Invoice: 5103
Voucher Codes:
ODL6
1WJ1
8FJ5
JX7D
ODL6
1WJ1
8FJ5
JX7D
Invoice: 5103
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:
Western Wyoming Family Health - Rock Springs
333 Broadway StSuite 120
Rock Springs, Wyoming 82901
Total Vouchers: 4
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 1 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| 1 | Rapid HIV test provided by CDU | $15.00 | $15.00 |
| 3 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $42.00 |
| Invoice Total | $71.00 | ||