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All specimens being shipped to the CDC, must be routed through the PHL and a CDC DASH form enclosed with each specimen forwarded to the CDC. Contact the individual PHL unit for specific information and turn-around times for specimens sent to the CDC for testing.

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Specimen collection and shipping instructions
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Testing methodologies and frequencies
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To ensure that specimens meet laboratory acceptance criteria, please review all appropriate content prior to specimen submission.

Name Sort descending	Updated	Required form	Specimen Collection and Submission Instructions	Pre-approval Requirement Procedure, if applicable	Methodology	Reportable Results	Reference Level (Normal Value)	Testing Frequency	Turnaround Time (business days)	Comments	Contact	Footnotes	Notifiable Conditions Info
Cryptosporidium/Giardia Confirmation Cryptosporidium species, Giardia lamblia, Cryptosporidiosis, Giardiasis	10/23/2026	Requisition Form - Microbiology (webform)	Cryptosporidium/Giardia Confirmation	Pre-approval required. Diagnostic Parasitology Services is provided only to the Local Health Jurisdictions (LHJ) and State Agencies. All other laboratories must obtain pre-approval from the Parasitology Laboratory before shipping 206-418-5469.	Formalin Ethyl Acetate Concentration procedure followed by Direct Fluorescent Antibody (DFA).	• Cryptosporidium species oocysts • Giardia species cysts	Not applicable	Weekly (testing days may vary depending on specimen submission)	2-5 days	Suspected organism must be documented on requisition form.	Parasitology: 206-418-5469		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Cyclospora/Cystoisospora belli Coccidia, Cyclospora, Cystoisospora belli	10/23/2026	Requisition Form - Microbiology (webform)	Cyclospora/Cystoisospora belli		Formalin Ethyl Acetate Concentration procedure followed by Modified Acid Fast staining.	• Cyclospora cayetanensis oocysts • Cystiospora belli oocysts	Not applicable	Weekly (testing days may vary depending on specimen submission)	2-5 days	Suspected organism must be documented on requisition form.	Parasitology: 206-418-5469		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Diarrhetic Shellfish Poisoning DSP, Dinophysis toxins, Lipophilic shellfish toxins, Biotoxin, Marine Toxin	03/30/2021		Contact the Shellfish Program to schedule testing and to obtain required form Collection and Submission Instructions Shellfish Toxin Testing (PDF) Instructional Video	Contact the Shellfish Program to schedule testing and to obtain required form	LC-MS/MS			Test is performed as needed	Within 24 hours of sample collection	Shellfish Related Illness: Questions concerning illness associated with eating shellfish should be directed either to the Local Health Jurisdiction or to the Office of Shellfish Program.	Marine Biotoxins Lab (206) 418-5441 Shellfish Program (360) 236-3328 Washington State Department of Health Shellfish Program	National Shellfish Sanitation Program	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule out Ebola Virus	10/15/2026	Requisition Form - Bioterrorism (webform)	Ebola Virus	Pre-approval required. Contact the Local Health Jurisdiction (LHJ) of the patient's county of residence and Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR); multiplexed nucleic acid based in vitro diagnostic test	• Ebola virus RNA detected by NGDS; • Ebola virus RNA not detected by NGDS	Not detected	As needed*	8-10 hours**		Bioterrorism: 206-418-5562	* Stat testing is available 24/7 for critical situations **Confirmation is performed at the Centers for Disease Control and Prevention (CDC)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Fastidious Bacterial Culture Fastidious, Slow growing bacteria	10/26/2026	Requisition Form - Microbiology (webform)	Fastidious Bacterial Culture	Pre-approval required. Healthcare providers (HCP) and laboratories must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Fastidious bacteria will be isolated using selective and enrichment media and characterized using Gram staining and biochemical workup.	Species identification	Not applicable	Daily, on regular business days	5-14 days*		Special Bacteriology: 206-418-5452	* Turnaround times may be extended when an isolate must be submitted to another reference laboratory (e.g. CDC) for further characterization.