James, there is no completely reliable test for Lyme disease. Some people who have Lyme do not have a positive test.
The Western Blot test lists a series of numerical bands with a + - or IND rating after each one. The CDC requires several bands to be positive for the test to be positive. Many people who have Lyme do not have this many bands. Lyme doctors often look at which bands are positive--some are specific for Lyme.
I think it is a good idea to start with at least the Western Blot. You could also do the urine test if your doctor recommends it.