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Get Ca Notification From Medical Provider Of Covid-19 Laboratory Results - County Of Los Angeles 2020-2024

MEDICAL PROVIDER INFORMATION Facility Name Physician/Infection Preventionist Name Physician/ Infection Preventionist Pager/Phone number E-mail Address Date of Report PATIENT INFORMATION Patient Name-Last, First, Middle Initial Facility name (if not living at home): Address- Number, Street, Apt # City Primary Phone Number Private residence Residential Care/Assisted Living Occupation: Hotel Healthcare Worker Teacher Detention facility Military base EMT Sex ZIP Code Email Addre.

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