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Name Sort descending	Updated	Required form	Specimen Collection and Submission Instructions	Pre-approval Requirement Procedure, if applicable	Methodology	Testing Frequency	Turnaround Time (business days)	Comments	Contact	Footnotes	Notifiable Conditions Info
Aerobic Bacterial Culture	06/01/2022	Requisition Form - Microbiology (webform)	Aerobic 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.	Bacteria of interest will be isolated using selective and enrichment media and characterized using Gram staining and biochemical workup.	Daily, on regular business days	7-14 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)
Aerobic Bacterial Identification Aerobes	06/01/2022	Requisition Form - Microbiology (webform)	Aerobic Bacterial Identification	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.	All clinical isolates will be identified by using biochemical and available molecular methods.	Daily, on regular business days	3-10 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)
Amnesic Shellfish Poisoning ASP, Domoic acid, 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 for required prior approval for testing	Quilliam Method, HPLC Diode Array Detection	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	National Shellfish Sanitation Program	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Anaerobic Bacterial Culture Anaerobic isolation. Anaerobes	06/01/2022	Requisition Form - Microbiology (webform)	Anaerobic 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.	Isolation and identification of pathogenic anaerobic organisms by selective plating and biochemicals.	Daily, on regular business days	10-20 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)
Anaerobic Bacterial Identification Anaerobes	06/01/2022	Requisition Form - Microbiology (webform)	Anaerobic Bacterial Identification	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.	All clinical isolates will be identified by using biochemical and available molecular methods.	Daily, on regular business days	10-20 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)
Antimicrobial Susceptibility Testing Sensitivity, MRSA, VRSA, VISA, Multidrug resistant, Minimal inhibition testing	06/01/2022	Requisition Form - Microbiology (webform)	Antimicrobial Susceptibility Testing	Pre-approval not required.	Isolates are tested using Kirby-Bauer and/or E-test for epidemiological purpose or upon request.	Monday-Thursday, excluding holidays	4-7 days	See CRE Screening Surveillance for CRE sensitivity testing. Sensitivities are performed on organisms that have CLSI guidelines for interpretation. Sensitivity is performed on N. meningitidis from sterile sites 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)
Archival Isolate Epidemiology, Archive, State Request	06/01/2022	Requisition Form - Microbiology (webform)	Archival Isolate	Pre-approval not required.	Frozen for archive for epidemiological purposes	Not applicable	Not applicable	Isolate will not be tested.	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)
Arsenic in Geoduck Testing	03/30/2021		Contact the Shellfish Program to schedule testing Three geoduck samples per sampling site are required for testing Collection and Submission Instructions Arsenic in Geoduck Testing (PDF)	Inquire with the laboratory for the required chain of custody form	Washington State Laboratories protocol (HPLC-ICP-MS)	Test is performed as needed (for international export of geoducks)	Turn around times may vary. Generally within 3 weeks of sample collection.	For geoduck inspection and export certification information, contact your local seafood inspection office at the National Oceanic and Atmospheric Administration (NOAA)	Shellfish Program (360) 236-3328 Washington State Department of Health Shellfish Program	Shellfish Chemistry Lab (206) 418-5441	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Bacillus anthracis (Anthrax) Bacillus anthracis, B. anthracis, anthrax, Rule out Bacillus anthracis, R/O Bacillus anthracis, Rule out B. anthracis, R/O B. anthracis	06/30/2022	Requisition Form - Bioterrorism (file)	Bacillus anthracis	Pre-approval required. Contact the Local Health Jurisdiction (LHJ) of the patient's county of residence and the 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	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations ** Results for confirmation have an extended turnaround time (48 hours)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Bacillus cereus (Environmental) foodborne illness, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Bacillus cereus (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Enumeration method based on the FDA Bacteriological Analytical Manual (BAM).	As needed upon request.	4-14 days	Testing performed only for outbreak investigations with DOH 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)
Bordetella pertussis Confirmation Whooping cough, Pertussis	06/01/2022	Requisition Form - Microbiology (webform)	Bordetella pertussis Confirmation	Pre-approval not required.	Isolates will be confirmed by Direct Fluorescent Antibody (DFA).	Daily, on regular business days	2-5 days	Please do not send mixed culture or media contaminated with fungus.	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)
Bordetella pertussis Culture Whooping cough, Pertussis	06/01/2022	Requisition Form - Microbiology (webform)	Bordetella pertussis 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.	Swab will be plated on selective media, and suspicious growth tested with Direct Fluorescent Antibody (DFA) and biochemicals.	Daily, on regular business days	7-10 days	Please use Dacron or rayon swabs for collection. Cotton swabs are toxic to B. pertussis. Additional testing methodologies are performed for B. pertussis: RT-PCR.	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)
Bordetella pertussis, Bortadella parapertussis Real-Time PCR. Pertussis, B. pertussis, B. parapertussis, Whooping cough	09/07/2018	Requisition Form - Microbiology (webform)	Bordetella pertussis, Bortadella parapertussis, Real-Time 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 Polymerase Chain Reaction (RT-PCR)	Once a week (Thursdays)*	5 days*	Additional testing methodology performed for B. pertussis: Culture.	Molecular Laboratory (206) 418-5563	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (for results on next business day).	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Brucella spp. Brucella suis, Brucella canis, Brucella abortus, Brucella melitensis, Brucellosis, undulant fever, Malta fever, Gibralter fever, Mediterranean fever.	06/30/2022	Requisition Form - Bioterrorism (file)	Brucella spp.	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 Polymerase Chain Reaction (RT-PCR), standard reference procedures for biochemical identification	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations. ** Results for confirmation have an extended turnaround time (15 days).	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Burkholderia mallei B. mallei, Glanders	06/30/2022	Requisition Form - Bioterrorism (file)	Burkholderia mallei	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 Polymerase Chain Reaction (RT-PCR), standard reference procedures for biochemical identification	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations. ** Results for confirmation have 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)
Burkholderia pseudomallei B. pseudomallei, Whitmores Disease, melioidosis	06/30/2022	Requisition Form - Bioterrorism (file)	Burkholderia pseudomallei	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 Polymerase Chain Reaction (RT-PCR), standard reference procedures for biochemical identification, susceptibility	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations. ** Results for confirmation have 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)
Campylobacter Identification Campylobacter confirmation, Confirm Campylobacter jejuni or coli	06/01/2022	Requisition Form - Microbiology (webform)	Campylobacter Identification	Pre-approval not required.	Isolates confirmed using biochemicals. Specimens may be forwarded to the CDC for speciation.	Daily, on regular business days.	2-7 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)
Carbapenem-resistant Enterobacteriaceae (CRE) Carbapenemase PCR E.coli, Klebsiella, Enterobacter, CRE, Multi-drug resistant organism, MDRO	05/11/2017	Requisition Form - Microbiology (webform)	Carbapenem-resistant Enterobacteriaceae (CRE) carbapenemase PCR	Pre-approval only required for submission from non-Washington states. If submitting specimens for ARLN testing, please refer to ARLN Test Menu.	Molecular testing for presence of select carbapenemase genes (KPC, NDM-1, VIM, IMP and OXA-48). This test is for epidemiological purposes only.	Twice weekly (batched)	2-5 days	Only pure isolates will be tested.	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)
Carbapenem-resistant Enterobacteriaceae (CRE) Screening Surveillance Culture CRE, Multi-drug Resistant Enterobacteriaceae, CRE culture	03/26/2015	Requisition Form - Microbiology (webform)	Carbapenem-resistant Enterobacteriaceae (CRE) Screening Surveillance 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.	Selective broth enrichment followed by isolation with selective media. Suspicious colonies will be identified and susceptibility testing will be performed, where appropriate.	As needed	2-10 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)
Chemical Incident Response (CIR) Chemical Emergency Response, Chemical Exposure, Chemical, Lead, Metals, Pesticides, Toxins, Poison, Poisons, Blood Lead, Child Lead and Chemicals.	11/12/2021	Biothreat Environmental Sample Submission and Chain-of-Custody Form (file)	Contact your Local Health Jurisdiction (LHJ) or your local law enforcement for their specimen submission instructions. Chemical Exposure Test Request Specimen-Collection Protocol for a Chemical-Exposure Incident Collection and Submission Instructions for Chemical Incident Response Testing Shipping Blood Specimens after a Chemical Exposure Incident Shipping Urine Specimens after a Chemical Exposure Incident Lead Fingerstick Instructions	Pre-approval required LHJ or law enforcement will contact CIR laboratory personnel Local Health Jurisdictions	Multiple, LRN-C Level 2 CDC Lab Response Network for Chemical Threats	Tests are performed as needed	ASAP depending on workload and the test(s) requested	Contact LHJ or your local law enforcement office to request testing If you suspect a specific chemical exposure, include that information in the sample form Notify your local law enforcement of any suspected criminal activity Local Health Jurisdictions	Chemical Incident Response Laboratory 206-418-5520		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Clostridium botulinum toxin Botulism, Bot toxin, C. botulinum	06/30/2022	Requisition Form - Bioterrorism (file)	Clostridium botulinum toxin	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 Polymerase Chain Reaction (RT-PCR), Mouse bioassay, ELISA, standard reference procedures for biochemical identification	Daily, on regular business days*	4-14 days		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Clostridium perfringens (Environmental) Enteritis necroticans, foodborne illness, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Clostridium perfringens (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Enumeration method based on the FDA Bacteriological Analytical Manual (BAM).	As needed upon request.	4-14 days	Testing performed only for outbreak investigations with DOH 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)
Coccidioides AB EIA	06/01/2022	Requisition Form - Microbiology (webform)	Coccidioides AB EIA Specimen instructions	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.	Enzyme-linked Immunosorbent Assay (EIA)	As needed	1-3 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)
