Invoice: 8783
Voucher Codes:
GJE2
GJE2
Invoice: 8783
Invoice Date: October 31, 2025
Service Dates: 10/1/2025 – 10/31/2025
TO:
Wyoming Department of Health
Communicable Disease Unit
122 West 25th Street, 3rd Floor West
Cheyenne, Wy, 82002
Phone (307) 777-3562 | Fax 307-777-8547
FROM:
Albany Community Health Clinic
1000 E University AveLaramie, wyoming 82071
Total Vouchers: 1
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 1 | HIV antibody/antigen blood draw, NO RAPID DONE OR CONTROLS FAILED | $45.00 | $45.00 |
| 1 | Syphilis blood draw | $0.00 | $0.00 |
| 1 | Hepatitis C antibody blood draw, NO RAPID DONE OR CONTROLS FAILED | $20.00 | $20.00 |
| 1 | Hepatitis B panel (hepatitis B surface antibody, surface antigen, core IgM) | $45.00 | $45.00 |
| 1 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| Invoice Total | $124.00 | ||