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Clinical Specimen Collection and Submission

The collection of clinical specimens must follow established laboratory policies and procedures. These policies and procedures must be documented as required by Chapter 246-338 WAC, Medical Test Site Rules, State of Washington Department of Health, Office of Laboratory Quality Assurance. General specimen submission instructions are given below. Contact the laboratory unit receiving the specimens for specific detailed information.

Blood or serum

1. Do not freeze whole blood.
2. Submit specimens in a screw-cap tube sealed with waterproof adhesive tape wound in the direction that tightens the cap. If the tube leaks during shipment, we reserve the right not to test the specimen.
3. Place tubes in individual plastic zip-lock type bags. Do not put the laboratory form in direct contact with the specimen tube. Use sufficient absorbent material to secure the contents and contain any leakage during shipment.
4. Wrap the laboratory form around the outside of the plastic zip-lock type bag and secure with rubber bands. Do not include more than four (4) laboratory forms with each inner can. Place the plastic bag and the laboratory form into a cardboard mailing container. Finally, place the cardboard mailing container into a plastic biohazard bag. Note that more than one cardboard container can be placed into the plastic biohazard bags for shipment.
5. Place a mailing address label onto the plastic biohazard bag before shipping specimen(s). On the outside of the biohazard bag, please specify the nature of the specimen or contents (Diagnostic, blood sample, etc).

Call us at (206) 418-5400 if you have questions about samples, interpretations, procedures, or any other aspect of Public Health Laboratories services. For public health emergencies after hours, call Communicable Disease Epidemiology at (206) 418-5500.

Kits are expensive and many have expiration dates. Return all unused and outdated specimen kits and mailing containers to the PHL for recycling. For information regarding mailing containers, biohazard bags or media, call Mail Services at (206) 418-5579 or fax (206) 418-5405 or e-mail to phl.mailroom@doh.wa.gov.

Submission Procedure

1. Complete the appropriate laboratory form specific to each PHL laboratory unit. The form must include patient ID, submitter name, mailing address and submitter phone number, and date of collection.
   • Use black, non-smearing ink and please print clearly.
   • All specimen ID information must correspond with the laboratory form.
2. Include your name, return address, phone number, and date with all specimens, letters, memos and requests for laboratory supplies.
3. All specimens submitted to the PHL must have the return address of the submitter and the name of the person requesting the examination.
4. The PHL receives shipments from Greyhound, UPS, Federal Express, and the United States Postal Service Monday through Saturday. Call the PHL at (206) 418-5579 before sending samples/specimens.
5. If there is a laboratory fee required for testing, make check or money order payable to the Department of Health and send to the Department of Health, Revenue Section, and PO BOX 1099, OLYMPIA, WA 98507-1099. Never send your payment with the specimen.
6. Before sending specimens, make sure there is sufficient postage. The Postal Service will not deliver packages that do not have the required postage. Do not send specimens collect unless you have made prior arrangements with the PHL.

Note: Greyhound Express shipments are routinely picked up by PHL staff at about 6:30 a.m. each weekday. To accommodate other bus arrival times (such as emergency and other special arrangements), courier service will be provided for delivery to the PHL.

During regular business hours, please call the lab units involved to make special arrangements before sending the specimens. (See pages 4-7)

Shipping

Important:
Appropriate regulations for the shipment of infectious materials must be followed when sending specimens to the PHL. In conjunction with appropriate training, the following resources may be used for shipping and mailing regulations:

• International Air Transport Association (IATA) - Dangerous Goods Regulations 46th Ed. (1/1/2005-12/31/2005)
• US Postal Service - Domestic Mail Manual Section C023 - Title 39 Code of Federal Regulations Part 111
• US Dept of Transportation - Title 49 Code of Federal Regulations Parts 171-185;
• Appendix A of this directory contains more information on shipping requirements including shipping reference tables.

Shipping of diagnostic specimens and infectious materials should be performed or supervised by a person who has received training in the shipping of such materials. It is the shipper's responsibility to ensure that packages being shipped meet current regulations. The Code of Federal Regulations can be accessed at the Code of Federal Regulations website. A copy of PHL shipping regulations may be obtained by contacting the PHL mailroom at (206) 418-5579.Ice packs must be used when submitting specimens in cooler boxes. In this directory ice packs refers to any one or a combination of: gel packs, frozen coolant packs, blue-ice packs, combination water and gel packs, or leak-proof plastic containers. It is important to ensure these products will not leak during shipment. Do NOT use wet ice to transport specimens to the PHL. Leaking packages may be rejected.

Instructions for Packing and Shipping Clinical Specimens

1. On the sample label print patient's complete name or confidential identifier corresponding with the requisition form, the type of specimen collected, and the date collected.
2. Do Not use ballpoint pens, wax, indelible pencils, or other writing instruments that tend to smear.
3. Enclose a completed laboratory request form with each and every properly labeled specimen, even if packaged in the same container.
4. Enclose the specimen in a screw cap tube or vial with a tight-fitting cap. For specimens shipped at ambient or higher temperatures positive means of ensuring a leak proof seal must be used, such as a skirted stopper, or metal crimp seal. If screw caps are used seal the cap with waterproof adhesive tape wound in the direction that tightens the cap.
5. Package specimens properly for transit (Figure 1) ensuring that personnel who handle the package will not come into contact with the enclosed specimen.
6. Place the tube or vial (primary container) in a watertight secondary container. Pack a suitable absorbent material around the tube to absorb shock and sufficient to absorb possible leakage of the entire contents. If several tubes are to be packed within the same can, wrap each tube individually in absorbent material. Do not place the request form within the secondary container; wrap it around the outside of the secondary container.
7. Place the secondary container into an outer shipping container. Seal the outer shipping container securely; affix a properly completed address label with a return address and postage, if required.
8. If specimens must be sent refrigerated or frozen, they should be packaged in an insulated container. The insulated container should be placed within a properly labeled cardboard box and sealed securely. The specimens should be packaged in a manner that prevents movement within the insulated container.
9. Try to time shipments (when possible) to arrive early in the week. Be particularly careful to avoid having the specimen arrive on a weekend or a holiday when possible. Call the PHL 24-hour number if shipments will be received outside of normal business hours. The 24-hour numbers are (206) 418-5500 and (877) 539-4344.
10. Never mail any clinical specimens or cultures in petri dishes.
11. Improperly packaged specimens and specimens that have leaked may not be accepted.
12. A specimen arriving with an incomplete or no request form may be held until the information is received. The proper request form for each specimen submitted must be completed as fully as possible. When possible, include patient name or confidential ID, date of specimen collection, type of specimen, birth date or age, sex, date of onset, diagnosis, symptoms, attending physician, county of residence, suspected agent, reference culture information including type of medium and source of isolate, and other pertinent medical information including contact with insects, animals, etc., antibiotic or anti-tuberculosis therapies, recent vaccinations, similar infections in the family or community, and recent travel including destination and dates.
13. Copies of the reports are mailed only to the source indicated on the request form. Be sure to include the full 9-digit zip code for each address.

Links to organizations outside the Washington State Department of Health are provided as a public service, without implied endorsement or attestation of accuracy.