Labcorp Receipt

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Labcorp Laboratory Corporation of America Clinical Laboratory Services 1555 Research Parkway Burlington, NC 27215 United States Phone: (336) 555-4821

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Accurate Testing. Trusted Results. Thank You For Choosing Labcorp Services.

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Patient Name

Daniel Roberts

Order #

LC-784512

Patient ID

LC-558392

Requisition #

99218473

DOB

06/14/1992

Physician

Dr. Sarah Mitchell

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Collection Date: 09/22/2026 Time: 9:45 AM Report Date: 09/23/2026

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Complete Blood Count (CBC)

$45.00

Lipid Panel Test

$65.00

Glucose Fasting Test

$30.00

Thyroid Panel (TSH)

$55.00

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Subtotal$195.00

Tax$0.00

Total

$195.00

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Payment MethodInsurance + Card

Insurance ProviderBlueCross BlueShield

StatusPending Insurance Approval

Co-Pay25.00

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