Derrick Davis

 
 University of Oklahoma 
 2018/29/10
 800 NE 15th Street Suite 227 Oklahoma City, OK 73127 
 Page 2 
 4052436866 Fax: 2436866 
 Lab Report 
 JIM C PARRY 
 Male DOB: 1994/04/08 
 2708046 
 Ins: BLUE CRO (22) Grp: {Random 2}
 (1) Order result status: Final 
 Collection or observation date-time: 2019/22/05 14:50 
 Requested date-time: 
 Receipt date-time: 2018/29/10 16:48 
 Reported date-time: 2018/15/11 12:54 
 Referring Physician: Adam Baxter 
 Ordering Physician: James Moss (AASCH) 
 Specimen Source: 0227: PN: S00272R 
 Source: HCA_LAB 
 Filler Order Number: 0226:PN: S00272R LAB 
 Lab site: OU MEDICAL CENTER Laboratory, 1200 Everett Drive 
 Oklahoma City 
 OK 73127 
 Producer ID *1:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73104 
 The following tests had no related values for dispersal to the flowsheet: 
 CHROMOSOME ANALYSIS REPORT, [No Value Reported], (F) 
 Electronically Signed by James Moss PA-C on 2021/18/11 at 11:37 AM
