Tracking Details - #1194

Tracking Information
Case No: 1105
Order Date: 12/03/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: 21st Century Optical Fashions
51 NY-111
Smithtown, NY 11787
Phone: 631-724-4545 • Fax: (631) 724-4575
Patient: Kendrick Lamar
DOB: 04/13/1990 • SSN: ***-**-7069
21st Century Optical Fashions
51 NY-111
Smithtown, NY 11787
Phone: 631-724-4545 • Fax: (631) 724-4575
Kendrick Lamar
DOB: 04/13/1990 • SSN: ***-**-7069
Requested Records
Record Status
Billing Pending
Medical Pending
File Name Uploaded Date Uploaded By
No documents found.
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 12/3/2025 3:47 PM
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