Medical Test Sites (MTS)

Welcome to the Medical Test Site Program webpage. Here you'll find information regarding the licensing of Medical Test Sites —facilities that perform medical tests to screen, diagnose, or treat health problems.

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Personnel Documentation Requirements

The final rule from the Centers for Medicare & Medicaid Services (CMS-3326-F) (PDF) related to personnel qualifications took effect on December 28, 2024. The rule specifies that all documentation supporting an individual’s education, training and experience must be generated or authored by a person or entity other than the individual seeking to meet laboratory personnel requirements. The MTS Program has created a guidance document (PDF) to help ensure your documentation is sufficient. 

Mission

To ensure that the public receives accurate and reliable clinical laboratory services and test results by monitoring and evaluating medical test sites for compliance with minimum standards of quality assurance for clinical laboratory testing.

History and Background

The federal Clinical Laboratory Improvement Amendments (CLIA), which require certification of all sites performing clinical laboratory testing, were passed in 1988. Prior to 1988, the only laboratories that were regulated were those that performed interstate testing or were independent laboratories and hospitals seeking Medicare reimbursement. CLIA changed the regulatory landscape dramatically by including all sites where testing was performed, such as doctors’ offices, clinics, and health departments.

The legislature passed the Medical Test Site (MTS) Licensure Law (chapter 70.42 RCW) in May 1989 to allow the state to regulate clinical laboratory testing. The rules implementing the law (chapter 246-338 WAC) were adopted in October 1990.

In September 1992, the federal regulations implementing CLIA became effective. CLIA allowed equivalent state programs to apply for an exemption from federal regulation. Washington State applied for exemption in October 1992. In October 1993, Washington became the first state to have its clinical laboratory licensure program determined by the federal Centers for Medicare and Medicaid Services (CMS) to be equivalent to CLIA and was granted an exemption. This exemption from CLIA allows regulatory oversight to remain at the state level rather than the federal level, where it is more accessible and responsive to local needs.

In 1996, the Joint Commission granted deemed status to the Washington State MTS program. This allows laboratories in Joint Commission-accredited[JH3.1] facilities to be inspected under the MTS program.

State Authority and Responsibilities

  • Issue licenses or certificates of waiver to over 7,000 test sites under the Washington State Medical Test Site licensure program;
  • Conduct biennial on-site surveys of non-waived medical test sites using an outcome-oriented approach;
  • Examine technical personnel qualifications, quality control and patient records, test performance, test reporting, management policies and quality assurance programs during on-site inspection;
  • Verify corrections of deficiencies by an on-site visit or through email or telephone contact, depending on the nature of deficiencies;
  • Monitor medical test site proficiency testing performance and compliance;
  • Provides consultation and technical assistance to regulated sites;
  • Perform complaint investigations;
  • Provide or facilitate training for technical personnel; and
  • Manage a database of all medical test sites and provide information to other state agencies and federal government.

Facilities and Services Regulated

  • Ambulatory surgical centers
  • Assisted living facilities
  • Blood banks
  • Clinics
  • Commercial independent laboratories
  • Community clinics
  • Correctional facilities
  • Drug treatment centers
  • Health departments
  • Home health agencies
  • Hospitals
  • Intermediate care facilities
  • Migrant health centers
  • Mobile units/sites
  • Physician office laboratories
  • Pregnancy counseling centers
  • Rural health clinics
  • Student health services