Invoice: 5104
Voucher Codes:
IS0O
JP3N
ZM08
IS0O
JP3N
ZM08
Invoice: 5104
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:
Sweetwater Community Nursing - Rock Springs
333 BroadwaySuite 110
Rock Springs, Wyoming 82901
Total Vouchers: 3
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 3 | Syphilis blood draw | $0.00 | $0.00 |
| 3 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 3 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 3 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| 3 | Rapid HIV test provided by CDU | $15.00 | $45.00 |
| 1 | HIV CONFIRMATORY blood draw for REACTIVE RAPID TEST ONLY, must notify CDU Area DIS | $45.00 | $45.00 |
| 1 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| 1 | Hepatitis C CONFIRMATORY blood draw for REACTIVE RAPID TEST ONLY, must notify CDU Area DIS | $20.00 | $20.00 |
| Invoice Total | $236.00 | ||