Form 0920-1309 GFAT v5.12

[NCEZID] Enterprise Laboratory Information Management System

Attachment 2B-Global File Accessioning Template_GFAT v5.12.xlsx

Global File Accessioning Template

OMB: 0920-1309

Document [xlsx]
Download: xlsx | pdf

Overview

Disclaimer
Introduction
Human FA Template
Animal FA Template
FEMB FA Template
Global Submitters
FastLookup


Sheet 1: Disclaimer

Disclaimer:
The Centers for Disease Control and Prevention (CDC), an agency of the Department of Health and Human Services, is authorized to collect this information, including the Social Security number (if applicable), under provisions of the Public Health Service Act, Section 301 (42 U.S.C. 241). Supplying the information is voluntary and there is no penalty for not providing it. The data will be used to increase understanding of disease patterns, develop prevention and control programs, and communicate new knowledge to the health community. Data will become part of CDC Privacy Act system 09-20-0106, "Specimen Handling for Testing and Related Data" and may be disclosed: to appropriate State or local public health departments and cooperating medical authorities to deal with conditions of public health significance; to private contractors assisting CDC in analyzing and refining records; to researchers under certain limited circumstances to conduct further investigations; to organizations to carry out audits and reviews on behalf of HHS; to the Department of Justice in the event of litigation, and to a congressional office assisting individuals in obtaining their records. An accounting of the disclosures that have been made by CDC will be made available to the subject individual upon request. Except for permissible disclosures expressly authorized by the Privacy Act, no other disclosure may be made without the subject individual's written consent.
Please refer to the CDC Infectious Diseases Laboratories Test Directory for information on specimen requirements. CDC must maintain and document specific acceptance criteria to perform laboratory tests on samples obtained from humans pursuant to the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and accompanying regulations. 42 U.S.C. § 263a; 42 C.F.R. § 493.1241.
Samples transferred to the CDC for testing or any other purpose will become the legal property of the agency unless otherwise agreed upon in writing. Samples will not be returned to the submitting entity.
Paperwork Reduction Act Information:
Form Approved
OMB Control No.: 0920-1309
Expiration date: 11/30/2023
Public reporting burden of this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-1309

Sheet 2: Introduction

Introduction:
File Accessioning is a feature of ELIMS which allows the User to accession one or more specimens into ELIMS as a single operation using the "File Accessioning" interface. The User simply creates a "File Accessioning" import file from the Global File Accessioning Template (GFAT) and uses the "File Accessioning" function to load the specimen data from the import file into ELIMS. The "File Accessioning" import file contains the same data that may be entered manually or through barcode accessioning by the User using the CDC Specimen Submission Form (Form 50.34). The "File Accessioning" function runs in the background, and an email is sent to the User when the import is completed.

Production Version: 5.12

What is a template/import file?
The File Accessioning process extracts specimen data from an import file and loads the data into ELIMS. The User creates the import file by, first, entering the specimen data into the "File Accessioning" template (Excel worksheet), which contains the same data the User enters when accessioning specimens one at a time (using the ELIMS Login/Sample Login interfaces or the CDC Specimen Submission Form [Form 50.34]). After the User enters the specimen data into the "File Accessioning" template, the Excel worksheet (.xlsx) can be imported into ELIMS.

Using this template:
1. This file contains three "File Accessioning" templates (Excel worksheets): Human, Animal, and FEMB (Food, Environmental, Medical Devices, and Biologics). Select the appropriate accessioning template based on the origin of each specimen. The file can contain specimens in each "Origin" tab if you are accessioning multiple origins, and it is saved and imported as an Excel file.
2. Row #1 contains the data captions on the CDC Specimen Submission Form (Form 50.34). This row should not be altered by the User for any reason. Row #2 contains the database field names that correspond to the data captions in Row #1. This row is hidden and must not be altered by the User for any reason. Editing values in this row will corrupt the import file. Row #3 (and each row following) is used to enter data for specimens. Each row of information represents a new specimen or aliquot record for a specimen that is being imported. The following fields are required; however, these fields are auto-populated if left blank:
• Package ID – Blank, if not specified
• CSID – Auto-populated, if not specified
• CUID – Auto-populated, if not specified
• Origin – Valid values are: "Human," "Animal," "Food," "Environmental," "Medical Device," or "Biologic." Origin is required and a value must be entered.
• Test order name - Blank, if not specified
3. Picklists are used for many of the cells within each template (Excel worksheet). These lists contain the same values in the CDC Specimen Submission Form (Form 50.34).
4. After the User enters all of the specimen data into the "File Accessioning" template (.xlsx), the Excel worksheet is saved and ready for ELIMS import. The import is only compatible with Excel files, and a single import file can have specimen data in each of the worksheet tabs (Human, Animal, and FEMB).
5. Specifying specimens, aliquots, and subsamples:
• Each row containing a blank or unique CSID value will be a new specimen.
• Aliquots will be created for each row with an existing CSID in the current GFAT and a unique or blank CUID.
• The GFAT cannot create subsamples (derivites). To batch create subsamples in ELIMS, use the SAIT file found in ELIMS àFile Bulk Processing à"Add Subsample/Aliquot" tab.
NOTE: If creating a child aliquot in the GFAT, the parent will be the first instance of the specimen's CSID in the file. ELIMS will not let you create a GFAT containing a CSID that already exists in the system. To batch create aliquots for specimens already in the system, use the SAIT file.
6. "FastLookup" tab and "Short List" checkboxes - The "Short List" checkboxes are a way to tailor the "File Accessioning" template to ensure the available picklist fields only list the subset of values the laboratory most frequently uses. To set up this feature, perform the following steps:
• Go to the "FastLookup" tab within the spreadsheet.
• Locate the desired picklist name for customization. The field title will show the correct name.
• Select the desired picklist values from the drop-down menu for the specific field. Do not leave any blank columns between the picklist rows.
• To see the full list of values for a picklist, leave the "Short List" checkbox in the "Title" row blank when entering the data. To view the sublist, check the box.
7. Some of the "Storage Location" fields (Room, Freezer, Shelf, Rack, and Box) have drop-down menus with no picklist values. Storage Locations can be manually typed into these fields. Alternatively, "Storage Location" information can be added by laboratories into the "Storage Location" section of FastLookup. This allows the User to choose the storage location within the associated fields of the "Origin" tabs, using the drop-down menus. This will decrease the number of data entry errors when importing into storage locations. To add a laboratory's storage location information into ELIMS, perform the following steps:
• Go to QBE Query in ELIMS.
• Choose the QBE template "Storage Locations Metadata."
• Choose the filter set "General."
• Query all storage locations.
• Use the list from QBE to populate the storage locations in FastLookup. Make sure the "Storage Location" types from the QBE match the locations in FastLookup (boxes appearing within the box section, shelves in the shelf section, etc.).
• Once the Storage Locations are added to the GFAT, save it as a template to ensure easy access to location information when creating an import file.
8. Copying and pasting values - It is possible to copy and paste values into the GFAT spreadsheet. If a value pasted into the picklist doesn't match one of the existing picklist records, that field will appear in red. Users need to change the field value to a valid ELIMS format or the file will fail during accessioning. When copying and pasting into the GFAT from an Excel file that has existing formatting or calculations in it, try to paste values only (or this may overwrite the existing GFAT formatting rules). Please contact the ELIMS Support Services Team if you have any questions at [email protected].
9. To assign a specimen to an SPHL, the SPHL ID must be specified. To determine the SPHL ID value, the "SPHL Institution Name" field has been added to the top of the GFAT file in the "SPHL" section. When the SPHL name is chosen, the corresponding SPHL ID will appear next to it. This field is for informational use, and the SPHL ID will still need to be populated in the specimen row in order to be imported into the specimen record.
10. To simplify assigning the SPHL ID to a specimen, an "SPHL Institution Name" field is included in the GFAT file next to the "SPHL ID" field. This field contains a list of all SPHLs in ELIMS. To use, perform the following steps:
• Select the SPHL name from the "SPHL Institution Name" field in a row within the GFAT.
• Select the drop-down menu next to the "SPHL ID" field—the corresponding SPHL ID for the selected institution will appear.
• Select the SPHL ID.
NOTE: Even though the SPHL name is selected, the User MUST still select a SPHL ID for it to be populated for the specimen during import.
11. The "Event ID" drop-down menu is used to simplify the Event ID selection process using the laboratory's ELIMS list of events. This will only work if the laboratory is assigning the specimen to a single event. Perform the following steps:
• Go to Events Management in ELIMS.
• Right click on the "Events Management" screen and select "Copy to Excel."
• Select the "Event ID" and "Event Name" fields and copy them. If you use a different field (such as "Local Event ID") to identify events, it can be used instead of "Event Name."
• Go to the "FastLookup" tab in the GFAT file and paste these values in the "Event ID"/"Event Name" fields.
• To assign an event to the GFAT file, go to the appropriate row and select the event name. This will filter the record to the correct Event ID.
NOTE: You must still select the Event ID for the record to be assigned to the event.
12. You can designate a row as a Subsample by entering a "Y" value in the "Is Subsample" field located on the second to last column of the GFAT. To Generate a SAIT file from a GFAT select a File Accessioning Row and click on the "Set Up Subsample" button on the screen. The system will then generate a SAIT file containing a Subsample for each row that is set to "Y" in the "Is Subsample" column in the GFAT. Please note the following Rules when using this feature:
• The generate Subsample feature will only work with GFATs that have Passed.
• If a Row is designated as a Subsample it will be ignored during File Accessioning.
• Although the Specimen Source Type field is required for each specimen in the GFAT, it will not be required for Samples designed as Subsamples or Aliquots.
• If the CSID, CUID, or Parent CUID are not specified in the GFAT for a Subsample, then those fields will be blank when importing into the SAIT.
• You cannot specify a Parent CUID if the "Is Subsample" field is left blank. This will cause the GFAT to fail.
• The CSID field will be highlighted in Blue if a row is designated as a Subsample.
• The following fields can be imported into the SAIT using this feature: "CSID, CUID, Parent CUID, CDC Local Aliquot ID and Specimen Source Type.

