Final Report Date : 06/30/2021

Patient Information

Name of Patient : xxxx

Gender : xxxx

Phone Number : xxx-xxx-xxxx

Address : xxx-xxx-xxxx

City : xxx-xxx-xxxx

Zip Code : xxx-xxx-xxxx

Test Information : xxxx

Specimen Source : xxxx

Clinician : xxx-xxx-xxxx

Collected : xxx-xxx-xxxx

Result: xxx-xxx-xxxx

Diagnosis Code: xxx-xxx-xxxx

CPT/Procedure Code: xxx-xxx-xxxx



This patient was tested using a fully integrated device containing a reverse transcription polymerase chain reaction (RT-PCR) based assey for qualitative detection of vural RNA from the SARS-CoV-2 virus. The device automatically performs all steps required to complete lysis,reverse transcription polymerase chain reaction,and amplificaton

Vechile Type: xxx-xxx-xxxx

Passport Number: xxx-xxx-xxxx

Passport Exp: xxx-xxx-xxxx

DL State and Number: xxx-xxx-xxxx

DL Exp: xxx-xxx-xxxx

Test Performed At:

ProscriptAmerica Inc

1801 Binz St. Suite 310, Houston, TX 77004

 Phone: (281) 816-6501


*** Final Report ***