Total and Fecal Coliform in Shellfish Wet Storage Testing Fecal, Coliform, E. coli, contamination, Recirculating Water, Shellfish Growing Tank, Wet Storage	04/07/2021	Shellfish Bacteriology Water Quality - Recirculating (file)	Fecal Coliform Shellfish Wet Storage (PDF) https://www.fda.gov/food/federalstate-food-programs/national-shellfish-sanitation-program-nssp	Contact the Shellfish Program for approval of testing	Multiple Tube Fermentation using Lauryl Tryptose Broth. Standard Methods for the Examination of Water and Wastewater: 9221 B.	Monday- Wednesday 8AM-4PM and Thursday 8AM-1PM	3-7 business days after receipt of sample	Enteric Pathogen Related Illness: Questions concerning illness associated with enteric pathogens should be directed to the Local Health Jurisdiction	Water Bacteriology Lab (206) 418-5441 Shellfish Program (360) 236-3328 Washington State Department of Health Shellfish Program	National Shellfish Sanitation Program Interstate Shellfish Sanitation Conference	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Fecal Coliform in Marine Water Fecal, Coliform, E. coli, Marine Water Testing, Shellfish Growing Areas	04/07/2021		Collection and Submission Instructions Fecal Coliform Marine Water (PDF)	Contact the Shellfish Program for approval of testing	Multiple Tube Fermentation using MA-1 Medium. Standard Methods for the Examination of Water and Wastewater: 9221 E.	Monday - Friday 8AM - 1PM	Within 48 hours of sample receipt	Enteric Pathogen Related Illness: Questions concerning illness associated with enteric pathogens should be directed to the Local Health Jurisdiction	Water Bacteriology Lab (206) 418-5441 Shellfish Program (360) 236-3328 Washington State Department of Health Shellfish Program	Test cost: Inquire with the Water Bacteriology Lab National Shellfish Sanitation Program Interstate Shellfish Sanitation Conference	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Coliform Testing (Environmental) Total and Fecal coliforms	10/14/2022	Requisition Form - Food Lab (file)	Coliform Testing (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Enumeration method based on the FDA Bacteriological Analytical Manual (BAM).	As needed upon request.	4-14 days	Testing performed only for outbreak investigations with DOH 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)
Corynebacterium diphtheriae Culture Corynediptheriae, Diptheria	06/01/2022	Requisition Form - Microbiology (webform)	Corynebacterium diphtheriae 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.	Selective media will be used to isolate and identify C. diphtheriae from clinical specimens.	Daily, on regular business days	5-7 days	If Corynebacterium diphtheriae is isolated, the isolate will be forwarded to CDC for toxigenicity testing.	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)
Corynebacterium diphtheriae Identification Corynediptheriae, Diptheria, C. diphtheriae confirmation	06/01/2022	Requisition Form - Microbiology (webform)	Corynebacterium diphtheriae Identification	Pre-approval not required.	Corynebacterium diptheriae will be confirmed using traditional biochemicals and forwarded to CDC for toxigenicity testing.	Daily, on regular business days	3-5 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)
COVID-19 2019 Novel Coronavirus	05/06/2022		COVID-19 Specimen Collection and Submission Instructions	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)	6 days per week	48 hours after approval and receipt of specimen	COVID-19 is an emerging condition. For details visit https://www.doh.wa.gov/Emergencies/Coronavirus	Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE): 206-418-5500. https://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Coxiella burnetii, RT-PCR Coxiella, Q fever	06/30/2022	Requisition Form - Bioterrorism (file)	Coxiella burnetii	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	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations. ** Confirmation is performed at the Centers for Disease and Control (CDC).	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Cryptosporidium/Giardia Confirmation Cryptosporidium species, Giardia lamblia, Cryptosporidiosis, Giardiasis	11/23/2022	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).	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	11/23/2022	Requisition Form - Microbiology (webform)	Cyclospora/Cystoisospora belli		Formalin Ethyl Acetate Concentration procedure followed by Modified Acid Fast staining.	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)
Ebola Virus	11/22/2022	Requisition Form - Bioterrorism (file)	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	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)
Enteric Pathogen Screen	10/03/2023	Requisition Form - Microbiology (webform)	Enteric Pathogen Screen	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.	All specimens will be analyzed via multiplex PCR. Positive Shiga toxin-producing E. coli (STEC), Salmonella, Shigella, and Vibrio will be confirmed via traditional culture and biochemical methodology.	Daily, on regular business days	7-14 days		Enteric Bacteriology (206) 418-5456		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	06/01/2022	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.	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	06/01/2022	Requisition Form - Microbiology (webform)	Fastidious Bacterial Identification	Pre-approval not required.	Fastidious bacteria identified using traditional biochemicals.	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)
