Patient Details Specimen Details Physician Details
Patient Details Specimen Details Physician Details
Patient Details Specimen Details Physician Details
Specimen ID: 148-229-6453-0 Acct #: 04115970 Phone: (909) 677-7168 Rte: 00
Control ID: PRP04115970
SBDPH_WH
RAMOS SYLVIA 247 S BOYD STREET
10796 PEMBERTON ST SAN BERNARDINO CA 92415
ADELANTO , CA 92301
(909) 496-1977
Please note 02
The date and/or time of collection was not indicated on the
requisition as required by state and federal law. The date of
receipt of the specimen was used as the collection date if not
supplied.