Specimen ID Accté# Control ID: Ellen S Marmur MD 12 East 87th Street Ste 1A w York NY 10128 SHULIAK, KARYNA Pati Specimen Details Physician Details DOB: Date collected: \@ F018 0000 Local Ordering: E MARMUR Age(y/n/¢) ae Date received: 11/30/2 Referring: Gender: F 4 Dateentered: 11/30, 1D: General Comments & Additional Information Clinical Info: SRC Date 3: 11/30/18 0611 ET FINAL REPORT This document ce h information protected by state and federal law 1995-2018 Laboratory ¢ 631 ) \ll Rights Reserved EFTA00522651

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ee Patent het Patieg KARYNA Specimen 10: DOB Patient iim Date collected: UNITS REFERENCE INTERVAL LAB FINAL REPORT rivate and confidential health informatio ted by state and federal law ocument in error, please call 800-631-525 EFTA00522652

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Patent Rano Pati KARYNA Specimen 10 nn boo lla Patient Control 1D: - Date collected: 475343838 0000 Loca - 4 ihe RESULT FLAG UNITS REFERENCE INTERVAL LAB Se RE BE SE ORT STE LAY FOREN EN ELC EE TS SI TT SO ESET TS Date Issued: 11/30/18 0611 ET FINAL REPORT Page 3 of 3 This document contains private and confidential health information protected by state and federal law 1995-2018 Laboratory Corporation of America® Holdings If you have received this document in error, please call 800-631-5250 All Rights Reserved - Enterprise Report Version: 1.00 EFTA00522653