Francisella tularensis Tularemia, rabbit fever, deerfly fever	06/30/2022	Requisition Form - Bioterrorism (file)	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	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	06/01/2022	Requisition Form - Microbiology (webform)	Haemophilus influenzae Identification	Pre-approval not required.	Isolates are identified and biotyped using biochemicals and growth requirements. Isolates are serotyped.	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	09/07/2018	Requisition Form - Virology (webform)	Influenza Diagnostic Guidance for Medical Examiners	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 and Copper Testing in School Drinking Water	04/01/2021	Lead/Copper Chain-of-Custody Form (file)	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 and Copper Testing (PDF)	Contact the "School Lead in Drinking Water Coordinator" for prior-approval and scheduling.	EPA method 200.8 (PDF)	Test is performed as needed	Within 10 business days 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	02/04/2022	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	06/01/2022	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)	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	06/01/2022	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.	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	06/01/2022	Requisition Form - Microbiology (webform)	Listeria Identification	Pre-approval not required.	Isolates are identified using biochemicals.	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 monocytogenes (Environmental) Listeriosis, foodborne illness, foodborne outbreak	10/14/2022	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).	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)
Marburg Virus	10/24/2022	Requisition Form - Bioterrorism (file)	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	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 IgG, EIA Rubeola	05/05/2022	Requisition Form - Virology (webform)	Measles IgG, EIA	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.	Enzyme-linked Immunosorbent Assay (EIA)	As needed*	2-5 days**	Additional testing methodologies performed for measles: Measles IgM EIA, Measles RT-PCR.	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)
Measles IgM, EIA Rubeola	05/05/2022	Requisition Form - Virology (webform)	Measles IgM, EIA	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.	Enzyme-linked Immunosorbent Assay (EIA)	As needed*	2-5 days**	Additional testing methodologies performed for measles: Measles IgG EIA, Measles RT-PCR.	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)
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)
Monkey pox (Non-variola Orthopox PCR)	08/11/2022	Requisition Form - Monkey Pox (webform)	Monkey pox (Non-variola Orthopox PCR)	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 Polymerase Chain Reaction (RT-PCR)	Daily, on regular business day	1 day from receipt		Bioterrorism (206) 418-5481	Confirmation may be 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)
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)
Neisseria species Identification Neisseria ID, GNDC	06/01/2022	Requisition Form - Microbiology (webform)	Neisseria species Identification	Pre-approval not required.	Isolates are identified using selective plating and biochemicals. Neisseria meningitidis isolates are serotyped and receive antibiotic sensitivity testing.	Daily, on regular business days	4-7 days	Neisseria meningitidis isolates should be from sterile sites 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)
Non-variola Orthopox Vaccinia, Monkey pox, Cow pox, Camel pox	01/19/2022	Requisition Form - Bioterrorism (file)	Non-variola Orthopox	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 Polymerase Chain Reaction (RT-PCR), cell culture	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations ** Confirmation is performed at the Centers for Disease and Control (CDC)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Norovirus, RT-PCR Norovirus PCR	06/27/2023	Requisition Form - Virology (webform)	Norovirus, 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) at 206-418-5500.	Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR)	Within 24 hours of arrival	2-5 days*	Individual cases are not reportable—only norovirus outbreaks suspected to be foodborne are reportable.	Molecular Laboratory (206) 418-5563	* Stat testing is provided with prior approval by Department of Health Communicable Disease Epidemiology (for results on next business day).	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Orthopox Vaccinia, Monkey pox, Cow pox, Camel pox	01/19/2022	Requisition Form - Bioterrorism (file)	Orthopox	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 Polymerase Chain Reaction (RT-PCR), cell culture	Daily, on regular business days*	8 hours**		Bioterrorism (206) 418-5562	* Stat testing is available 24/7 for critical situations ** Confirmation is performed at the Centers for Disease and Control (CDC)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Paralytic Shellfish Poisoning PSP, Saxitoxin, 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.	Bioassay	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)
Parasite - Blood Confirmation Malaria, Babesia sp., Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale, Microfilariae, Trypanosomes, parasites, blood parasite, blood parasites	11/23/2022	Requisition Form - Microbiology (webform)	Parasite - Blood Confirmation	Pre-approval not required.	Standard blood smear examination. Blood may be required for Malaria PCR speciation.*	Daily, on regular business days	2-5 days	Suspected organism must be documented on requisition form. Travel history required.	Parasitology (206) 418-5469	* Specimen submission is for reference purposes only; Diagnostic testing must be performed by submitting laboratory. Full workup of thick and thin smears may not be performed.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Parasite - Gross Specimen Identification Arthropod ID; Ascaris lumbricoides; Dermacentor species; Diphyllobothrium latum; Ixodes species; Taenia species; Tapeworm; Tick ID; Trichuris trichiura; Worm ID, parasites	11/23/2022	Requisition Form - Microbiology (webform)	Parasite - Gross Specimen Identification	Specimens are only accepted from Healthcare Providers (HCP).	Macroscopic examination	Daily, on regular business days	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)
