what stood out to me is my name has been printed as Last, First on every medical form i have ever seen!

From all the ways, that is probably the worst argument to dismiss it with.

There are similar documents you can find online and they all look pretty similar, from comparing them, I'd say the document itself is authentic, although that tells us nothing but that the pdf does come from a lab that does drug testing and that it has his name on it. We don't know if it was his urine, or if he paid to have a clean report or anything the like.

I think that's normal according to this random PDF I've found

Not saying much, he has an infinite amount of ways of faking it

At least you know he's positive for all those things.