EFTA00522213.pdf

rajQuest Diagnostics Report Status: Partial SHULIAK, KARYNA Patient Information Specimen Information Client Information SHULIAK, DOB: 05/31/1989 Gender: Phone: Patient ID: KARYNA AGE: F 29 Specimen: MR190205P Requisition: 0007032 Collected: 12/06/2018 Received: 12/06/2018 / 20:12 EST Reported: 12/10/2018 / 10:27 EST Client #: MOSKOWITZ, BRUCE W BRUCE MOSKOWITZ, MD Attn: NATIONWIDE ACCOUNT 1411 N FLAGLER DR STE 7100 WEST PALM BEACH, FL 33401.3418 ViliAP Hams Tn Ranee. Out Of Amino Rpfprpncp Ranao Lab CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P Quest. Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. PAGE 1 OF 4 EFTA00522213 Quest Diagnostics RkportStatus:Pardal - SHULIAK, Patient Information Specimen Information Client Information SHULIAK, KARYNA Specimen: MR190205P Client # Collected: 12/06/2018 MOSKOWITZ. BRUCE W DOB: AGE:■ Received: 12/06/2018 / 20:12 EST Gender: F Reported: 12/10/2018 / 10:27 EST Patient ID: Teat Name In Range Out Of Range Reference Range Lab Endnote I Please fax this signed form to Please do not attempt to return this document by other methods. Documents will not be viewed by a representative. Please do not use this fax number for other service requests. CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P PAGE 2 OF 4 Quest. Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. EFTA00522214 Report Status: Partial raj Quest Diagnostics' SHULIAK, —• Patient Information SHULIAK, KARYNA DOB AGE. Gender: F Patient ID: Specimen Information Specimen: MR190205P Collected: 12/06/2018 Received: 12/06/2018 120:12 EST Reported: 12/10/2018 10:27 EST Client Information Client # MOSKOWITZ, BRUCE W PERFORMING SITE: MI QUEST DIAGNOSTICSNIIAMI IMO COMMERCE PARKWAY. MIRAMAR. FL 33015.3938 Laboratory Diector: JULIE L FRIEDMAN.MD. CLIA: 11/D0277311 TP QUEST DIAGNOSTICSTAMPA. 1225 E FOWLER AVE TAMPA. FL 33617.2026 Laboratory Director GLEN L HORTIN.MD.PIID. CUA: 1000291120 CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P PAGE 3 OF 4 Quest. Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. EFTA00522215 11) Quest Diagnostics Report Status: Partial SHULIAK, KARYNA Patient Information SHULIAK, KARYNA Specimen: MR190205P Collected: 12/06/2018 DOB: Received: 12/06/2018 / 20:12 EST Gender: F Reported: 12/10/2018 10:27 EST Patient ID: Specimen Information Client Information Teat Name Client W mosicowin, BRUCE W In Range Out Of Range Reference Range Lab PERFORMING SITE: TP QUEST DIAGNOSTICSTAMPA 4223 E FOWLER AVE TAMPA FL 33617.2026 MEDICAL DIRECTOR: GLEN L HORTIN.MD.PHDCLIA NO: 1000291120 CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P Quest. Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. PAGE 4 OF 4 EFTA00522216