rajQuest Diagnostics Report Status: Partial SHULIAK, IT N DOB: Gender: Phone: Patient ID: Health ID: Specimen Information Client Information Specimen: MR190205P Requisition: 0007032 Collected: Received: Reported: 12/06/2018 12/06/2018 I 20:12 EST 12/07/2018 / 05:20 EST Tn o rh c Client #: 78300020 56W5265 MOSKOWITZ, BRUCE W BRUCE MOSKOWITZ, MD Attn: NATIONWIDE ACCOUNT 1411 N FLAGLER DR STE 7100 WEST PALM BEACH, FL 33401.3418 Tat. 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. PAGE I OF 2 EFTA00522202 Report Status: Partial raj Quest —• Diagnostics' SHULIAK, Patient Information Specimen Information Client Information SHULIAK, Specimen: MR190205P Client # Collected: 12/06/2018 MOSKOWITZ, BRUCE W DOB: Received: 12/06/2018 / 20:12 EST Gender: F Reported: 12/07/2018 / 05:20 EST Patient ID: Health ID: PERFORMING SITE: MI QUEST DIAGNOSTICS/JIM.% I0M0 COMMERCE PARKWAY. MIRAMAR. FL 33015.3938 Lai:pommy DINCIOI: JULIE I. FRIEDMAN.MD. CLIA: I0D027731.1 CLIENT SERVICES: 866.697.8378 SPECIMEN: MR190205P PAGE 2 OF 2 Quest. Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. EFTA00522203