Ambulatory Surgical Facilities

License Requirements

In Washington state, all distinct business entities offering outpatient specialty and multi-specialty surgical services meeting the licensing requirements in chapter 70.230 RCW need to be licensed as ambulatory surgical facilities (ASF). Certain exemptions to licensure apply. Our frequently asked questions webpage can assist you in determining if your practice or facility requires state ASF licensure.

The licensing steps include:

Step 1: Contact the department's ambulatory surgical facilities program manager at 360-236-2929 to discuss if licensure if required and to understand the overall licensing process.

Step 2: Submit ASF state licensing application (PDF) and submit the fee.

Note: After you submit your application (PDF) and fee, your application will remain in a pending status until steps 3A, 3B, and 4 are completed.

Step 3A: Submit a separate application and fee to the department's Construction Review Services (CRS) to have your building reviewed and approved according to applicable building codes. The timeline for CRS to review and approve your building varies. It may take several months if your building requires significant construction or renovation work in order to meet standards. CRS main phone # is 360-236-2944.

Note: CRS staff members can also provide technical assistance about a building you are considering to use as an ASF. This assistance can be done at your location. You can get upfront information on what the requirements are and learn about any obvious issues in an existing building. Technical assistance is most helpful near the beginning of your process to assist you in making informed purchasing decisions. Contact CRS at 360-236-2944 to discuss if scheduling a technical assistance would be beneficial.

Step 3B: Submit a separate application and fee to the department's Certificate of Need (CoN) program. Contact CoN at 360-236-2955 to discuss the specifics of your business and to determine what type of application is needed.

Step 4: Cooperate with the department's survey program to complete your initial on-site state survey. Surveys are conducted by registered nurses who are trained to inspect ASFs to confirm compliance with state regulatory standards in chapter 246-330 WAC.

Note: Your on-site state survey is the last step in the licensing process. The on-site survey cannot be scheduled until CRS and CoN have approved your facility. An on-site survey must be completed and approved prior to receiving your ASF state license.

As noted above, the CRS and CoN processes require separate applications and fees and can take several months to complete. Applicants may choose to complete the CRS and CoN processes first and then submit their ASF licensing application.