MetropolitanMedicalLaboratory, PLCis your independent,full-service laboratoryfor all of your wellnessneeds.You can choose to havethese convenient laboratorytests to assess your basichealth without a doctor’sorder. We work directlyand confidentially with youalone.*

Some tests require fastingfor more accurate results.Please note the fastingrequirements beforeconsidering these tests.

Where & When do I gofor Testing?

Bring your order form to oneof these locations only. Noappointment necessary.Metropolitan Medical Laboratory, PLC

3906 Lillie Avenue, Ste. 3, Davenport, IA(Northeast of Marquette St & Kimberly Rd)Phone (563) 386-3000Mon – Fri 6 am – 6 pmSat 6 am - Noon

Metropolitan Medical Laboratory, PLC1828 E. Locust St, Davenport, IAPhone (563) 324-0471Mon – Fri 6 am – 6 pmSat - Sun 6 am – Noon

Metropolitan Medical Laboratory, PLC3625 Utica Ridge Rd, Bettendorf, IAPhone (563) 345-6575Mon – Fri 6 am – 6 pmSat 6 am - Noon

For more information or if you havequestions on this information, please callone of our Marketing Representatives at:

(309) 762-8555 -or- (563) 324-0471

Gary RassoExt. 3622Cassandra StoneExt. 3329Dave DampExt. 3605

w ww.M et r oM ed L a b . c om

Your Health Is Our Concern!

HEALTH

LAB

CHOICE

Since 1914

METROPOLITANMEDICAL

LABORATORY, PLCQua l i t y

S e r v i c ea n d

Moline - Davenport - Rock Island - Bettendorf - Silvis - Galesburg

Since 1914

METROPOLITANMEDICAL

LABORATORY, PLCQua l i t y

S e r v i c ea n d

Moline - Davenport - Rock Island - Bettendorf - Silvis - Galesburg

Payment for tests will becollected when you arrive.Either credit card or yourpersonal check will beacceptable.

Your confidential results willbe mailed to you within 72hours. Results will not besent to anyone else * (notyour healthcare provider;and not your insurancecompany).

Questions about abnormalresults should bediscussed with yourhealthcare provider – besure to take your resultswith you on your next visit.

Since 1914

METROPOLITANMEDICAL

LABORATORY, PLCQua l i t y

S e r v i c ea n d

Moline - Davenport - Rock Island - Bettendorf - Silvis - Galesburg

* Positive/reactive tests/results will be

reported by law to State Health authorities.

simple testsoffered at…

Name: _______________________________________________________Address: ________________________________Phone: _______________

City, State, Zip ____________________________

Date of Birth ______/______/_______

ORDERFORM

Since 1914

METROPOLITANMEDICAL

LABORATORY, PLCQua l i t y

S e r v i c ea n d

Moline - Davenport - Rock Island - Bettendorf - Silvis - Galesburg

Direct Access Testing

Hemoglobin A1cRecommended as a screening tool for diagnosisof diabetes.

● No fasting required

Complete Blood Count (CBC)

Used to evaluate variety of health conditionsincluding anemia, infections & even leukemia.Your doctor will likely wish to see results incombination with other tests. Includes 14 tests.

● No fasting required

Comprehensive Metabolic Panel (CMP)

Used to provide vital information on kidneyfunction, liver function, electrolytes & fluidbalance. Includes 14 tests.

● 12 Hours Fasting Required

Cardiac Risk Lipid ProfileCombines tests to analyze risk of heart disease.Includes measurement of cholesterol &triglycerides, & ratios of good (HDL) to bad(LDL) cholesterol.

● 12 Hours Fasting Required

. Vitamin D 25-HydroxyVitamin D is used in your body to controlcalcium & phosphate levels. It has been foundto be not only important in the health of yourbones, but also, there is increasing evidencethat it is important to cardiovascular health,mental health & a host of other medical issues.

● 12 Hours Fasting Recommended

More than 35 individual test resultsare included with these tests:

◻ $80 Wellness Profile – SAVE! [400001] YES◻ $27 DAT- HCG for Pregnancy,S/P [469022] NO◻ $20 DAT- Blood Type ABO Group & Rh [450500] NO◻ $60 DAT- Chlamydia trachomatis NAA * [451120] NO◻ $60 DAT- Neisseria gonorrhoeae NAA * [451130] NO◻ $25 DAT- FIT-CHEK Fecal Occult Blood [408252] NO◻ $15 DAT- Free T4 [410075] NO◻ $25 DAT- Hepatitis C Antibody Screen * [430080] NO◻ $50 DAT- Influenza A/B Antigen Screen [415226] NO◻ $23 DAT- Iron (Fe) / TIBC [460040] YES◻ $12 DAT- Magnesium [460012] NO◻ $10 DAT- Mononucleosis Ab Screen [435001] NO◻ $25 DAT- Rubella IgG Antibody Screen [435061] NO◻ $44 DAT- Strep A Antigen Screen [408000] NO◻ $27 DAT- TSH (Thyroid-Stimulating Hormone) [410015] NO◻ $ 5 DAT- Urinalysis [407011] NO◻ $25 DAT- Varicella Zoster IgG Antibody (Chicken Pox) [436123] NO◻ $25 DAT- Vitamin B-12 Assay [410045] NO◻ $30 DAT- Prostate-Specific Antigen (PSA) [410041] NO◻ $42 DAT- Testosterone [420005] NO

Wellness Profile Available as Individual Tests:◻ $20 DAT- A1c, Glycohemoglobin [460065] NO◻ $15 DAT- Complete Blood Count [401001] NO◻ $20 DAT- Comprehensive Metabolic Panel [400365] YES◻ $20 DAT- Cardiac Risk Lipid Profile [400331] YES◻ $45 DAT- Vitamin D, 25-Hydroxy [410090] YES

$ Order Total

Genera l Hea l th Test ing a tM et r opo l i tan M ed ica l La bo r ato r y, PLC

● Beta HCG (Pregnancy)● Blood Type & Rh● Chlamydia, Urine *● Gonorrhoeae, Urine *● Fit-chek (Stool test) Fecal occult blood● Free T4 (Thyroid)● Hepatitis C Antibody *● Influenza A/B Antigen● Iron (Fe) / TIBC● Magnesium● Mononucleosis (”Mono”)● Rubella IgG● Strep A Antigen● TSH (Thyroid-Stimulating Hormone)● Urinalysis● Varicella Zoster (Chicken Pox)● Vitamin B-12

Please complete this order form, which can ONLYbe brought to one of the convenient locations

listed on the back cover of this brochure.PRICES SUBJECT TO CHANGE

Order forms also available at draw site locations.

Fasting?Except for water,

avoid food & drinkfor 12 hoursbefore test?

- No appointment necessary.- Pay by credit card or check when you arrive.- Confidential results mailed to you.

● Prostate-Specific Antigen (PSA)

● Testosterone (Men 21 years or older)

Testing for Men Only

Additional Tests Available

For Metro Staff only:● Verify order total. Credit Card or Check accepted.● Use Direct Access Testing Account METRODA [#16629] as requesting & ordering client.● Be sure to use DAT Test Codes.● METRODA will generate a report to be sent to customer’s specific address.● If customer has not fasted as recommended above, note this on order.

Some tests may require that you fast. The order formindicates which of the available tests may require that yourefrain from eating/drinking for 12 hours prior to testing.

* Positve/reactive tests/results will be reported by law toState Health authorities.

www.MetroMedLab.com

Rev: Nov 14, 2017