Report Status: Partial SHULIAK, Patient Information Specimen Information Client Information (@) Quest cimen: MR190205P Clie! 56W5265 Requisition: 0007032 MOSK BRUCE W BRUCE MOSKOWITZ, MD NATIONWIDE ACCOUNT 11 N FLAGLER DR STE 7100 WEST PALM BEACH, FL 33401-3418 Collected: Received: Reported: § / 05:20 EST Health ID: 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. EFTA00522202

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Patient Information SHULIAK, DOB: Gender: Patient ID: Health ID: PERFORMING SITE: MI QUEST DIAGNOSTICS-MIAMI, 10200 COMMERCE PARKWAY, MIRAMAR, FL 33025.3938 Laboratory Director: JULIE L FRIEDMAN MD, CLIA: 1010277334 CLIENT SERVICES: 866.697.8378 Specimen Information Specimen: MR190205P Collected: 12/06/2018 Received: 12/06/2018 / 20:12 EST Reported: — 12/07/2018 / 05:20 EST SPECIMEN: MR190205P Report Status: Partial SHULIAK, Client Information Client +: MOSKOWITZ, BRUCE W PAGE 2 OF 2 EFTA00522203