Parasite - Intestinal Confirmation Amebiasis; Ascaris lumbricoides; Balantidium coli; Blastocystis hominis; Dientamoeba fragilis; Chilomastix mesnili; Diphyllobothrium latum; Endolimax nana; Entamoeba histolytica; Entamoeba species; Giardia lamblia; Hookworm; Hymenolepis species; Iodamoeba buetschlii; Paragonimus; Schistosoma mansoni; Schistosoma japonicum; Strongyloides stercoralis; Taenia species; Trichuris trichiura, parasites, intestinal parasite, intestinal parasites	11/23/2022	Requisition Form - Microbiology (webform)	Parasite - Intestinal Confirmation	Pre-approval not required.	Standard Ova & Parasite (O&P) examination procedures may include wetmount or trichrome.*	Daily, on regular business days	2-5 days	Suspected organism must be documented on requisition form.	Parasitology (206) 418-5469	* Specimen submission is for reference purposes only; Diagnostic testing must be performed by submitting laboratory. Full O&P workup may not be performed depending on suspected organism.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Parasite - Intestinal Screen Amebiasis; Ascaris lumbricoides; Balantidium coli; Blastocystis hominis; Dientamoeba fragilis; Chilomastix mesnili; Diphyllobothrium latum; Endolimax nana; Entamoeba histolytica; Entamoeba species; Giardia lamblia; Hookworm; Hymenolepis species; Iodamoeba buetschlii; Paragonimus; Schistosoma mansoni; Schistosoma japonicum; Strongyloides stercoralis; Taenia species; Trichuris trichiura, parasites, intestinal parasite, intestinal parasites	11/23/2022	Requisition Form - Microbiology (webform)	Parasite - Intestinal Screen	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.	Standard Ova & Parasite (O&P) examination procedures may include wetmount or trichrome.	Daily, on regular business days	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)
Parasite - Miscellaneous Paragonimus; Paragonimiasis; Schistosoma haematobium; Schistosomiasis; Strongyloides stercoralis; Strongyloidiasis, parasites	11/23/2022	Requisition Form - Microbiology (webform)	Parasite - Miscellaneous	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.	Standard examination procedures, may include; concentration, centrifugation, wetmount, and stains as necessary.	Daily, on regular business days	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)
Rabies, DFA Rabies	09/07/2018	Requisition Form - Rabies (webform)	Rabies, DFA	Pre-approval required. All submissions must be pre-approved by and sent through the Local Health Jurisdiction (LHJ) of the patient's county of residence. LHJ staff must obtain pre-approval from Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500 before shipping.	Direct Fluorescent Antibody (DFA)	Daily, on regular business days*	30 hours**	1) Please see detailed information at: Guidelines for the Submission of Specimens for Rabies Testing Rabies Specimen Packaging Procedure 2) Further testing to rule out non-specific fluorescence or to confirm a positive with low antigen distribution is performed by the Centers for Disease Control and Prevention (CDC).	Virology Lab (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)
BioFire Respiratory Panel 2.1 Adenovirus, Coronavirus 229E, Coronavirus HKU1, Coronavirus NL63, Coronavirus OC43, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Human Metapneumovirus, Human Rhinovirus/Enterovirus, Influenza A and Influenza B, Parainfluenza 1, 2, 3, and 4, Respiratory Synctial Virus, Bordetella parapertussis, Bordetella pertussis, Chlamydia pneumoniae, and Mycoplasma pneumoniae.	10/11/2023	Requisition Form - Virology (webform)	Respiratory Panel (PDF) Guidance for Medical Examiners (PDF)	All cases from the Medical Examiner Offices will be tested without prior approval. 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.	The BioFire Respiratory 2.1 (RP2.1) Panel is an FDA aproved platform.	As needed	5 business days	Adenovirus typing is not performed at WA PHL. Testing will be forwarded to CDC upon request. Positive Influenza specimens will be typed, and forwarded to CDC if applicable.		* 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)
Ricin Toxin Ricinus communis, ricin	06/30/2022	Biothreat Environmental Sample Submission and Chain-of-Custody Form (file)	Ricin Toxin	Pre-approval required. Contact the FBI (First responders), 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.	Time resolved fluorescence (TRF).	Stat processing 24/7 for critical situations	8 hours*		Bioterrorism (206) 418-5562	* Results for confirmation have an extended turnaround time (15 days). Some confirmation processes are performed at CDC.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rubella IgG, EIA	05/05/2022	Requisition Form - Virology (webform)	Rubella IgG, EIA	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.	Enzyme-linked Immunosorbent Assay (EIA)	As needed*	2-5 days**	Another rubella testing option is: Rubella IgM EIA	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)
Rubella IgM, EIA	05/05/2022	Requisition Form - Virology (webform)	Rubella IgM, EIA	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.	Enzyme-linked Immunosorbent Assay (EIA)	As needed*	2-5 days**	Another rubella testing option is: Rubella IgG EIA	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)
Rule Out Campylobacter species Campylobacteriosis, Campylobacter jejuni, Campylobacter coli, R/O Campylobacter, Rule-Out Campylobacter	01/15/2015	Requisition Form - Microbiology (webform)	R/O Campylobacter species	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.	All specimens will be screened on non-selective and selective media.	Daily, on regular business days	7-14 days*		Enteric Bacteriology (206) 418-5456	* Turnaround times may be extended when an isolate must be submitted to another reference laboratory (e.g. CDC) for further characterization. This test is for Epi investigations only.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule Out Salmonella species Salmonella, Salmonellosis, Test of Cure, R/O Salmonella, Rule-Out Salmonella	05/31/2022	Requisition Form - Microbiology (webform)	R/O Salmonella species	Positive test must be shipped, no pre-approval necessary.	All specimens will be screened with selective plating. Suspicious isolates will have biochemical identification and serotyping performed.	Daily, on regular business days	7-14 days		Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule Out Shiga Toxin-Producing E. coli (STEC) STEC, Toxin-Producing E. coli, Toxigenic E. coli, Test of cure, R/O Shiga Toxin-Producing E. coli, Rule-Out Shiga Toxin-Producing E. coli, R/O Shiga Toxigenic E. coli (STEC), Rule-Out Shiga Toxigenic E. coli (STEC), Rule Out STEC, Rule-Out STEC	05/31/2022	Requisition Form - Microbiology (webform)	R/O Shiga Toxigenic E. coli (STEC)	Positive tests must be shipped. No pre-approval necessary.	All specimens will have EIA-based shiga toxin test. Biochemical identification and serotyping will be performed on any shiga toxin positive isolates that grow on selective media.	Daily, on regular business days	7-14 days		Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule Out Shigella species Shigellosis, Test of cure, R/O Shigella species, Rule-Out Shigella	05/31/2022	Requisition Form - Microbiology (webform)	R/O Shigella species	Positive tests must be shipped. No pre-approval necessary.	All specimens will be screened with selective plating. Suspicious isolates will have biochemical identification and serotyping performed.	Daily, on regular business days	7-14 days		Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Rule Out Yersinia enterocolitica Yersiniosis, R/O Yersinia enterocolitica, Rule-Out Yersinia enterocolitica	01/15/2015	Requisition Form - Microbiology (webform)	R/O Yersinia enterocolitica	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.	All specimens will be screened on selective media. Suspicious isolates will have identification and biotyping performed.	Daily, on regular business days	7-14 days	Submission from Local Health Jurisdictions (LHJ) and state Communicable Disease Epidemiology (CDE) only. This test is for test of cure or Epi investigations only.	Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Salmonella confirmation Salmonella identification, Salmonella serotyping	01/15/2015	Requisition Form - Microbiology (webform)	Salmonella confirmation	Pre-approval not required.	All specimens with suspicious colonies growing on selective media will have serotyping performed. Biochemical speciation will be performed if necessary.	Daily, on regular business days	4-7 days	This test is for isolates only. Please see Enteric Pathogen Screen for stool culture.	Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Salmonella species (Environmental) Salmonellosis, foodborne illness, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Salmonella species (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).	As needed upon request.	4-14 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)
Shiga Toxigenic E. coli (STEC) Confirmation EHEC (Enterohemorrhagic E. coli) confirmation, E. coli identification, E. coli O157 identification, verotoxin confirmation, STX confirmation, STEC confirmation	01/15/2015	Requisition Form - Microbiology (webform)	Shiga Toxigenic E. coli (STEC) Confirmation	Pre-approval not required.	All specimens will have EIA-based shiga toxin test. Biochemical identification and serotyping will be performed on any shiga toxin positive isolates that grow on selective media.	Daily, on regular business days	4-7 days	This test is for isolates and positive MacConkey or GN broths only. Please see Enteric Pathogen Screen for stool culture.	Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Shiga toxin-producing Escherichia coli (Environmental) Shiga toxin-producing Escherichia coli (Environmental), STEC, EHEC, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Shiga toxin-producing Escherichia coli (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Real-time PCR screening method, isolation and confirmation based on the FDA Bacteriological Analytical Manual (BAM).	As needed upon request.	4-14 days	Testing performed only for outbreak investigations with DOH 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)
Shigella confirmation Shigella identification, Shigella serotyping	01/15/2015	Requisition Form - Microbiology (webform)	Shigella confirmation	Pre-approval not required.	All specimens with suspicious colonies growing on selective media will have biochemical identification and serotyping performed.	Daily, on regular business days	4-7 days	This test is for isolates only. Please see Enteric Pathogen Screen for stool culture.	Enteric Bacteriology (206) 418-5456		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Shigella species (Environmental) Shigellosis, foodborne illness, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Shigella species (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).	As needed upon request.	4-14 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)
Staphylococcus aureus (Environmental) Staphylococcal intoxication, foodborne illness, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Staphylococcus aureus (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Enumeration method based on the FDA Bacteriological Analytical Manual (BAM).	As needed upon request.	4-14 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)
Syphilis, Clinical - Serum Syphilis, RPR, TP-PA	08/23/2022	Requisition Form - Sexually Transmitted Infections (webform)	Syphilis, Clinical	Pre-approval not required.	Treponemal Specific Assays CMIA (chemiluminescent Immunoassay): Detection of IgG and IgM antibodies by Abbott Alinity i. TP-PA: (Treponema pallidum Particle Agglutination) Confirmation of IgG and IgM antibodies. Non-Treponemal Specific Assay RPR: (Rapid Plasma Reagin) Qualitative and quantitative detection of non-specific antibodies.	Weekdays (excluding state holidays).	CMIA and RPR test results are available 3 business days from specimen receipt. TP-PA test results are available 5 business days from specimen receipt.	CMIA and RPR are performed on each specimen. If the results are inconclusive or discrepant between the two tests, a confirmatory TP-PA is performed.	STI Lab (206) 418-5622	* For CSF specimen, RPR, and TP-PA are *not* performed. Testing on CSF is performed by VDRL. Please see Syphilis - VDRL.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Syphilis, Reference - Serum Syphilis, RPR, TP-PA	08/23/2022	Requisition Form - Sexually Transmitted Infections (webform)	Syphilis, Reference	Pre-approval not required.	Treponemal Specific Assays CMIA (Chemiluminescent Immunoassay): Detection of IgM/IgG antibodies by Abbott Alinity i. TP-PA: (Treponema pallidum Particle Agglutination) Confirmation of IgG and IgM antibodies.. Non-Treponemal Specific Assay RPR: (Rapid Plasma Reagin) Qualitative and quantitative detection of non-specific antibodies.	Weekdays (excluding state holidays).	CMIA and RPR test results are available 3 business days from specimen receipt. TP-PA test results are available 5 business days from specimen receipt.	Reference specimens that test positive/reactive for syphilis are submitted to WA PHL STI laboratory for confirmation.	STI Lab (206) 418-5622	* For CSF specimen, CMIA and RPR are *not* performed. Testing on CSF is performed by VDRL. Please see Syphilis - VDRL.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Syphilis, VDRL - CSF Syphilis, VDRL	11/17/2022	Requisition Form - Sexually Transmitted Infections (webform)	Syphilis, VDRL	Pre-approval not required.	VDRL (Venereal Disease Research Laboratory): Qualitative and quantitative detection of non-specific antibodies.	Once a week, usually Thursdays	5 business days	For CSF only VDRL testing is performed.	STI Lab (206) 418-5622		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB AFB Culture AFB smear, Mycobacteria, TB culture, TB, AFB, TB acid-fast-bacilli, tuberculosis, consumption	10/01/2015	Requisition Form - Microbiology (webform)	AFB, Culture	Specimens must be submitted through the Local Health Jurisdiction (LHJ). If shipping Stool specimens, prior arrangement must be made with WAPHL TB Lab.	AFB smear and AFB culture	Monday-Friday, excluding holidays	AFB smears 24 hours. Positive AFB culture results available within 21-28 days; Negative results within 8 weeks.	All diagnostic specimens requesting isolation of TB will have an AFB smear and culture performed. To request additional testing please go to orderable tests for TB NAAT and TB Sensitivities.	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB AFB ID MOTT Identification, Mycobacterium Identification, Non-TB Identification, TB, AFB, TB acid-fast-bacilli, tuberculosis, consumption	11/19/2014	Requisition Form - Mycobacterium (file)	AFB, ID	Pre-approval not required.	DNA Sequencing	Weekly	14 days	Identification of AFB-positive isolates that are not MTB.	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB AFB Sensitivities, First Line Drugs TB sensitivities, TB drug resistance, TB, AFB, TB acid-fast-bacilli, tuberculosis, consumption	11/12/2014	Requisition Form - Mycobacterium (file)	AFB Sensitivities, First Line Drugs	Clinical specimens must be submitted through the Local Health Jurisdiction (LHJ). MTB Sensitivities will be performed on the first TB isolate and will be repeated after 3 months of therapy if the cultures are still positive.	BACTEC MGIT First Line Sensitivities, (Isoniazid, Rifampin, Ethambutol and Pyrazinamide)	1-2 times per week	Diagnostic specimen 7-14 days after TB identification; Isolates 7-14 days after receipt.	Diagnostic specimens will have smear and culture performed. Isolates must be submitted as pure culture.	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB AFB Sensitivities, Second Line Drugs TB sensitivities, TB drug resistance, TB, AFB, TB acid-fast-bacilli, tuberculosis, consumption	11/12/2014	Requisition Form - Mycobacterium (file)	AFB Sensitivities, Second Line Drugs	Pre-approval not required.	Agar proportion or disk diffusion	Once per week on as needed basis.	21-27 days after receipt or identification of TB culture.	May take longer if not pure isolate, or scant growth.	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB AFB Smear TB Smear, TB, AFB, TB acid-fast-bacilli, tuberculosis, consumption	10/01/2015	Requisition Form - Microbiology (webform)	AFB, Smear	Specimens must be submitted through the Local Health Jurisdiction (LHJ). If shipping Stool specimens, prior arrangement must be made with WAPHL TB Lab.	AFB smear and AFB culture	Monday-Friday, excluding holidays	AFB smears 24 hours.	All diagnostic specimens requesting isolation of TB will have an AFB smear and culture performed. To request additional testing please go to orderable tests for TB NAAT and TB Sensitivities.	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB GeneXpert Mycobacteriology (TB)	07/25/2022	Requisition Form - Microbiology (webform)	TB GeneXpert	Specimens must be submitted through the Local Health Jurisdiction (LHJ) or Core/Reference Laboratories.	Real-Time Polymerase Chain Reactions (TR-PCR)	Monday-Friday, excluding holidays	24 hours from test	GeneXpert is performed on all first-time AFB smear positive patients. One test per patient, additional tests available with approval through TB program. GeneXpert cannot be used to monitor treatment. GeneXpert can only be performed on sputum or treated sputum specimens. For diagnostic samples that have not been decontaminated/digested, please submit a completed Microbiology Requisition Form (Requisition Form Mycobacterium not required).	Mycobacteriology (TB) 206-418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB NAAT / M. avium complex, NAAT TB NAAT, TB, NAAT, TB Nucleic Acid Amplification Test, Molecular test for TB, TB PCR, TB, PCR, tuberculosis, consumption	02/15/2018	Requisition Form - Mycobacterium (file)	TB NAAT	Specimens must be submitted through the Local Health Jurisdiction (LHJ) or Core/Reference laboratories.	Real-Time Polymerase Chain Reaction (RT-PCR)	Tuesday and Thursday	24 hours from test.	NAAT is performed on all first-time AFB smear positive patients. Up to two (2) NAATs will be performed per patient. NAAT cannot be used to monitor treatment. NAAT can only be performed on respiratory specimens. For diagnostic samples that have not been decontaminated/digested, please submit a completed Microbiology Requisition Form (Requisition Form - Mycobacterium not required)	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
