Ann Arbor Medical Review

QPassport ID: Q********

Collection Site:

Medical Review Officer

NEIL J DASH MD

*** ******** ***

MASSAPEQUA, NY, 11758

Phone: 800-***-****

Fax: 800-***-****

Donor Details

Donor Name: Anthony Moore

Donor ID: a00TR00000GdRaIYAV

Test Reason: PRE-EMPLOYMENT

Ordered Date: 07/31/2024 11:26 AM

Ordered By: Integration

Account/Employer: ANN ARBOR - 11952038

10 CROSBY ST 2ND FL

RIA SHRIVASTAVA

NEW YORK, NY 10013 -

Phone: 917-***-****

Client Specific Option(s): DER: - 917-***-**** R SHRIVASTAVA; TESTING AUTHORITY - FTA Collection Service(s): Split

Test Type(s): 65304N - DOT DRUG PANEL W/TS (Urine) Donor Instructions: Please bring this confirmation and your driver's license or other government issued photo ID to the collection site for identification.

Collection Site Instructions: This collection should not be conducted under direct observation. Expires On:10/29/2024 12:00 AM Eastern

Michigan UC & Occ Hlth - Ann Arbor

3280 Washtenaw Ave, Ste A

Ann Arbor, MI 48104-4283

734-***-****

Organization

VIA TRANSPORTATION

160 VARICK ST 4TH FL

NEW YORK, NY 10013

Phone: 817-***-****

Hours of Operation/Drug Screen Hours M-Su 8:00 am-8:00 pm To find a collection site location and to make an appointment, visit www.questdiagnostics.com/reg

For questions on what to expect at your drug test, visit our website at www.EmployerSolutions.com/mydrugtest

Get Directions

Quest Diagnostics Customer Service 855-***-****

Contact this candidate