Invoice: 8803
Voucher Codes:
TXCY
KPRJ
KPZL
WOPE
2QGD
TXCY
KPRJ
KPZL
WOPE
2QGD
Invoice: 8803
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:
Uinta County Public Health - Evanston
350 City View DriveSuite 101
Evanston, Wyoming 82930
Total Vouchers: 5
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 1 | Hepatitis B panel (hepatitis B surface antibody, surface antigen, core IgM) | $45.00 | $45.00 |
| 5 | Rapid HIV test provided by CDU | $15.00 | $75.00 |
| 4 | Pharyngeal specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 2 | Rectal specimen – Chlamydia and Gonorrhea | $14.00 | $28.00 |
| 1 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| 5 | Syphilis blood draw | $0.00 | $0.00 |
| 4 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 2 | Rapid Hepatitis C test provided by CDU | $0.00 | $0.00 |
| Invoice Total | $274.00 | ||