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Fastidious Bacterial Identification Fastidious bacteria ID, Slow growing bacteria identification	10/26/2026	Requisition Form - Microbiology (webform)	Fastidious Bacterial Identification	Pre-approval not required.	Fastidious bacteria identified using traditional biochemicals.	Species identification	Not applicable	Daily, on regular business days	5-14 days*		Special Bacteriology: 206-418-5452	* Turnaround times may be extended when an isolate must be submitted to another reference laboratory (e.g. CDC) for further characterization.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Food Safety Screen (pH and Water Activity) pH & Aw	10/14/2022	Requisition Form - Food Lab (file)	Food Safety Screen (pH and Water Activity)	Pre-approval required. Healthcare providers (HCP) and laboratories must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500 and the laboratory 206-418-5442 before shipment of specimens.	Food is tested directly by pH meter and water activity meter.			As needed upon request.	4-14 days	Please notify laboratory (206) 418-5442 before shipment of specimens.	Food Microbiology (206) 418-5442		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule out Francisella tularensis Tularemia, rabbit fever, deerfly fever	10/15/2026	Requisition Form - Bioterrorism (webform)	Francisella tularensis	Pre-approval required. Contact the Local Health Jurisdiction (LHJ) of the patient's county of residence and Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR); multiplexed nucleic acid based in vitro diagnostic test	• Franciesella tularensis DNA detected by NGDS; • Franciesella tularensis DNA not detected by NGDS	Not detected	Daily, on regular business days*	8 hours**		Bioterrorism: 206-418-5562	* Stat testing is available 24/7 for critical situations. ** Results for confirmation have a an extended turnaround time (7 days).	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Haemophilus influenzae Identification Haemophilus serotyping	10/26/2026	Requisition Form - Microbiology (webform)	Haemophilus influenzae Identification	Pre-approval not required.	Isolates are identified and biotyped using biochemicals and growth requirements. Isolates are serotyped.	Species identification	Not applicable	Daily, on regular business days	3-7 days	Identification performed on Isolates from patients under 5 years old or invasive isolates only.	Special Bacteriology: 206-418-5452		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Hantavirus Hantavirus IgM/IgG Serology Test, SNV IgM, SNV IgG	02/16/2023	Requisition Form - Virology (webform)	Hantavirus IgM/IgG Serology Test	Healthcare providers (HCP) and laboratories must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500	Enzyme-Linked Immunoabsorbent Assay			As needed*	3 days**		Virology (206) 418-5458	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (for results on next business day). ** Results for additional testing have an extended turnaround time	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
HIV 1/ HIV 2 Differentiation Assay Geenius	08/23/2022	Requisition Form - Sexually Transmitted Infections (webform)	HIV Differentiation		Bio-Rad Geenius HIV-1/HIV-2 Supplemental Assay			Monday-Friday, excluding holidays	1 day	If the HIV CMIA is positive on a serum, HIV-1/HIV-2 differentiation supplemental assay is performed.	(206) 418-5622		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
HIV, CMIA HIV	08/23/2022	Requisition Form - Sexually Transmitted Infections (webform)	HIV-CMIA		Chemiluminescent Immunoassay (CMIA): Detection of HIV-I p24 antigen, antibody for HIV-I (group m and group o), and antibody for HIV-2 by Abbott Alinity			Monday-Friday, excluding holidays	2 business days	If the HIV CMIA is positive on a serum, HIV-1/HIV-2 differentiation assay is performed.	(206) 418-5622		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Influenza, RT-PCR Diagnostic Flu A PCR, Flu B PCR, Influenza PCR, H5, H1N1, Pandemic swine flu, H7, Avian influenza, novel influenza, influenza subtyping, influenza genotyping	04/15/2024	Requisition Form - Virology (webform)	Influenza Diagnostic Guidance for Medical Examiners Influenza Virus Testing at WAPHL	Pre-approval required under certain criteria. Healthcare providers (HCP) and laboratories must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR)			Three times per week (Monday, Wednesday, Friday)*	3 days**	Additional testing methodologies performed for influenza: culture and oseltamivir resistance.	