6971872618 16:38 Fron: FP Woodson C. Merrell M Webfax Page: 8/11 - 1D oro SSS See a erapemreeaeeapmpr meron Specimen (D: 257-480-2715 Acct $31 143092 Phone: Rte: 68 Control ID: END31 143092 Woodson Merrell EPSTEIN, JEFFREY 44E67thSt 9E7ISTST New York NY 10065 — nde eee hale Patient Details Specimen Details Physician Details DOB: 01/20/1953 Date collected: 09/14/2018 1255 Local Ordering: W MERRELL Age(y/m/d): 065/07/25 Date received: 09/15/2018 Gender: M SSN: Dateentered: 09/15/2018 D: Patient ID: Date reported: 09/18/2018 0610 ET NPI: 1023153509 General Comments & Additional information Total Volume: Not Provided Fasting: No Ordered tems Chiamydia/GC Amplification; Pane! 083835; HCV Ab wiRfix to Verification; RPR, Rfx Qn RPR/Confirm TP Chlamydia/GC Amplification Chlamydia trachomatis, NAA Negative Negative ol Neisseria gonorrhoeae, MAA Negative Negative 01 Panel 083935 HIV Screen 4th Generation wRfx Non Reactive Non Reactive 01 HCV Ab w/Rflx to Verification HCV Ab <0.1 s/co ratio 0.0 - 0.9 01 Comment : 01 Non reactive HCV antibody screen is consistent with no HCV infection, unless recent infection is suspected or other evidence exists to indicate HCV infection. RPR, Rfx Qn RPR/Confirm TP RPR Non Reactive Non Reactive 01 Date Issued: 09/18/18 1053 ET FINAL REPORT Page tof! This document contains private and confidential health information protected by state and federal law. ‘© 1995-2018 Laboratory Corporation of America® Holdings Mf you have received this document in error, please call 800-631-5250 Ali Rights Reserved - Enterprise Report Version: 1.00 EFTA00314045