Invoice: 9168
Voucher Codes:
AZXJ
EKCQ
DGSP
L5PV
P2UL
AZXJ
EKCQ
DGSP
L5PV
P2UL
Invoice: 9168
Invoice Date: November 30, 2025
Service Dates: 11/1/2025 – 11/30/2025
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: 5
| Vouchers | Test Name | Test Price | Total |
|---|---|---|---|
| 4 | Vaginal specimen – Chlamydia and Gonorrhea | $14.00 | $56.00 |
| 1 | Urine specimen – Chlamydia and Gonorrhea | $14.00 | $14.00 |
| 1 | Rapid HIV test provided by CDU | $15.00 | $15.00 |
| Invoice Total | $85.00 | ||