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 Lab Name: ABC Lab
Correlation Date:
Correlation Set Lot#:  
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Test
Unit
Sample 1 Result
Sample 2 Result
Sample 3 Result
Sample 4 Result
Sample 5 Result
Sample 6 Result
Instrument
Reference Range
Low
High
Albumin
g/dL
Roche Modular
3.5
5.5
ALT
g/dL
Roche Modular
10
40
AST
g/dL
Roche Modular
10
43