EFTA00522659.pdf

:-ILabCorp Specimen ID: Control ID: Patient Report SHULIAK, KARYNA 301 EAST 66TH STREET APT 8H NEW YORK NY 10065 y/n DOB Agel Gender: F SSN: Acct a: Ellen S Marmur MD 12 East 87th Street Ste 1 A New York NY 10128 Phone: Rte: 67 Patient Details Physician Details Ordering: E MARMUR Referring: ID: Patient ID NPI: Specimen Details Date collected: 09/13/2018 0000 Local Date received: 09/14/2018 Date entered: 09/14/2018 Date reported: 09/14/2018 0819 ET General Comments & Additional Information Clinical Info: SRC: For inquiries. the physician may contact Branch: 800.631.5250 Lab: 8004314250 Date Issued:09/14/18 0819 ET FINAL REPORT This document contains private and confidential health information protected by state and federal law. If you have received this document in error, please call 8CO-631-S250 Page 1 of 1 O199S-2018 Laboratory Corporation of Americas' Holdings All Rights Reserved - Enterprise Report Version: 1.00 EFTA00522659