Virology (206) 418-5458	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (turnaround time of 24 hours). ** Results for additional testing have an extended turnaround time.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Influenza, RT-PCR Surveillance Flu A PCR, Flu B PCR, Influenza PCR, H5, H1N1, Pandemic swine flu, H7, Avian influenza, novel influenza, influenza subtyping, influenza genotyping, Surveillance, Sentinel, SARS-COV2	09/25/2023	Requisition Form - Influenza Surveillance (webform)	Influenza Surveillance	Specimens are only accepted from surveillance laboratories (Sentinel Laboratories in WA)*.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR)			Once every two weeks	Reports will be generated once a month in aggregate.	SARS-COVS testing performed on specimens with no previous known results.	Virology (206) 418-5458		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Lead Testing in School Drinking Water	10/15/2026	Lead Chain-of-Custody Form (webform)	Contact the "School Lead in Drinking Water Coordinator" regarding scheduling a site visit for sample collection and analysis. For sampling requirments, see the EPA Lead and Copper Rule information Collection and Submission Instructions Lead Testing	Contact the "School Lead in Drinking Water Coordinator" for prior-approval and scheduling.	EPA method 200.8 (PDF)	Lead in drinking water: µg/L	• < 15 µg/L EPA enforceable action level for drinking water • < 1.0 µg/L EPA maximum contaminant level goal for drinking water	Test is performed as needed	Within six weeks of sample collection	See the EPA official government website for more information. Also, you may call the "Safe Drinking Water Hotline" at: 1-800-426-4791	School Drinking Water Coordination: 360-236-3248	"3 T's" sampling protocol (PDF)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Legionella Environmental Testing Legionnaires' Disease, ELITE, Pontiac Fever	02/10/2025	Legionella Chain-of-Custody Form (file)	Legionella Environmental Sample Collection and Submission Instructions Contact the WA EPH Program (360-236-3000) regarding sample collection, submission form, and shipment. Also see CDC sample collection guidance	Pre-approval required. Must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ). LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500	Culture or RT-PCR https://www.cdc.gov/legionella/labs/procedures-manual.html			various	RT-PCR within 2 business days Culture within 14 business days	Questions concerning illness associated with Legionella should be directed to the local health jurisdiction or to Communicable Disease Epidemiology, (206) 418-5500.	Laboratory email is envmicrolab@doh.wa.gov Laboratory phone is 206-418-5489	ELITE Lab https://wwwn.cdc.gov/elite/Public/MemberList.aspx	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Legionella Identification Legionnaire's Disease, Pontiac Fever	10/26/2026	Requisition Form - Microbiology (webform)	Legionella Identification	Pre-approval not required.	Isolates identified using selective plating and latex agglutination or RT-PCR (Legionella species and/or Legionella pneumophila)	Species identification	Not applicable	Daily, on regular business days.	3-14 days*		Special Bacteriology: 206-418-5452	* Turnaround times may be extended when an isolate must be submitted to another reference laboratory (e.g. CDC) for further characterization.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Legionella Species Culture (Clinical) Legionella culture, Legionnaire's Disease, Pontiac Fever	10/26/2026	Requisition Form - Microbiology (webform)	Legionella Species Culture (Clinical)	Pre-approval not required.	All specimens will be tested using Real-Time Polymerase Chain Reaction (RT-PCR). Positive RT-PCR specimens are cultured and suspicious colonies are tested by latex agglutination or RT-PCR.	Species identification	Not applicable	Daily, on regular business days.	7-14 days*	* Turnaround times may be extended when an isolate must be submitted to another reference laboratory (e.g. CDC) for further characterization	Special Bacteriology: 206-418-5452		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Listeria Identification Listeriosis, Listeria monocytogenes	10/26/2026	Requisition Form - Microbiology (webform)	Listeria Identification	Pre-approval not required.	Isolates are identified using biochemicals.	