[CL-006] feat: Implement laboratory module

Add comprehensive laboratory module for managing lab tests, orders, and results: Entities: - LabTest: Catalog of available tests with reference ranges and categories - LabOrder: Lab orders linked to patients and consultations - LabResult: Results with values, status, and abnormal value detection Services: - LabTestService: CRUD operations for test catalog - LabOrderService: Order lifecycle (create, collect sample, process, complete, cancel) - LabResultService: Record results, verify, amend with history tracking Features: - Multi-tenant support (tenantId in all queries) - Automatic abnormal/critical value flagging - Result amendment with audit trail - Order number auto-generation - Reference range support by gender and age REST Endpoints: - /api/laboratory/tests/* - Test catalog management - /api/laboratory/orders/* - Order lifecycle management - /api/laboratory/results/* - Result recording and verification Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
2026-01-30 18:15:10 -06:00 · 2026-01-30 18:15:10 -06:00 · 27ea1fd4a6
commit 27ea1fd4a6
parent d0420bc135
13 changed files with 1802 additions and 0 deletions
--- a/src/modules/laboratory/controllers/index.ts
+++ b/src/modules/laboratory/controllers/index.ts
@ -0,0 +1 @@
+export { LaboratoryController } from './laboratory.controller';
--- a/src/modules/laboratory/controllers/laboratory.controller.ts
+++ b/src/modules/laboratory/controllers/laboratory.controller.ts
@ -0,0 +1,501 @@
+import { Router, Request, Response, NextFunction } from 'express';
+import { DataSource } from 'typeorm';
+import { LabTestService, LabOrderService, LabResultService } from '../services';
+import {
+  CreateLabTestDto,
+  UpdateLabTestDto,
+  LabTestQueryDto,
+  CreateLabOrderDto,
+  UpdateLabOrderDto,
+  CollectSampleDto,
+  CancelLabOrderDto,
+  LabOrderQueryDto,
+  RecordLabResultDto,
+  VerifyLabResultDto,
+  AmendLabResultDto,
+  LabResultQueryDto,
+} from '../dto';
+
+export class LaboratoryController {
+  public router: Router;
+  private testService: LabTestService;
+  private orderService: LabOrderService;
+  private resultService: LabResultService;
+
+  constructor(dataSource: DataSource, basePath: string = '/api') {
+    this.router = Router();
+    this.testService = new LabTestService(dataSource);
+    this.orderService = new LabOrderService(dataSource);
+    this.resultService = new LabResultService(dataSource);
+    this.setupRoutes(basePath);
+  }
+
+  private setupRoutes(basePath: string): void {
+    const labPath = `${basePath}/laboratory`;
+
+    // Lab Tests Routes
+    this.router.get(`${labPath}/tests`, this.findAllTests.bind(this));
+    this.router.get(`${labPath}/tests/categories`, this.getTestCategories.bind(this));
+    this.router.get(`${labPath}/tests/:id`, this.findTestById.bind(this));
+    this.router.post(`${labPath}/tests`, this.createTest.bind(this));
+    this.router.patch(`${labPath}/tests/:id`, this.updateTest.bind(this));
+    this.router.delete(`${labPath}/tests/:id`, this.deleteTest.bind(this));
+
+    // Lab Orders Routes
+    this.router.get(`${labPath}/orders`, this.findAllOrders.bind(this));
+    this.router.get(`${labPath}/orders/stats`, this.getOrderStats.bind(this));
+    this.router.get(`${labPath}/orders/:id`, this.findOrderById.bind(this));
+    this.router.get(`${labPath}/orders/patient/:patientId`, this.findOrdersByPatient.bind(this));
+    this.router.get(`${labPath}/orders/consultation/:consultationId`, this.findOrdersByConsultation.bind(this));
+    this.router.post(`${labPath}/orders`, this.createOrder.bind(this));
+    this.router.patch(`${labPath}/orders/:id`, this.updateOrder.bind(this));
+    this.router.post(`${labPath}/orders/:id/collect-sample`, this.collectSample.bind(this));
+    this.router.post(`${labPath}/orders/:id/start-processing`, this.startProcessing.bind(this));
+    this.router.post(`${labPath}/orders/:id/complete`, this.completeOrder.bind(this));
+    this.router.post(`${labPath}/orders/:id/cancel`, this.cancelOrder.bind(this));
+
+    // Lab Results Routes
+    this.router.get(`${labPath}/results`, this.findAllResults.bind(this));
+    this.router.get(`${labPath}/results/critical`, this.getCriticalResults.bind(this));
+    this.router.get(`${labPath}/results/abnormal`, this.getAbnormalResults.bind(this));
+    this.router.get(`${labPath}/results/order/:orderId`, this.findResultsByOrder.bind(this));
+    this.router.get(`${labPath}/results/:id`, this.findResultById.bind(this));
+    this.router.post(`${labPath}/results/:id/record`, this.recordResult.bind(this));
+    this.router.post(`${labPath}/results/:id/verify`, this.verifyResult.bind(this));
+    this.router.post(`${labPath}/results/:id/amend`, this.amendResult.bind(this));
+  }
+
+  private getTenantId(req: Request): string {
+    const tenantId = req.headers['x-tenant-id'] as string;
+    if (!tenantId) {
+      throw new Error('x-tenant-id header is required');
+    }
+    return tenantId;
+  }
+
+  // Lab Tests Handlers
+  private async findAllTests(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const query: LabTestQueryDto = {
+        search: req.query.search as string,
+        category: req.query.category as any,
+        status: req.query.status as any,
+        page: req.query.page ? parseInt(req.query.page as string) : 1,
+        limit: req.query.limit ? parseInt(req.query.limit as string) : 50,
+      };
+
+      const result = await this.testService.findAll(tenantId, query);
+      res.json({
+        data: result.data,
+        meta: {
+          total: result.total,
+          page: query.page,
+          limit: query.limit,
+          totalPages: Math.ceil(result.total / (query.limit || 50)),
+        },
+      });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async getTestCategories(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const categories = await this.testService.getCategories(tenantId);
+      res.json({ data: categories });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async findTestById(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+
+      const test = await this.testService.findById(tenantId, id);
+      if (!test) {
+        res.status(404).json({ error: 'Lab test not found', code: 'LAB_TEST_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: test });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async createTest(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const dto: CreateLabTestDto = req.body;
+
+      const test = await this.testService.create(tenantId, dto);
