Background: The need for a Next-Generation Sequencing  NGS  orkflo in a CAPCLIA accredited laboratory is rapidly increasing as the sequencing technology matures and becomes more feasible as a diagnostic tool. Validating such a orkflo for use on formalin-fixed paraffin tissues  FFPE  is very challenging. Determination of tumor status is important to identify patient populations that may be poor responders to standard therapies and ould benefit from alternative therapeutic strategies. Driven by tissue context, sequencing joined ith immuno-histochemical  IHC  tests for specific markers can provide comprehensive information to inform clinicians on potential treatment pathays. We have developed an integrated orkflo solution that combines the use of IHC, digital imaging, micro-dissection, and NGS to capture important information to drive therapeutic opportunities. Methods: Our Integrated Companion Diagnostics  ICDx  orkflo involves staining of a FFPE specimen using a validated IHC test for a specific biomarker. A pathologist ould annotate regions of interest that are negative for the primary marker on a digital image. The selected area s  ould be excised on subsequent serial sections by micro-dissection. The captured FFPE tissue ould then pass through our automated NGS orkflo, hereupon additional validated IHC diagnostic tests identified via sequencing could be employed in our CAPCLIA accredited laboratory to confirm findings and inform clinicians. Results: To demonstrate the orkflo, e excised tissue from tumor regions on hole tissue resections and sequenced utilizing our custom and analytically  in-house  validated Ventana Medical Systems Inc  VMSI  targeted cancer panel. We ere able to sho that samples acquired from micro-dissection are suitable for use in our donstream orkflo for NGS library preparation and sequencing. Additionally, e found that the use of tissue dissection in regions of interest can allo for detection of mutations that ould otherise go undetected. Conclusions: This orkflo is aimed to provide as much information as possible about clinical samples to aid in treatment decisions.,J Clin Oncol 34, 2016  suppl; abstr e23273 ,Publication Only Tumor Biology