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    • Quest Diagnostics Receipt

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    Anteprima dal vivo

    Logo

    Quest Diagnostics Patient Service Center Lab Location #Q-214 550 Madison Avenue New York, NY 10022 United States Phone: (212) 555-7642

    -------------------------------------------

    Committed to Quality Laboratory Testing Thank You For Choosing Quest Diagnostics

    -------------------------------------------
    Patient Name
    Michael Johnson
    Accession #
    QD-784521
    DOB
    04/12/1988
    Ordered By
    Dr. Sarah Collins
    Patient ID
    QD-558231
    Collected By
    Lab Tech A. Reed
    -------------------------------------------
    Collection Date: 10/18/2026 Collection Time: 9:32 AM Report Date: 10/19/2026
    -------------------------------------------
    1
    Complete Blood Count (CBC)
    $45.00
    1
    Lipid Panel Test
    $60.00
    1
    Blood Glucose Test
    $25.00
    1
    Vitamin D Test
    $75.00
    -------------------------------------------
    Subtotal$205.00
    Tax $0.00
    Receipts.cartier.totalCartier
    $205.00
    -------------------------------------------
    Payment MethodVisa Credit Card
    Card Last 44921
    Entry MethodChip
    Authorization Code662841
    StatusApproved
    -------------------------------------------
    1234567890

    Please retain this receipt for your records. Results will be available via patient portal. Visit www.questdiagnostics.com for more information. Thank you for choosing Quest Diagnostics.

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