+      res.status(201).json({ data: test });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async updateTest(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: UpdateLabTestDto = req.body;
+
+      const test = await this.testService.update(tenantId, id, dto);
+      if (!test) {
+        res.status(404).json({ error: 'Lab test not found', code: 'LAB_TEST_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: test });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async deleteTest(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+
+      const deleted = await this.testService.softDelete(tenantId, id);
+      if (!deleted) {
+        res.status(404).json({ error: 'Lab test not found', code: 'LAB_TEST_NOT_FOUND' });
+        return;
+      }
+
+      res.status(204).send();
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  // Lab Orders Handlers
+  private async findAllOrders(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const query: LabOrderQueryDto = {
+        patientId: req.query.patientId as string,
+        doctorId: req.query.doctorId as string,
+        consultationId: req.query.consultationId as string,
+        dateFrom: req.query.dateFrom as string,
+        dateTo: req.query.dateTo as string,
+        status: req.query.status as any,
+        priority: req.query.priority as any,
+        page: req.query.page ? parseInt(req.query.page as string) : 1,
+        limit: req.query.limit ? parseInt(req.query.limit as string) : 20,
+      };
+
+      const result = await this.orderService.findAll(tenantId, query);
+      res.json({
+        data: result.data,
+        meta: {
+          total: result.total,
+          page: query.page,
+          limit: query.limit,
+          totalPages: Math.ceil(result.total / (query.limit || 20)),
+        },
+      });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async getOrderStats(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const [pendingCount, statusBreakdown] = await Promise.all([
+        this.orderService.getPendingOrdersCount(tenantId),
+        this.orderService.getOrdersByStatus(tenantId),
+      ]);
+
+      res.json({
+        data: {
+          pendingCount,
+          statusBreakdown,
+        },
+      });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async findOrderById(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+
+      const order = await this.orderService.findById(tenantId, id);
+      if (!order) {
+        res.status(404).json({ error: 'Lab order not found', code: 'LAB_ORDER_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async findOrdersByPatient(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { patientId } = req.params;
+      const limit = req.query.limit ? parseInt(req.query.limit as string) : 10;
+
+      const orders = await this.orderService.findByPatient(tenantId, patientId, limit);
+      res.json({ data: orders });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async findOrdersByConsultation(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { consultationId } = req.params;
+
+      const orders = await this.orderService.findByConsultation(tenantId, consultationId);
+      res.json({ data: orders });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async createOrder(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const dto: CreateLabOrderDto = req.body;
+
+      const order = await this.orderService.create(tenantId, dto);
+      res.status(201).json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async updateOrder(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: UpdateLabOrderDto = req.body;
+
+      const order = await this.orderService.update(tenantId, id, dto);
+      if (!order) {
+        res.status(404).json({ error: 'Lab order not found', code: 'LAB_ORDER_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async collectSample(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: CollectSampleDto = req.body;
+
+      const order = await this.orderService.collectSample(tenantId, id, dto);
+      if (!order) {
+        res.status(404).json({ error: 'Lab order not found', code: 'LAB_ORDER_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async startProcessing(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+
+      const order = await this.orderService.startProcessing(tenantId, id);
+      if (!order) {
+        res.status(404).json({ error: 'Lab order not found', code: 'LAB_ORDER_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async completeOrder(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+
+      const order = await this.orderService.complete(tenantId, id);
+      if (!order) {
+        res.status(404).json({ error: 'Lab order not found', code: 'LAB_ORDER_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async cancelOrder(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: CancelLabOrderDto = req.body;
+
+      const order = await this.orderService.cancel(tenantId, id, dto);
+      if (!order) {
+        res.status(404).json({ error: 'Lab order not found', code: 'LAB_ORDER_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: order });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  // Lab Results Handlers
+  private async findAllResults(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const query: LabResultQueryDto = {
+        labOrderId: req.query.labOrderId as string,
+        labTestId: req.query.labTestId as string,
+        status: req.query.status as any,
+        abnormalFlag: req.query.abnormalFlag as any,
+        isCritical: req.query.isCritical === 'true' ? true : req.query.isCritical === 'false' ? false : undefined,
+        page: req.query.page ? parseInt(req.query.page as string) : 1,
+        limit: req.query.limit ? parseInt(req.query.limit as string) : 50,
+      };
+
+      const result = await this.resultService.findAll(tenantId, query);
+      res.json({
+        data: result.data,
+        meta: {
+          total: result.total,
+          page: query.page,
+          limit: query.limit,
+          totalPages: Math.ceil(result.total / (query.limit || 50)),
+        },
+      });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async getCriticalResults(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const results = await this.resultService.getCriticalResults(tenantId);
+      res.json({ data: results });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async getAbnormalResults(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const limit = req.query.limit ? parseInt(req.query.limit as string) : 50;
+      const results = await this.resultService.getAbnormalResults(tenantId, limit);
+      res.json({ data: results });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async findResultsByOrder(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { orderId } = req.params;
+
+      const results = await this.resultService.findByOrder(tenantId, orderId);
+      res.json({ data: results });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async findResultById(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+
+      const result = await this.resultService.findById(tenantId, id);
+      if (!result) {
+        res.status(404).json({ error: 'Lab result not found', code: 'LAB_RESULT_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: result });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async recordResult(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: RecordLabResultDto = req.body;
+
+      const result = await this.resultService.recordResult(tenantId, id, dto);
+      if (!result) {
+        res.status(404).json({ error: 'Lab result not found', code: 'LAB_RESULT_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: result });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async verifyResult(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: VerifyLabResultDto = req.body;
+
+      const result = await this.resultService.verifyResult(tenantId, id, dto);
+      if (!result) {
+        res.status(404).json({ error: 'Lab result not found', code: 'LAB_RESULT_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: result });
+    } catch (error) {
+      next(error);
+    }
+  }
+
+  private async amendResult(req: Request, res: Response, next: NextFunction): Promise<void> {
+    try {
+      const tenantId = this.getTenantId(req);
+      const { id } = req.params;
+      const dto: AmendLabResultDto = req.body;
+
+      const result = await this.resultService.amendResult(tenantId, id, dto);
+      if (!result) {
+        res.status(404).json({ error: 'Lab result not found', code: 'LAB_RESULT_NOT_FOUND' });
+        return;
+      }
+
+      res.json({ data: result });
+    } catch (error) {
+      next(error);
+    }
+  }
+}
--- a/src/modules/laboratory/dto/index.ts
+++ b/src/modules/laboratory/dto/index.ts
@ -0,0 +1,384 @@
+import {
+  IsString,
+  IsOptional,
+  IsUUID,
+  IsEnum,
+  IsBoolean,
+  IsDateString,
+  IsInt,
+  IsNumber,
+  IsArray,
+  ValidateNested,
+  MaxLength,
+  Min,
+  Max,
+} from 'class-validator';
+import { Type } from 'class-transformer';
+import {
+  LabTestCategory,
+  LabTestStatus,
+  ResultValueType,
+  LabOrderStatus,
+  LabOrderPriority,
+  LabResultStatus,
+  AbnormalFlag,
+} from '../entities';
+
+// Reference Range DTO
+export class ReferenceRangeDto {
+  @IsOptional()
+  @IsNumber()
+  min?: number;
+
+  @IsOptional()
+  @IsNumber()
+  max?: number;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(50)
+  unit?: string;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(200)
+  normalText?: string;
+
+  @IsOptional()
+  @IsEnum(['male', 'female', 'all'])
+  gender?: 'male' | 'female' | 'all';
+
+  @IsOptional()
+  @IsInt()
+  @Min(0)
+  ageMin?: number;
+
+  @IsOptional()
+  @IsInt()
+  @Min(0)
+  ageMax?: number;
+}
+
+// Lab Test DTOs
+export class CreateLabTestDto {
+  @IsString()
+  @MaxLength(50)
+  code: string;
+
+  @IsString()
+  @MaxLength(200)
+  name: string;
+
+  @IsOptional()
+  @IsString()
+  description?: string;
+
+  @IsOptional()
+  @IsEnum(['hematology', 'chemistry', 'urinalysis', 'microbiology', 'immunology', 'hormones', 'tumor_markers', 'other'])
+  category?: LabTestCategory;
+
+  @IsOptional()
+  @IsEnum(['numeric', 'text', 'boolean', 'range', 'qualitative'])
+  resultValueType?: ResultValueType;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(50)
+  unit?: string;
+
+  @IsOptional()
+  @IsArray()
+  @ValidateNested({ each: true })
+  @Type(() => ReferenceRangeDto)
+  referenceRanges?: ReferenceRangeDto[];
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(100)
+  sampleType?: string;
+
+  @IsOptional()
+  @IsString()
+  preparationInstructions?: string;
+
+  @IsOptional()
+  @IsInt()
+  @Min(1)
+  processingTimeHours?: number;
+
+  @IsOptional()
+  @IsNumber()
+  @Min(0)
+  price?: number;
+
+  @IsOptional()
+  @IsInt()
+  displayOrder?: number;
+}
+
+export class UpdateLabTestDto {
+  @IsOptional()
+  @IsString()
+  @MaxLength(50)
+  code?: string;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(200)
+  name?: string;
+
+  @IsOptional()
+  @IsString()
+  description?: string;
+
+  @IsOptional()
+  @IsEnum(['hematology', 'chemistry', 'urinalysis', 'microbiology', 'immunology', 'hormones', 'tumor_markers', 'other'])
+  category?: LabTestCategory;
+
+  @IsOptional()
+  @IsEnum(['numeric', 'text', 'boolean', 'range', 'qualitative'])
+  resultValueType?: ResultValueType;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(50)
+  unit?: string;
+
+  @IsOptional()
+  @IsArray()
+  @ValidateNested({ each: true })
+  @Type(() => ReferenceRangeDto)
+  referenceRanges?: ReferenceRangeDto[];
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(100)
+  sampleType?: string;
+
+  @IsOptional()
+  @IsString()
+  preparationInstructions?: string;
+
+  @IsOptional()
+  @IsInt()
+  @Min(1)
+  processingTimeHours?: number;
+
+  @IsOptional()
+  @IsNumber()
+  @Min(0)
+  price?: number;
+
+  @IsOptional()
+  @IsEnum(['active', 'inactive', 'discontinued'])
+  status?: LabTestStatus;
+
+  @IsOptional()
+  @IsInt()
+  displayOrder?: number;
+}
+
+export class LabTestQueryDto {
+  @IsOptional()
+  @IsString()
+  search?: string;
+
+  @IsOptional()
+  @IsEnum(['hematology', 'chemistry', 'urinalysis', 'microbiology', 'immunology', 'hormones', 'tumor_markers', 'other'])
+  category?: LabTestCategory;
+
+  @IsOptional()
+  @IsEnum(['active', 'inactive', 'discontinued'])
+  status?: LabTestStatus;
+
+  @IsOptional()
+  page?: number;
+
+  @IsOptional()
+  limit?: number;
+}
+
+// Lab Order DTOs
+export class OrderTestItemDto {
+  @IsUUID()
+  labTestId: string;
+}
+
+export class CreateLabOrderDto {
+  @IsUUID()
+  patientId: string;
+
+  @IsOptional()
+  @IsUUID()
+  consultationId?: string;
+
+  @IsUUID()
+  orderingDoctorId: string;
+
+  @IsOptional()
+  @IsEnum(['routine', 'urgent', 'stat'])
+  priority?: LabOrderPriority;
+
+  @IsOptional()
+  @IsString()
+  clinicalNotes?: string;
+
+  @IsArray()
+  @ValidateNested({ each: true })
+  @Type(() => OrderTestItemDto)
+  tests: OrderTestItemDto[];
+}
+
+export class UpdateLabOrderDto {
+  @IsOptional()
+  @IsEnum(['pending', 'sample_collected', 'processing', 'completed', 'cancelled'])
+  status?: LabOrderStatus;
+
+  @IsOptional()
+  @IsEnum(['routine', 'urgent', 'stat'])
+  priority?: LabOrderPriority;
+
+  @IsOptional()
+  @IsString()
+  clinicalNotes?: string;
+}
+
+export class CollectSampleDto {
+  @IsOptional()
+  @IsUUID()
+  collectedBy?: string;
+}
+
+export class CancelLabOrderDto {
+  @IsString()
+  @MaxLength(500)
+  reason: string;
+}
+
+export class LabOrderQueryDto {
+  @IsOptional()
+  @IsUUID()
+  patientId?: string;
+
+  @IsOptional()
+  @IsUUID()
+  doctorId?: string;
+
+  @IsOptional()
+  @IsUUID()
+  consultationId?: string;
+
+  @IsOptional()
+  @IsDateString()
+  dateFrom?: string;
+
+  @IsOptional()
+  @IsDateString()
+  dateTo?: string;
+
+  @IsOptional()
+  @IsEnum(['pending', 'sample_collected', 'processing', 'completed', 'cancelled'])
+  status?: LabOrderStatus;
+
+  @IsOptional()
+  @IsEnum(['routine', 'urgent', 'stat'])
+  priority?: LabOrderPriority;
+
+  @IsOptional()
+  page?: number;
+
+  @IsOptional()
+  limit?: number;
+}
+
+// Lab Result DTOs
+export class RecordLabResultDto {
+  @IsOptional()
+  @IsString()
+  @MaxLength(500)
+  resultValue?: string;
+
+  @IsOptional()
+  @IsNumber()
+  numericValue?: number;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(50)
+  unit?: string;
+
+  @IsOptional()
+  @IsNumber()
+  referenceRangeMin?: number;
+
+  @IsOptional()
+  @IsNumber()
+  referenceRangeMax?: number;
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(200)
+  referenceRangeText?: string;
+
+  @IsOptional()
+  @IsString()
+  comments?: string;
+
+  @IsOptional()
+  @IsUUID()
+  performedBy?: string;
+}
+
+export class VerifyLabResultDto {
+  @IsUUID()
+  verifiedBy: string;
+
+  @IsOptional()
+  @IsString()
+  comments?: string;
+}
+
+export class AmendLabResultDto {
+  @IsString()
+  @MaxLength(500)
+  newValue: string;
+
+  @IsOptional()
+  @IsNumber()
+  newNumericValue?: number;
+
+  @IsString()
+  @MaxLength(500)
+  reason: string;
+
+  @IsUUID()
+  amendedBy: string;
+}
+
+export class LabResultQueryDto {
+  @IsOptional()
+  @IsUUID()
+  labOrderId?: string;
+
+  @IsOptional()
+  @IsUUID()
+  labTestId?: string;
+
+  @IsOptional()
+  @IsEnum(['pending', 'in_progress', 'completed', 'verified', 'amended'])
+  status?: LabResultStatus;
+
+  @IsOptional()
+  @IsEnum(['normal', 'low', 'high', 'critical_low', 'critical_high', 'abnormal'])
+  abnormalFlag?: AbnormalFlag;
+
+  @IsOptional()
+  @IsBoolean()
+  isCritical?: boolean;
+
+  @IsOptional()
+  page?: number;
+
+  @IsOptional()
+  limit?: number;
+}
--- a/src/modules/laboratory/entities/index.ts
+++ b/src/modules/laboratory/entities/index.ts
@ -0,0 +1,3 @@
+export { LabTest, LabTestCategory, LabTestStatus, ResultValueType, ReferenceRange } from './lab-test.entity';
+export { LabOrder, LabOrderStatus, LabOrderPriority } from './lab-order.entity';
+export { LabResult, LabResultStatus, AbnormalFlag, ResultHistory } from './lab-result.entity';
--- a/src/modules/laboratory/entities/lab-order.entity.ts
+++ b/src/modules/laboratory/entities/lab-order.entity.ts
@ -0,0 +1,74 @@
+import {
+  Entity,
+  PrimaryGeneratedColumn,
+  Column,
+  CreateDateColumn,
+  UpdateDateColumn,
+  Index,
+  OneToMany,
+} from 'typeorm';
+import { LabResult } from './lab-result.entity';
+
+export type LabOrderStatus = 'pending' | 'sample_collected' | 'processing' | 'completed' | 'cancelled';
+export type LabOrderPriority = 'routine' | 'urgent' | 'stat';
+
+@Entity({ name: 'lab_orders', schema: 'clinica' })
+export class LabOrder {
+  @PrimaryGeneratedColumn('uuid')
+  id: string;
+
+  @Index()
+  @Column({ name: 'tenant_id', type: 'uuid' })
+  tenantId: string;
+
+  @Index()
+  @Column({ name: 'order_number', type: 'varchar', length: 50 })
+  orderNumber: string;
+
+  @Index()
+  @Column({ name: 'patient_id', type: 'uuid' })
+  patientId: string;
+
+  @Column({ name: 'consultation_id', type: 'uuid', nullable: true })
+  consultationId?: string;
+
+  @Index()
+  @Column({ name: 'ordering_doctor_id', type: 'uuid' })
+  orderingDoctorId: string;
+
+  @Column({ name: 'order_date', type: 'timestamptz', default: () => 'NOW()' })
+  orderDate: Date;
+
+  @Column({ type: 'enum', enum: ['pending', 'sample_collected', 'processing', 'completed', 'cancelled'], default: 'pending' })
+  status: LabOrderStatus;
+
+  @Column({ type: 'enum', enum: ['routine', 'urgent', 'stat'], default: 'routine' })
+  priority: LabOrderPriority;
+
+  @Column({ name: 'clinical_notes', type: 'text', nullable: true })
+  clinicalNotes?: string;
+
+  @Column({ name: 'sample_collected_at', type: 'timestamptz', nullable: true })
+  sampleCollectedAt?: Date;
+
+  @Column({ name: 'sample_collected_by', type: 'uuid', nullable: true })
+  sampleCollectedBy?: string;
+
+  @Column({ name: 'completed_at', type: 'timestamptz', nullable: true })
+  completedAt?: Date;
+
+  @Column({ name: 'cancelled_at', type: 'timestamptz', nullable: true })
+  cancelledAt?: Date;
+
+  @Column({ name: 'cancellation_reason', type: 'text', nullable: true })
+  cancellationReason?: string;
+
+  @OneToMany(() => LabResult, (result) => result.labOrder)
+  results?: LabResult[];
+
+  @CreateDateColumn({ name: 'created_at', type: 'timestamptz' })
+  createdAt: Date;
+
+  @UpdateDateColumn({ name: 'updated_at', type: 'timestamptz' })
+  updatedAt: Date;
+}
--- a/src/modules/laboratory/entities/lab-result.entity.ts
+++ b/src/modules/laboratory/entities/lab-result.entity.ts
@ -0,0 +1,100 @@
+import {
+  Entity,
+  PrimaryGeneratedColumn,
+  Column,
+  CreateDateColumn,
+  UpdateDateColumn,
+  Index,
+  ManyToOne,
+  JoinColumn,
+} from 'typeorm';
+import { LabOrder } from './lab-order.entity';
+
+export type LabResultStatus = 'pending' | 'in_progress' | 'completed' | 'verified' | 'amended';
+export type AbnormalFlag = 'normal' | 'low' | 'high' | 'critical_low' | 'critical_high' | 'abnormal';
+
+export interface ResultHistory {
+  value: string;
+  amendedAt: Date;
+  amendedBy: string;
+  reason: string;
+}
+
+@Entity({ name: 'lab_results', schema: 'clinica' })
+export class LabResult {
+  @PrimaryGeneratedColumn('uuid')
+  id: string;
+
+  @Index()
+  @Column({ name: 'tenant_id', type: 'uuid' })
+  tenantId: string;
+
+  @Index()
+  @Column({ name: 'lab_order_id', type: 'uuid' })
+  labOrderId: string;
+
+  @ManyToOne(() => LabOrder, (order) => order.results)
+  @JoinColumn({ name: 'lab_order_id' })
+  labOrder: LabOrder;
+
+  @Index()
+  @Column({ name: 'lab_test_id', type: 'uuid' })
+  labTestId: string;
+
+  @Column({ name: 'test_code', type: 'varchar', length: 50 })
+  testCode: string;
+
+  @Column({ name: 'test_name', type: 'varchar', length: 200 })
+  testName: string;
+
+  @Column({ type: 'enum', enum: ['pending', 'in_progress', 'completed', 'verified', 'amended'], default: 'pending' })
+  status: LabResultStatus;
+
+  @Column({ name: 'result_value', type: 'varchar', length: 500, nullable: true })
+  resultValue?: string;
+
+  @Column({ name: 'numeric_value', type: 'decimal', precision: 15, scale: 5, nullable: true })
+  numericValue?: number;
+
+  @Column({ type: 'varchar', length: 50, nullable: true })
+  unit?: string;
+
+  @Column({ name: 'reference_range_min', type: 'decimal', precision: 15, scale: 5, nullable: true })
+  referenceRangeMin?: number;
+
+  @Column({ name: 'reference_range_max', type: 'decimal', precision: 15, scale: 5, nullable: true })
+  referenceRangeMax?: number;
+
+  @Column({ name: 'reference_range_text', type: 'varchar', length: 200, nullable: true })
+  referenceRangeText?: string;
+
+  @Column({ name: 'abnormal_flag', type: 'enum', enum: ['normal', 'low', 'high', 'critical_low', 'critical_high', 'abnormal'], default: 'normal' })
+  abnormalFlag: AbnormalFlag;
+
+  @Column({ name: 'is_critical', type: 'boolean', default: false })
+  isCritical: boolean;
+
+  @Column({ type: 'text', nullable: true })
+  comments?: string;
+
+  @Column({ name: 'performed_by', type: 'uuid', nullable: true })
+  performedBy?: string;
+
+  @Column({ name: 'performed_at', type: 'timestamptz', nullable: true })
+  performedAt?: Date;
+
+  @Column({ name: 'verified_by', type: 'uuid', nullable: true })
+  verifiedBy?: string;
+
+  @Column({ name: 'verified_at', type: 'timestamptz', nullable: true })
+  verifiedAt?: Date;
+
+  @Column({ name: 'result_history', type: 'jsonb', nullable: true })
+  resultHistory?: ResultHistory[];
+
+  @CreateDateColumn({ name: 'created_at', type: 'timestamptz' })
+  createdAt: Date;
+
+  @UpdateDateColumn({ name: 'updated_at', type: 'timestamptz' })
+  updatedAt: Date;
+}
--- a/src/modules/laboratory/entities/lab-test.entity.ts
+++ b/src/modules/laboratory/entities/lab-test.entity.ts
@ -0,0 +1,82 @@
+import {
+  Entity,
+  PrimaryGeneratedColumn,
+  Column,
+  CreateDateColumn,
+  UpdateDateColumn,
+  DeleteDateColumn,
+  Index,
+} from 'typeorm';
+
+export type LabTestCategory = 'hematology' | 'chemistry' | 'urinalysis' | 'microbiology' | 'immunology' | 'hormones' | 'tumor_markers' | 'other';
+export type LabTestStatus = 'active' | 'inactive' | 'discontinued';
+export type ResultValueType = 'numeric' | 'text' | 'boolean' | 'range' | 'qualitative';
+
+export interface ReferenceRange {
+  min?: number;
+  max?: number;
+  unit?: string;
+  normalText?: string;
+  gender?: 'male' | 'female' | 'all';
+  ageMin?: number;
+  ageMax?: number;
+}
+
+@Entity({ name: 'lab_tests', schema: 'clinica' })
+export class LabTest {
+  @PrimaryGeneratedColumn('uuid')
+  id: string;
+
+  @Index()
+  @Column({ name: 'tenant_id', type: 'uuid' })
+  tenantId: string;
+
+  @Index()
+  @Column({ type: 'varchar', length: 50, unique: false })
+  code: string;
+
+  @Column({ type: 'varchar', length: 200 })
+  name: string;
+
+  @Column({ type: 'text', nullable: true })
+  description?: string;
+
+  @Column({ type: 'enum', enum: ['hematology', 'chemistry', 'urinalysis', 'microbiology', 'immunology', 'hormones', 'tumor_markers', 'other'], default: 'other' })
+  category: LabTestCategory;
+
+  @Column({ name: 'result_value_type', type: 'enum', enum: ['numeric', 'text', 'boolean', 'range', 'qualitative'], default: 'numeric' })
+  resultValueType: ResultValueType;
+
+  @Column({ type: 'varchar', length: 50, nullable: true })
+  unit?: string;
+
+  @Column({ name: 'reference_ranges', type: 'jsonb', nullable: true })
+  referenceRanges?: ReferenceRange[];
+
+  @Column({ name: 'sample_type', type: 'varchar', length: 100, nullable: true })
+  sampleType?: string;
+
+  @Column({ name: 'preparation_instructions', type: 'text', nullable: true })
+  preparationInstructions?: string;
+
+  @Column({ name: 'processing_time_hours', type: 'int', nullable: true })
+  processingTimeHours?: number;
+
+  @Column({ type: 'decimal', precision: 10, scale: 2, nullable: true })
+  price?: number;
+
+  @Column({ type: 'enum', enum: ['active', 'inactive', 'discontinued'], default: 'active' })
+  status: LabTestStatus;
+
+  @Column({ name: 'display_order', type: 'int', default: 0 })
+  displayOrder: number;
+
+  @CreateDateColumn({ name: 'created_at', type: 'timestamptz' })
+  createdAt: Date;
+
+  @UpdateDateColumn({ name: 'updated_at', type: 'timestamptz' })
+  updatedAt: Date;
+
+  @DeleteDateColumn({ name: 'deleted_at', type: 'timestamptz', nullable: true })
+  deletedAt?: Date;
+}
--- a/src/modules/laboratory/index.ts
+++ b/src/modules/laboratory/index.ts
@ -0,0 +1,33 @@
+export { LaboratoryModule, LaboratoryModuleOptions } from './laboratory.module';
+export {
+  LabTest,
+  LabTestCategory,
+  LabTestStatus,
+  ResultValueType,
+  ReferenceRange,
+  LabOrder,
+  LabOrderStatus,
+  LabOrderPriority,
+  LabResult,
+  LabResultStatus,
+  AbnormalFlag,
+  ResultHistory,
+} from './entities';
+export { LabTestService, LabOrderService, LabResultService } from './services';
+export { LaboratoryController } from './controllers';
+export {
+  CreateLabTestDto,
+  UpdateLabTestDto,
+  LabTestQueryDto,
+  CreateLabOrderDto,
+  UpdateLabOrderDto,
+  CollectSampleDto,
+  CancelLabOrderDto,
+  LabOrderQueryDto,
+  RecordLabResultDto,
+  VerifyLabResultDto,
+  AmendLabResultDto,
+  LabResultQueryDto,
+  ReferenceRangeDto,
+  OrderTestItemDto,
+} from './dto';
--- a/src/modules/laboratory/laboratory.module.ts
+++ b/src/modules/laboratory/laboratory.module.ts
@ -0,0 +1,19 @@
+import { Router } from 'express';
+import { DataSource } from 'typeorm';
+import { LaboratoryController } from './controllers';
+
+export interface LaboratoryModuleOptions {
+  dataSource: DataSource;
+  basePath?: string;
+}
+
+export class LaboratoryModule {
+  public router: Router;
+  private controller: LaboratoryController;
+
+  constructor(options: LaboratoryModuleOptions) {
+    const { dataSource, basePath = '/api' } = options;
+    this.controller = new LaboratoryController(dataSource, basePath);
+    this.router = this.controller.router;
+  }
+}
--- a/src/modules/laboratory/services/index.ts
+++ b/src/modules/laboratory/services/index.ts
@ -0,0 +1,3 @@
+export { LabTestService } from './lab-test.service';
+export { LabOrderService } from './lab-order.service';
+export { LabResultService } from './lab-result.service';
--- a/src/modules/laboratory/services/lab-order.service.ts
+++ b/src/modules/laboratory/services/lab-order.service.ts
@ -0,0 +1,262 @@
+import { DataSource, Repository } from 'typeorm';
+import { LabOrder, LabResult, LabTest } from '../entities';
+import {
+  CreateLabOrderDto,
+  UpdateLabOrderDto,
+  CollectSampleDto,
+  CancelLabOrderDto,
+  LabOrderQueryDto,
+} from '../dto';
+
+export class LabOrderService {
+  private repository: Repository<LabOrder>;
+  private resultRepository: Repository<LabResult>;
+  private testRepository: Repository<LabTest>;
+
+  constructor(dataSource: DataSource) {
+    this.repository = dataSource.getRepository(LabOrder);
+    this.resultRepository = dataSource.getRepository(LabResult);
+    this.testRepository = dataSource.getRepository(LabTest);
+  }
+
+  async findAll(tenantId: string, query: LabOrderQueryDto): Promise<{ data: LabOrder[]; total: number }> {
+    const { patientId, doctorId, consultationId, dateFrom, dateTo, status, priority, page = 1, limit = 20 } = query;
+
+    const queryBuilder = this.repository.createQueryBuilder('order')
+      .leftJoinAndSelect('order.results', 'results')
+      .where('order.tenant_id = :tenantId', { tenantId });
+
+    if (patientId) {
+      queryBuilder.andWhere('order.patient_id = :patientId', { patientId });
+    }
+
+    if (doctorId) {
+      queryBuilder.andWhere('order.ordering_doctor_id = :doctorId', { doctorId });
+    }
+
+    if (consultationId) {
+      queryBuilder.andWhere('order.consultation_id = :consultationId', { consultationId });
+    }
+
+    if (dateFrom) {
+      queryBuilder.andWhere('order.order_date >= :dateFrom', { dateFrom });
+    }
+
+    if (dateTo) {
+      queryBuilder.andWhere('order.order_date <= :dateTo', { dateTo });
+    }
+
+    if (status) {
+      queryBuilder.andWhere('order.status = :status', { status });
+    }
+
+    if (priority) {
+      queryBuilder.andWhere('order.priority = :priority', { priority });
+    }
+
+    queryBuilder
+      .orderBy('order.order_date', 'DESC')
+      .skip((page - 1) * limit)
+      .take(limit);
+
+    const [data, total] = await queryBuilder.getManyAndCount();
+    return { data, total };
+  }
+
+  async findById(tenantId: string, id: string): Promise<LabOrder | null> {
+    return this.repository.findOne({
+      where: { id, tenantId },
+      relations: ['results'],
+    });
+  }
+
+  async findByOrderNumber(tenantId: string, orderNumber: string): Promise<LabOrder | null> {
+    return this.repository.findOne({
+      where: { orderNumber, tenantId },
+      relations: ['results'],
+    });
+  }
+
+  async findByPatient(tenantId: string, patientId: string, limit: number = 10): Promise<LabOrder[]> {
+    return this.repository.find({
+      where: { tenantId, patientId },
+      relations: ['results'],
+      order: { orderDate: 'DESC' },
+      take: limit,
+    });
+  }
+
+  async findByConsultation(tenantId: string, consultationId: string): Promise<LabOrder[]> {
+    return this.repository.find({
+      where: { tenantId, consultationId },
+      relations: ['results'],
+      order: { orderDate: 'DESC' },
+    });
+  }
+
+  async create(tenantId: string, dto: CreateLabOrderDto): Promise<LabOrder> {
+    const orderNumber = await this.generateOrderNumber(tenantId);
+
+    const tests = await this.testRepository.createQueryBuilder('test')
+      .where('test.tenant_id = :tenantId', { tenantId })
+      .andWhere('test.id IN (:...ids)', { ids: dto.tests.map(t => t.labTestId) })
+      .andWhere('test.status = :status', { status: 'active' })
+      .getMany();
+
+    if (tests.length === 0) {
+      throw new Error('No valid active tests found');
+    }
+
+    const order = this.repository.create({
+      tenantId,
+      orderNumber,
+      patientId: dto.patientId,
+      consultationId: dto.consultationId,
+      orderingDoctorId: dto.orderingDoctorId,
+      priority: dto.priority || 'routine',
+      clinicalNotes: dto.clinicalNotes,
+      status: 'pending',
+    });
+
+    const savedOrder = await this.repository.save(order);
+
+    const results = tests.map(test => {
+      const referenceRange = test.referenceRanges && test.referenceRanges.length > 0
+        ? test.referenceRanges.find(r => r.gender === 'all') || test.referenceRanges[0]
+        : null;
+
+      return this.resultRepository.create({
+        tenantId,
+        labOrderId: savedOrder.id,
+        labTestId: test.id,
+        testCode: test.code,
+        testName: test.name,
+        unit: test.unit,
+        referenceRangeMin: referenceRange?.min,
+        referenceRangeMax: referenceRange?.max,
+        referenceRangeText: referenceRange?.normalText,
+        status: 'pending',
+        abnormalFlag: 'normal',
+        isCritical: false,
+      });
+    });
+
+    await this.resultRepository.save(results);
+
+    return this.findById(tenantId, savedOrder.id) as Promise<LabOrder>;
+  }
+
+  async update(tenantId: string, id: string, dto: UpdateLabOrderDto): Promise<LabOrder | null> {
+    const order = await this.findById(tenantId, id);
+    if (!order) return null;
+
+    if (order.status === 'completed' || order.status === 'cancelled') {
+      throw new Error('Cannot update completed or cancelled order');
+    }
+
+    Object.assign(order, dto);
+    await this.repository.save(order);
+
+    return this.findById(tenantId, id);
+  }
+
+  async collectSample(tenantId: string, id: string, dto: CollectSampleDto): Promise<LabOrder | null> {
+    const order = await this.findById(tenantId, id);
+    if (!order) return null;
+
+    if (order.status !== 'pending') {
+      throw new Error('Sample can only be collected for pending orders');
+    }
+
+    order.status = 'sample_collected';
+    order.sampleCollectedAt = new Date();
+    order.sampleCollectedBy = dto.collectedBy;
+
+    await this.repository.save(order);
+
+    await this.resultRepository.createQueryBuilder()
+      .update(LabResult)
+      .set({ status: 'in_progress' })
+      .where('lab_order_id = :orderId', { orderId: id })
+      .andWhere('tenant_id = :tenantId', { tenantId })
+      .execute();
+
+    return this.findById(tenantId, id);
+  }
+
+  async startProcessing(tenantId: string, id: string): Promise<LabOrder | null> {
+    const order = await this.findById(tenantId, id);
+    if (!order) return null;
+
+    if (order.status !== 'sample_collected') {
+      throw new Error('Can only start processing after sample collection');
+    }
+
+    order.status = 'processing';
+    await this.repository.save(order);
+
+    return this.findById(tenantId, id);
+  }
+
+  async complete(tenantId: string, id: string): Promise<LabOrder | null> {
+    const order = await this.findById(tenantId, id);
+    if (!order) return null;
+
+    const pendingResults = order.results?.filter(r => r.status !== 'completed' && r.status !== 'verified');
+    if (pendingResults && pendingResults.length > 0) {
+      throw new Error('Cannot complete order with pending results');
