EFTA00522659.pdf

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