Quest Diagnostics
Patient Service Center
Lab Location #Q-214
550 Madison Avenue
New York, NY 10022
United States
Phone: (212) 555-7642
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Committed to Quality Laboratory Testing
Thank You For Choosing Quest Diagnostics
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Patient Name
Michael Johnson
Ordered By
Dr. Sarah Collins
Collected By
Lab Tech A. Reed
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Collection Date: 10/18/2026
Collection Time: 9:32 AM
Report Date: 10/19/2026
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1
Complete Blood Count (CBC)
$45.00
1
Blood Glucose Test
$25.00
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Payment MethodVisa Credit Card
Card Last 44921
Entry MethodChip
Authorization Code662841
StatusApproved
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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.