+    }
+
+    order.status = 'completed';
+    order.completedAt = new Date();
+    await this.repository.save(order);
+
+    return this.findById(tenantId, id);
+  }
+
+  async cancel(tenantId: string, id: string, dto: CancelLabOrderDto): Promise<LabOrder | null> {
+    const order = await this.findById(tenantId, id);
+    if (!order) return null;
+
+    if (order.status === 'completed') {
+      throw new Error('Cannot cancel completed order');
+    }
+
+    order.status = 'cancelled';
+    order.cancelledAt = new Date();
+    order.cancellationReason = dto.reason;
+    await this.repository.save(order);
+
+    return this.findById(tenantId, id);
+  }
+
+  async getPendingOrdersCount(tenantId: string): Promise<number> {
+    return this.repository.count({
+      where: { tenantId, status: 'pending' },
+    });
+  }
+
+  async getOrdersByStatus(tenantId: string): Promise<{ status: string; count: number }[]> {
+    const result = await this.repository.createQueryBuilder('order')
+      .select('order.status', 'status')
+      .addSelect('COUNT(*)', 'count')
+      .where('order.tenant_id = :tenantId', { tenantId })
+      .groupBy('order.status')
+      .getRawMany();
+
+    return result.map(r => ({ status: r.status, count: parseInt(r.count, 10) }));
+  }
+
+  private async generateOrderNumber(tenantId: string): Promise<string> {
+    const today = new Date();
+    const dateStr = today.toISOString().slice(0, 10).replace(/-/g, '');
+
+    const count = await this.repository.createQueryBuilder('order')
+      .where('order.tenant_id = :tenantId', { tenantId })
+      .andWhere('DATE(order.created_at) = CURRENT_DATE')
+      .getCount();
+
+    const sequence = (count + 1).toString().padStart(4, '0');
+    return `LAB-${dateStr}-${sequence}`;
+  }
+}
--- a/src/modules/laboratory/services/lab-result.service.ts
+++ b/src/modules/laboratory/services/lab-result.service.ts
@ -0,0 +1,229 @@
+import { DataSource, Repository } from 'typeorm';
+import { LabResult, LabOrder, AbnormalFlag } from '../entities';
+import {
+  RecordLabResultDto,
+  VerifyLabResultDto,
+  AmendLabResultDto,
+  LabResultQueryDto,
+} from '../dto';
+
+export class LabResultService {
+  private repository: Repository<LabResult>;
+  private orderRepository: Repository<LabOrder>;
+
+  constructor(dataSource: DataSource) {
+    this.repository = dataSource.getRepository(LabResult);
+    this.orderRepository = dataSource.getRepository(LabOrder);
+  }
+
+  async findAll(tenantId: string, query: LabResultQueryDto): Promise<{ data: LabResult[]; total: number }> {
+    const { labOrderId, labTestId, status, abnormalFlag, isCritical, page = 1, limit = 50 } = query;
+
+    const queryBuilder = this.repository.createQueryBuilder('result')
+      .where('result.tenant_id = :tenantId', { tenantId });
+
+    if (labOrderId) {
+      queryBuilder.andWhere('result.lab_order_id = :labOrderId', { labOrderId });
+    }
+
+    if (labTestId) {
+      queryBuilder.andWhere('result.lab_test_id = :labTestId', { labTestId });
+    }
+
+    if (status) {
+      queryBuilder.andWhere('result.status = :status', { status });
+    }
+
+    if (abnormalFlag) {
+      queryBuilder.andWhere('result.abnormal_flag = :abnormalFlag', { abnormalFlag });
+    }
+
+    if (isCritical !== undefined) {
+      queryBuilder.andWhere('result.is_critical = :isCritical', { isCritical });
+    }
+
+    queryBuilder
+      .orderBy('result.created_at', 'DESC')
+      .skip((page - 1) * limit)
+      .take(limit);
+
+    const [data, total] = await queryBuilder.getManyAndCount();
+    return { data, total };
+  }
+
+  async findById(tenantId: string, id: string): Promise<LabResult | null> {
+    return this.repository.findOne({
+      where: { id, tenantId },
+    });
+  }
+
+  async findByOrder(tenantId: string, labOrderId: string): Promise<LabResult[]> {
+    return this.repository.find({
+      where: { tenantId, labOrderId },
+      order: { testName: 'ASC' },
+    });
+  }
+
+  async recordResult(tenantId: string, id: string, dto: RecordLabResultDto): Promise<LabResult | null> {
+    const result = await this.findById(tenantId, id);
+    if (!result) return null;
+
+    if (result.status === 'verified') {
+      throw new Error('Cannot modify verified result. Use amend instead.');
+    }
+
+    result.resultValue = dto.resultValue;
+    result.numericValue = dto.numericValue;
+    result.comments = dto.comments;
+    result.performedBy = dto.performedBy;
+    result.performedAt = new Date();
+    result.status = 'completed';
+
+    if (dto.unit) result.unit = dto.unit;
+    if (dto.referenceRangeMin !== undefined) result.referenceRangeMin = dto.referenceRangeMin;
+    if (dto.referenceRangeMax !== undefined) result.referenceRangeMax = dto.referenceRangeMax;
+    if (dto.referenceRangeText) result.referenceRangeText = dto.referenceRangeText;
+
+    const { abnormalFlag, isCritical } = this.evaluateResult(result);
+    result.abnormalFlag = abnormalFlag;
+    result.isCritical = isCritical;
+
+    return this.repository.save(result);
+  }
+
+  async verifyResult(tenantId: string, id: string, dto: VerifyLabResultDto): Promise<LabResult | null> {
+    const result = await this.findById(tenantId, id);
+    if (!result) return null;
+
+    if (result.status !== 'completed') {
+      throw new Error('Can only verify completed results');
+    }
+
+    result.status = 'verified';
+    result.verifiedBy = dto.verifiedBy;
+    result.verifiedAt = new Date();
+
+    if (dto.comments) {
+      result.comments = result.comments
+        ? `${result.comments}\n\nVerification note: ${dto.comments}`
+        : `Verification note: ${dto.comments}`;
+    }
+
+    const saved = await this.repository.save(result);
+
+    await this.checkAndCompleteOrder(tenantId, result.labOrderId);
+
+    return saved;
+  }
+
+  async amendResult(tenantId: string, id: string, dto: AmendLabResultDto): Promise<LabResult | null> {
+    const result = await this.findById(tenantId, id);
+    if (!result) return null;
+
+    if (result.status !== 'verified' && result.status !== 'completed') {
+      throw new Error('Can only amend completed or verified results');
+    }
+
+    const historyEntry = {
+      value: result.resultValue || '',
+      amendedAt: new Date(),
+      amendedBy: dto.amendedBy,
+      reason: dto.reason,
+    };
+
+    result.resultHistory = result.resultHistory || [];
+    result.resultHistory.push(historyEntry);
+
+    result.resultValue = dto.newValue;
+    if (dto.newNumericValue !== undefined) {
+      result.numericValue = dto.newNumericValue;
+    }
+
+    result.status = 'amended';
