST. 
 CLIA ID # 12D2066057 
 KINAU 405 
 HONOLULU, HI 96813 
 GENERAL MEDICINE PERSONAL PHARMACOGENOMICS EVALUATION TEST REPORT 
 Created On: Thursday, 02-11-2018
 PATIENT AND ORDER INFORMATION 
 PATIENT 
 Jessica Hansen 
 ORDER 10 
 DATE OF BIRTH 
 01-16-1999 
 SAMPLE TYPE 
 Buccal Swab 
 AGE 
 42 
 COLLECTION DATE 
   02-17-2022 
 GENDER 
 Female 
 RECEIVED DATE 
   02-11-2018 
 STATED ETHNICITY 
 Caucasian 
 PRACTICE 
 GHPMA-PLL-WILLIS 
 PATIENT to 
 10000004410 
 PHYSICIAN 
 CONSIDER MONITORING FOR MALAISE, ORAL CANDIDIASIS, 
 ARTHRALGIA, SINUSITIS/SINUS INFECTION; MINOR DOSE 
 ADJUSTMENT (DECREASE) MAY BE NECESSARY 
 FLEXERIL 
 DDI 
 RISK OF INCREASED LEVELS AND CLINICAL EFFECTS FROM 
 2/11 
 Name: Jessica Hansen 
 DOB: 01-16-1999 
 Date:
