IlabCorp Specimen ID: Control ID: Patient Report SHULIAK, KARYNA Acct Ellen S Marmur MD 12 East 87th Street Ste 1A New York NY 10128 Phone: Patient la Specimen Details Physician Details DOR: Date collected: Wgi2018 0000 Local Ordering: E MARMUR Age(y/m/d) Date received: 11/30/2018 Referring: Gender: F SSN: Date entered: 11/30/2018 ID: Patient ID: Date reported: 11/30/2018 0610 ET NPI: Rte: 67 General Comments & Additional Information Clinical Info: SRC: Alternate Control Number: 16719 Total Volume: Not Provided Ordered Items Alternate Patient ID: Fasting: No Date Issued: 11/30/180611 ET FINAL REPORT This document contains private and confidential heats Information protected by state and federal law. If you have received tiltsdocument in elm, please call 800631.5250 Page 1 of 3 0 199S-2018 Laboratory Commotion of Ametica•Holdings All Rights Reserved • Enterprise Report Version 1.00 EFTA00522654

;1 LabCorp Patient Report Patient: SHULIA KARYNA DOB Patient ID Control ID: Specimen ID: Date collected. 0000 Local It 19 aOtt TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB Cate Issued: 11/30/1$ 0611 U FINAL REPORT This document contains private and confidential health information protected by state and federal law If you have received the document in mot, please cal 800631.5250 Page le 0 19954018 Laboratory Corporabon of American Holdings AN Rights Reserved - Enlerpnse Report Version: 100 EFTA00522655

LabCorp Patient Report Patent SHULIAK KARYNA D08 Patient ID: ControlID: Specimen ID Date collected: 0000local 1% `A It TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB Date Issued: 11/30/18 0611 ET FINAL REPORT This document contains private and confidential health information protected by state and federal Ian. If you have Medved MIS document In error, please call 800-631-S2SO Page 3 of 3 o 1995.2016 Laboratory Corporation of Americas Holdings Al Rights Reserved - Enterpnse Repon Version: 1.00 EFTA00522656