Report Status: Final

Report Status: Final

Patient Information

DOB: AGE:

Gender: Phone: Patient ID: Health ID:

Specimen Information

Specimen: Requisition: Lab Ref#:

Collected: Received: Reported:

Client Information

Test Name CHLAMYDIA TRACHOMATIS

RNA, TMA, UROGENITAL See Endnote 1

NEISSERIA GONORRHOEAE RNA, TMA, UROGENITAL See Endnote 1

In Range

Out Of Range Reference Range

Lab

KS

NOT DETECTED

NOT DETECTED

KS

NOT DETECTED

NOT DETECTED

Endnote 1

The analytical performance characteristics of this assay, when used to test SurePath(TM) specimens have been determined by Quest Diagnostics. The modifications have not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

For additional information, please refer to (This link is being provided for information/ educational purposes only.)

CLIENT SERVICES: 866.697.8378

SPECIMEN:

Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics.

PAGE 1 OF 2

Report Status: Final

Patient Information

DOB: AGE: Gender: Patient ID: Health ID:

Specimen Information

Specimen: Collected: Received: Reported:

Client Information

Infectious Diseases

Test Name

Result

Reference Range

Lab

HIV 1/2 ANTIGEN/ANTIBODY, FOURTH GENERATION W/RFL

KS

HIV AG/AB, 4TH GEN

I I NON-REACTIVE

NON-REACTIVE

HIV-1 antigen and HIV-1/HIV-2 antibodies were not detected. There is no laboratory evidence of HIV infection.

PLEASE NO TE: This information has been disclosed to you from records whose confidentiality may be protected by state law. If your state requires such protection, then the state law prohibits you from making any further disclosure of the information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. A general authorization for the release of medical or other information is NOT sufficient for this purpose.

For additional information please refer to (This link is being provided for informational/ educational purposes only.)

The performance of this assay has not been clinically validated in patients less than 2 years old.

Physician Comments:

CLIENT SERVICES: 866.697.8378

SPECIMEN:

Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics.

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