+    result.comments = result.comments
+      ? `${result.comments}\n\nAmendment: ${dto.reason}`
+      : `Amendment: ${dto.reason}`;
+
+    const { abnormalFlag, isCritical } = this.evaluateResult(result);
+    result.abnormalFlag = abnormalFlag;
+    result.isCritical = isCritical;
+
+    return this.repository.save(result);
+  }
+
+  async getCriticalResults(tenantId: string): Promise<LabResult[]> {
+    return this.repository.find({
+      where: { tenantId, isCritical: true },
+      order: { createdAt: 'DESC' },
+      take: 50,
+    });
+  }
+
+  async getAbnormalResults(tenantId: string, limit: number = 50): Promise<LabResult[]> {
+    return this.repository.createQueryBuilder('result')
+      .where('result.tenant_id = :tenantId', { tenantId })
+      .andWhere('result.abnormal_flag != :normal', { normal: 'normal' })
+      .orderBy('result.is_critical', 'DESC')
+      .addOrderBy('result.created_at', 'DESC')
+      .take(limit)
+      .getMany();
+  }
+
+  async getPendingResultsCount(tenantId: string): Promise<number> {
+    return this.repository.count({
+      where: { tenantId, status: 'pending' },
+    });
+  }
+
+  private evaluateResult(result: LabResult): { abnormalFlag: AbnormalFlag; isCritical: boolean } {
+    if (result.numericValue === null || result.numericValue === undefined) {
+      return { abnormalFlag: 'normal', isCritical: false };
+    }
+
+    const value = result.numericValue;
+    const min = result.referenceRangeMin;
+    const max = result.referenceRangeMax;
+
+    if (min === null && max === null) {
+      return { abnormalFlag: 'normal', isCritical: false };
+    }
+
+    let abnormalFlag: AbnormalFlag = 'normal';
+    let isCritical = false;
+
+    if (min !== null && min !== undefined && value < min) {
+      const percentBelow = ((min - value) / min) * 100;
+      if (percentBelow > 30) {
+        abnormalFlag = 'critical_low';
+        isCritical = true;
+      } else {
+        abnormalFlag = 'low';
+      }
+    } else if (max !== null && max !== undefined && value > max) {
+      const percentAbove = ((value - max) / max) * 100;
+      if (percentAbove > 30) {
+        abnormalFlag = 'critical_high';
+        isCritical = true;
+      } else {
+        abnormalFlag = 'high';
+      }
+    }
+
+    return { abnormalFlag, isCritical };
+  }
+
+  private async checkAndCompleteOrder(tenantId: string, labOrderId: string): Promise<void> {
+    const results = await this.repository.find({
+      where: { tenantId, labOrderId },
+    });
+
+    const allVerified = results.every(r => r.status === 'verified' || r.status === 'amended');
+
+    if (allVerified) {
+      await this.orderRepository.update(
+        { id: labOrderId, tenantId },
+        { status: 'completed', completedAt: new Date() }
+      );
+    }
+  }
+}
--- a/src/modules/laboratory/services/lab-test.service.ts
+++ b/src/modules/laboratory/services/lab-test.service.ts
@ -0,0 +1,111 @@
+import { DataSource, Repository } from 'typeorm';
+import { LabTest } from '../entities';
+import { CreateLabTestDto, UpdateLabTestDto, LabTestQueryDto } from '../dto';
+
+export class LabTestService {
+  private repository: Repository<LabTest>;
+
+  constructor(dataSource: DataSource) {
+    this.repository = dataSource.getRepository(LabTest);
+  }
+
+  async findAll(tenantId: string, query: LabTestQueryDto): Promise<{ data: LabTest[]; total: number }> {
+    const { search, category, status, page = 1, limit = 50 } = query;
+
+    const queryBuilder = this.repository.createQueryBuilder('test')
+      .where('test.tenant_id = :tenantId', { tenantId })
+      .andWhere('test.deleted_at IS NULL');
+
+    if (category) {
+      queryBuilder.andWhere('test.category = :category', { category });
+    }
+
+    if (status) {
+      queryBuilder.andWhere('test.status = :status', { status });
+    }
+
+    if (search) {
+      queryBuilder.andWhere(
+        '(test.code ILIKE :search OR test.name ILIKE :search)',
+        { search: `%${search}%` }
+      );
+    }
+
+    queryBuilder
+      .orderBy('test.category', 'ASC')
+      .addOrderBy('test.display_order', 'ASC')
+      .addOrderBy('test.name', 'ASC')
+      .skip((page - 1) * limit)
+      .take(limit);
+
+    const [data, total] = await queryBuilder.getManyAndCount();
+    return { data, total };
+  }
+
+  async findById(tenantId: string, id: string): Promise<LabTest | null> {
+    return this.repository.findOne({
+      where: { id, tenantId },
+    });
+  }
+
+  async findByCode(tenantId: string, code: string): Promise<LabTest | null> {
+    return this.repository.findOne({
+      where: { code, tenantId },
+    });
+  }
+
+  async findByIds(tenantId: string, ids: string[]): Promise<LabTest[]> {
+    if (ids.length === 0) return [];
+
+    return this.repository.createQueryBuilder('test')
+      .where('test.tenant_id = :tenantId', { tenantId })
+      .andWhere('test.id IN (:...ids)', { ids })
+      .andWhere('test.deleted_at IS NULL')
+      .getMany();
+  }
+
+  async findActiveByCategory(tenantId: string, category: string): Promise<LabTest[]> {
+    return this.repository.find({
+      where: { tenantId, category: category as any, status: 'active' },
+      order: { displayOrder: 'ASC', name: 'ASC' },
+    });
+  }
+
+  async create(tenantId: string, dto: CreateLabTestDto): Promise<LabTest> {
+    const test = this.repository.create({
+      ...dto,
+      tenantId,
+    });
+    return this.repository.save(test);
+  }
+
+  async update(tenantId: string, id: string, dto: UpdateLabTestDto): Promise<LabTest | null> {
+    const test = await this.findById(tenantId, id);
+    if (!test) return null;
+
+    Object.assign(test, dto);
+    return this.repository.save(test);
+  }
+
+  async softDelete(tenantId: string, id: string): Promise<boolean> {
+    const test = await this.findById(tenantId, id);
+    if (!test) return false;
+
+    await this.repository.softDelete(id);
+    return true;
+  }
+
+  async getCategories(tenantId: string): Promise<{ category: string; count: number }[]> {
+    const result = await this.repository.createQueryBuilder('test')
+      .select('test.category', 'category')
+      .addSelect('COUNT(*)', 'count')
+      .where('test.tenant_id = :tenantId', { tenantId })
+      .andWhere('test.deleted_at IS NULL')
+      .andWhere('test.status = :status', { status: 'active' })
+      .groupBy('test.category')
+      .orderBy('test.category', 'ASC')
+      .getRawMany();
+
+    return result.map(r => ({ category: r.category, count: parseInt(r.count, 10) }));
+  }
+}
				`@ -0,0 +1 @@`
				`export { LaboratoryController } from './laboratory.controller';`