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DOT Drug Testing Semi-Annual Laboratory Report

The following items are required on each report:

Reporting Period: (inclusive dates) Laboratory Identification: (name and address) Employer Identification: (name; may include billing code or ID code) C/C/TPA Identification: (where applicable; name and address)

 

1. Number of specimen results reported: (total number)

By test type:

(a) Pre-employment testing: (number)

(b) Post-accident testing: (number)

(c) Random testing: (number)

(d) Reasonable suspicion/cause testing: (number)

(e) Return-to-duty testing: (number)

(f) Follow-up testing: (number)

(g) Type not noted on CCF: (number)

 

2. Number of specimens reported as

(a) Negative: (total number)

(b) Negative-dilute: (number)

 

3. Number of specimens reported as Rejected for Testing: (total number) By reason:

(a) Fatal flaw: (number)

(b) Uncorrected flaw: (number)

 

4. Number of specimens reported as Positive: (total number)

By drug:

(a) Marijuana Metabolite: (number)

(b) Cocaine Metabolite: (number)

(c) Opiates:

(1) Codeine: (number)

(2) Morphine: (number)

(3) 6–AM: (number)

(d) Phencyclidine: (number)

(e) Amphetamines: (number)

(1) Amphetamine: (number)

(2) Methamphetamine: (number):

 

5. Adulterated: (number)

 

6. Substituted: (number)

 

7. Invalid results: (number)