Invoice: 5116
Voucher Codes:
CLN0
NPI9
CLN0
NPI9
Invoice: 5116
Invoice Date: May 31, 2025
Service Dates: 5/1/2025 – 5/31/2025
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:
Northwest Wyoming Family Planning
P.O. Box 941Cody, wyoming 82414
Total Vouchers: 2
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 1 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 1 | Rapid HIV test provided by CDU | $15.00 | $15.00 |
| 2 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| Invoice Total | $43.00 | ||