Physicians Choice Laboratory Services (PCLS) is validating a panel of biomarkers isolated from voided urine for their combined ability to reliably detect the presence of transformed cell populations. These markers include somatic mutations in a number of oncogenes that have been well established as important etiologic factors in the development of bladder cancer in the scientific and clinical literature. In addition, regional hypermethylation of the genome is evaluated, as is the presence or absence of specific proteins involved in the disease state. Through measurement of these biomarkers using next generation sequencing and immunoassays, PCLS has been able to establish both the analytical and clinical validity of these markers in diagnosing disease. The statistical correlation of these biomarkers with the presence of transitional cell carcinoma has resulted in the ability to define a distinct disease signature indicative of disease in preliminary studies. The current study aims to expand upon these findings in an effort to offer physicians an additional tool with which to manage bladder cancer.