TEST INFORMATION

Test performed at Labcorp Monogram Biosciences, 345 Oyster Point Blvd., South San Francisco, CA 94080

PATIENT REPORT

Patient's results continue on following page(s).

Patient: DOB: Age: Gender: Patient Identifiers:

Visit Number (FIN):

Client: ARUP Physician Services321 TESTING ANSR EXTRACTSalt Lake City, NY 84108

Physician: test test

ARUP Test Code: 3001242

Collection Date: 05/18/2020Received in lab: 05/18/2020Completion Date: 05/19/2020

Human Immunodeficiency Virus Type 1 (HIV-1) GenoSure MG

ARUP Enhanced Reporting | May 19, 2020 | page 1 of 3

Chart continues on following page(s)

Patient: ARUP Accession: 20-139-106240