Report Status: Partial SHULIAK, KARYNA (@) Quest Patient Information Specimen Information Client Information SHULIAK, KARYNA Specimen: +MR19020SP Cent . ee Requisition: 0007032 MOSKOWITZ, BRUCE W DOB: 05/31/1989 AGE: 29 BRUCE MOSKOWITZ, MD Gender: F Collected: 12/06/2018 Attn: NATIONWIDE ACCOUNT Phone: Receiv 01 — 1411 iLER DR STE 7100 Patient ID: Reported: / . . WEST PALM BEACH, FL 33401-3418 CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P PAGE | OF 4 Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. EFTA00522213

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7 ; Report Status: Partial SHULIAK, Patient Information Specimen Information Client Information SHULIAK, KARYNA Specimen: MR190205P Client a _ Collected: 12/06/2018 MOSKOWITZ, BRUCE W pos: i cr: Received: 12/06/2018 / 20:12 EST Gender: Reported: = 12/10/2018 / 10:27 EST Patient ID ; Test Name In Range Out Of Range Reference Range Lab Endnote | CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P PAGE 2 OF 4 EFTA00522214

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{@, Quest Patient Information Specimen Information SHULIAK, KARYNA Specimen: MR190205P Collected: 12/06/2018 pos: sac Received: 12/06/2018 / 20:12 EST Gender: Reported: = 12/10/2018 / 10:27 EST Patient ) iii” PERFORMING SITE: MI QUEST DIAGNOSTICS-MIAMI_ 10200 COMMERCE PARKWAY, MIRAM. TP QUEST DIAGNOSTICS-TAMPA, 4225 E FOWLER AVE. TAMPA, FL 336 FL 3302 CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P Report Status: Partial SHULIAK, Si Client Information Client iii” MOSKOWITZ, BRUCE W 25.3938 Laboratory Director: JULIE L FRIEDMAN MD, CLIA: 10D0277334 1126 Laborutary Director: GLEN L HORTIN.MD.PHD, CLIA: 101029112 PAGE 3 OF 4 EFTA00522215

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Patient Information Specimen Information SHULIAK, KARYNA Specimen: MR190205P . ae Collected: 12/06/2018 wr | Received: 12/06/2018 / 20:12 EST Gender: E Reported: = 12/10/2018 / 10:27 EST Patient ID: | Test Name PERFORMING SI TP QUEST DIAGNOSTICS-TAMPA 4225 E. FOWLER AVE TAMPA FL 33617 CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P In Range Out Of Range 226 MEDICAL DIRECTOR: GLEN L HORTIN,MD.PHD CLIA NO: 10D02 Report Status: Partial SHULIAK, KARYNA Client Information Client : iz MOSKOWITZ, BRUCE W Reference Range Lab 91120 PAGE 4 OF 4 EFTA00522216