3495 Hacks Cross Road, Memphis, TN 38125

Tel (901) 526-7444 Fax (901) 526-0791

Toll Free: (888) 2GI-PATH
Richard S Kinsey, M.D., Laboratory Director
CLIA # 44D0915029

Patient: CARTER, DESTINY Accession Number: COR-21-223596

Address: 1563 Barton St Office Visit Date: 8/20/2021 1:29 PM
MEMPHIS, TN 38106 Specimen Received: 8/20/2021
Gender: F DOB: 5/2/2009 Age: 12 MR/Chart: 19346593/
Physician: Jackie Makapugay, MD Referring
Client: PHC DRIVE THRU TESTING Physician:

SOURCE OF SPECIMEN: NASAL SWAB

CLINICAL HISTORY: Headache; Nausea
SARS-CoV-2 RESULT:

Pathogen Name Result

SARS-CoV-2 RNA NEGATIVE
pan-Sarbecovirus including SARS-CoV-2 NEGATIVE
COVID-19 assay is a real-time RT-PCR test intended for the presumptive qualitative detection of nucleic acid from SARS-CoV-2 in
nasopharyngeal swab, nasopharyngeal aspirate, and bronchoalveolar lavage (BAL) specimens from individuals meeting CDC COVID-
19 clinical criteria (e.g., clinical signs and symptoms associated with SARS-Cov-2 infection) in conjunction with CDC COVID-19
epidemiological criteria (e.g., history of residence in or travel to a geographic region with active SARS-CoV-2 transmission at the time of
travel, or other epidemiologic criteria for which SARS-CoV-2 testing may be indicated.

Negative results do not preclude SARS-CoV-2 infection and should not be used as the sole basis for patient management decisions.
Negative results must be combined with clinical observations, patient history, and epidemiological information.

This test was developed by Roche on COBAS® 6800/8800 and its performance characteristics verified by Poplar Healthcare. Cobas®
SARS-CoV-2 test is FDA approved under Emergency Use Authorization (EUA). Poplar Healthcare is regulated under CLIA as qualified
to perform high-complexity testing.

Anami Patel, Ph.D. MB (ASCP) CM DLM CM

Chief Science Officer
Electronically signed Aug 20, 2021
Date Reported: Aug 20, 2021

CPT Code: U0003

ICD Code: