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Announcement

Clinical specimens submitted on paper forms after January 1^st, 2024 will be subject to rejection per WAC 246-101-215 without prior approval. Clinical specimens shipped to the WAPHL must be ordered through WAPHL LWP Portal. *Environmental samples will still be accepted via paper requisition form.

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Specimen Pass Through Form

Please review all CDC submission requirements, including proper patient identifiers before shipping specimens to PHL.

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Testing methodologies and frequencies
Turnaround times and contact information

To ensure that specimens meet laboratory acceptance criteria, please review all appropriate content prior to specimen submission.

Name Sort descending	Updated	Required form	Specimen Collection and Submission Instructions	Pre-approval Requirement Procedure, if applicable	Methodology	Testing Frequency	Turnaround Time (business days)	Comments	Contact	Footnotes	Notifiable Conditions Info
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 (webform)	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	01/22/2024	Requisition Form - Microbiology (webform)	Vibrio species Identification	Pre-approval not required.	Isolates are identified using biochemicals and MALDI.	Daily, on regular business days	3-7 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)