Species identification	Not applicable	Daily, on regular business days	3-5 days		Special Bacteriology: 206-418-5452		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Listeria identification Listeriosis, foodborne illness, foodborne outbreak	10/19/2026	Requisition Form - Food Lab (file)	Listeria monocytogenes (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Isolation and confirmation methods based on the FDA Bacteriological Analytical Manual (BAM).	• Listeria monocytogenes not detected • Listeria monocytogenes detected	Not detected	As needed upon request.	14-30 days	Testing performed only for outbreak investigations with CDE approval.	Food Microbiology: 206-418-5442		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule out Marburg Virus	10/15/2026	Requisition Form - Bioterrorism (webform)	Marburg Virus Collection and Submission Instructions	Pre-approval required. Contact the Local Health Jurisdiction (LHJ) of the patient's county of residence and Washington State Department of Health Communicable Disease Epidemiology 206-418-4400.	Multiplexed nucleic acid based in vitro diagnostic test	• Marburg virus RNA detected by NGDS • Marburg virus not detected by NGDS	Not detected	As needed *	8 hours **		Bioterrorism: 206-418-5418	Stat testing available 24/7 for critical situations *Confirmation is performed at the Centers for Disease Control and Prevention (CDC)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Measles, RT-PCR Measles PCR	05/05/2022	Requisition Form - Virology (webform)	Measles RT-PCR Measles Specimen Shipping Guide	Pre-approval required. Healthcare providers (HCP) and laboratories must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR)			Within 24 hours of arrival*	1 day**	Additional testing methodologies performed for measles: Serology.	Virology (206) 418-5458	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (turnaround time of 24 hours). ** Results for additional testing have an extended turnaround time.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Mumps IgG, EIA	05/05/2022	Requisition Form - Virology (webform)	Mumps IgG, EIA	Send sera for testing commercially unless otherwise instructed by Local Health Jurisdiction (LHJ) or Washington State Department of Health Communicable Disease Epidemiology (DOH CD-Epi). Pre-approval required for testing at PHL. Healthcare providers and laboratories may obtain pre-approval by contacting the LHJ for the patient's county of residence. If testing at PHL is approved, LHJ staff must then notify DOH CD-Epi at 206-418-5500.	Enzyme-linked Immunosorbent Assay (EIA)			As needed*	2-5 days**	Additional testing methodologies performed for mumps: Mumps IgM EIA, Mumps RT-PCR, Mumps culture	Virology Lab (206) 418-5458	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (for results on next business day). ** Results for additional testing have an extended turnaround time.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Mumps IgM, EIA	05/05/2022	Requisition Form - Virology (webform)	Mumps IgM, EIA	Send sera for testing commercially unless otherwise instructed by Local Health Jurisdiction (LHJ) or Washington State Department of Health Communicable Disease Epidemiology (DOH CD-Epi). Pre-approval required for testing at PHL. Healthcare providers and laboratories may obtain pre-approval by contacting the LHJ for the patient's county of residence. If testing at PHL is approved, LHJ staff must then notify DOH CD-Epi at 206-418-5500.	Enzyme-linked Immunosorbent Assay (EIA)			As needed*	2-5 days**	Additional testing methodologies performed for mumps: Mumps IgG EIA, Mumps RT-PCR, Mumps culture	Virology Lab (206) 418-5458	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (for results on next business day). ** Results for additional testing have an extended turnaround time.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Mumps, RT-PCR Mumps PCR	09/07/2018	Requisition Form - Virology (webform)	Mumps RT-PCR	Pre-approval required. Healthcare providers (HCP) and laboratories must obtain pre-approval by contacting the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR)			Within 24 hours of arrival*	3 days**	Additional testing methodologies performed for mumps: culture and serology.	Virology Lab (206) 418-5458	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (for results on next business day). ** Results for additional testing have an extended turnaround time.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)