TB, Stock Stock Culture, TB Stock, tuberculosis, consumption	12/01/2014	Requisition Form - Mycobacterium (file)	TB, Stock	Pre-approval not required.	Freezing at ultra low temperatures for specimen preservation.	As needed	Not applicable	According to WAC 246-101-201, laboratories in the State of Washington must send one MTB isolate per patient to the WA PHL within 2 business days of identification.	Mycobacteriology (TB) (206) 418-5473		Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Varicella zoster virus, PCR (VZV, Chickenpox) Herpes zoster, shingles, varicella-zoster	06/30/2022	Requisition Form - Bioterrorism (file)	Varicella zoster virus (Chicken pox)	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 Polymerase Chain Reaction (RT-PCR)	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 (15 days)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Vibrio species (Environmental) Vibrio parahaemolyticus, Vibrio cholerae, Vibrio vulnificus, Vibriosis, foodborne illness, foodborne outbreak	10/14/2022	Requisition Form - Food Lab (file)	Vibrio species (Environmental)	Pre-approval required. Must be approved by Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Enumeration of Vibrio parahaemolyticus through an MPN based real-time PCR assay. Other species of Vibrio are tested using isolation and confirmation methods based on the FDA Bacteriological Analytical Manual (BAM).	As needed upon request.	3-14 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)
Vibrio species Identification Vibriosis, Vibrio vulnificus, Vibrio parahaemolyticus, Vibrio cholerae	06/01/2022	Requisition Form - Microbiology (webform)	Vibrio species Identification	Pre-approval not required.	Isolates are identified using biochemicals and PCR.	Daily, on regular business days	3-7 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)
West Nile Virus / St. Louis encephalitis WN, WNV, St. Louis, SLE	09/07/2018	Requisition Form - Virology (webform)	West Nile Virus / St. Louis Encephalitis, MIA	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.	Microsphere Immunoassay (MIA)	As needed*	2-5 days**		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)
West Nile Virus in Mosquitoes Mosquito, WNV, Vector-borne Diseases, Flavivirus, RNA virus, Viral Hemorrhagic Fevers, Arbovirus, Arboviral	07/06/2022		Contact the Zoonotic and Vector-borne Disease Program in Communicable Disease Epidemiology (CDE) to schedule testing - zd@doh.wa.gov Collection and Submission Instructions for West Nile Virus in Mosquitos Testing (PDF) Protocol for Transporting, Packaging and Shipping Mosquitos (PDF) WNV Resources: Forms and Video - How to set up an EVS trap	Pre-approval by the ZD/VBD Program in CDE required zd@doh.wa.gov	Reverse Transcription Polymerase Chain Reaction (RT-PCR)	Variable	48 hours		ZD/VBD Program in Communicable Disease Epidemiology (206) 418-5500	WNV in the US: Guidelines for Surveillance, Prevention, and Control (CDC)(PDF)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
White Powder, Unknown Unknown white powder	06/30/2022	Biothreat Environmental Sample Submission and Chain-of-Custody Form (file)	White Powder Unknown	Pre-approval required. Contact the FBI (First responders), 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 Polymerase Chain Reaction (RT-PCR), Time resolved flourescence (TRF), standard reference procedures for biochemical identification	Stat processing 24/7 for critical situations	8 hours*		Bioterrorism (206) 418-5562	* Results for confirmation have an extended turnaround time (15 days). Some confirmation processes are performed at CDC.	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Yersinia pestis Y. pestis, pestis, plague, bubonic plague, black death	06/30/2022	Requisition Form - Bioterrorism (file)	Yersinia pestis	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	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 (5 days)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)
Yersinia species Identification	06/01/2022	Requisition Form - Microbiology (webform)	Yersinia species Identification	Pre-approval not required.	Isolates are identified and biotypes (if applicable) using biochemicals.	Daily, on regular business days	3-7 days	Yerisinia pestis has special requirements and approvals. Please refer to the Yersinia pestis BT test.	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)
Zika Virus, rRT-PCR Zika, Flavivirus, Arbovirus	06/30/2022	Requisition Form - Zika (file)	Zika, rRT-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. Please complete and fax the Zika Virus Intake Form to the LHJ. LHJ staff must then notify Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) 206-418-5500.	Reverse Transcriptase Real-Time Polymerase Chain Reaction (rRT-PCR)	Once per week on Wednesdays.	14 business days*	Additional testing methodologies performed for Zika: IgM Antibody Detection	Bioterrorism (206) 418-5562	*Additional testing may be performed at Centers for Disease and Control (CDC)	Notifiable Conditions Overview List of Notifiable Conditions (includes links to reporting forms, guidelines for public health investigations, and case definition)