Importing a GFAT file into ELIMS:
1. Navigate to the "File Accessioning" interface by selecting the "File Accessioning" link in the "Login Options" section of ELIMS.
2. Prepare the GFAT import file. Ensure the file is the most current version (to check the version, select the "Download Global File Accessioning Template" link found in the "File Accessioning" interface).
3. Select the "Import" button on the "File Accessioning" screen.
4. Select the GFAT file for import.
5. Select “Current User” in field titled “When import completes send email to." Next, select the "Import" button. This will cause the "Batch Import" message to appear.
6. Select "OK" on the "Batch Import" message. The User will receive a notification email indicating the import is complete. This process usually occurs quickly, but timing is dictated by the number of specimens being imported.
7. Review the email for the imported batch.
8. Return to the "File Accessioning" interface and select the "Filter By Status" picklist. Select "Passed" from the filter. The User will see the batch of the file that was imported.
9. Go to the "Sample Login" screen. Specimens imported through File Accessioning will appear in the Specimen List.

References:
Submitting Specimens to the CDC - CDC Specimen Submission Form (Form 50.34)
ELIMS v10 Training Scripts


Sheet 3: Human FA Template

Package ID CSID CUID Origin
(This field is required)
Test Order Name Suspected Agent Date Sent to CDC At CDC, bring to the attention of: CDC Patient ID CDC Local Patient ID Patient name, Last Patient name, First Patient name, Middle Initial Patient name, Suffix Patient Birthdate Patient Age Age units Patient Sex Pregnant Clinical Diagnosis Date of onset Fatal Date of Death White Black or African American Asian American Indian and Alaska Native Native Hawaiian and Other Pacific Islander Specimen collected date Specimen collected time Material submitted Specimen source (Type) (Required for Specimens Only) Specimen source modifier Specimen source site Specimen source site modifier Collection method Treatment of specimen Transport medium/Specimen preservative Specimen handling SPHL Submitter ID SPHL Submitter Institution Name SPHL Submitter Point of Contact Name, Prefix SPHL Submitter Point of Contact Name, Last SPHL Submitter Point of Contact Name, First SPHL Submitter Point of Contact Name, Middle Initial SPHL Submitter Point of Contact Name, Suffix SPHL Submitter Point of Contact Name, Degree SPHL Submitter Point of Contact Phone, Country Code SPHL Submitter Point of Contact Phone, Area Code SPHL Submitter Point of Contact Phone, Local Number SPHL Submitter Point of Contact Phone, Extension SPHL Submitter Point of Contact Email SPHL Submitter Patient ID SPHL Submitter Alternative Patient ID SPHL Submitter Specimen ID SPHL Submitter Alternative Specimen ID Original Submitter ID Original Submitter Lab Director or Designee Name, Prefix Original Submitter Lab Director or Designee Name, Last Original Submitter Lab Director or Designee Name, First Original Submitter Lab Director or Designee Name, Middle Initial Original Submitter Lab Director or Designee Name, Suffix Original Submitter Lab Director or Designee Name, Degree Original Submitter Institution Name Original Submitter Address, Street Address Line 1 Original Submitter Address, Street Address Line 2 Original Submitter Address, City Original Submitter Address, Zip/Postal Code Original Submitter Address, State Original Submitter Address, Country Original Submitter Fax, Country Code Original Submitter Fax, Area Code Original Submitter Fax, Local Number Original Submitter Email Original Submitter Contact ID Original Submitter Point of Contact Name, Prefix Original Submitter Point of Contact Name, Last Original Submitter Point of Contact Name, First Original Submitter Point of Contact Name, Middle Initial Original Submitter Point of Contact Name, Suffix Original Submitter Point of Contact Name, Degree Original Submitter Point of Contact Phone, Country Code Original Submitter Point of Contact Phone, Area Code Original Submitter Point of Contact Phone, Local Number Original Submitter Point of Contact Phone, Extension Original Submitter Point of Contact Email Original Submitter Patient ID Original Submitter Alternative Patient ID Original Submitter Specimen ID Original Submitter Alternative Specimen ID Intermediate Submitter ID Intermediate Submitter Lab Director or Designee Name, Prefix Intermediate Submitter Lab Director or Designee Name, Last Intermediate Submitter Lab Director or Designee Name, First Intermediate Submitter Lab Director or Designee Name, Middle Initial Intermediate Submitter Lab Director or Designee Name, Suffix Intermediate Submitter Lab Director or Designee Name, Degree Intermediate Submitter Institution Name Intermediate Submitter Address, Street Address Line 1 Intermediate Submitter Address, Street Address Line 2 Intermediate Submitter Address, City Intermediate Submitter Address, Zip/Postal Code Intermediate Submitter Address, State Intermediate Submitter Address, Country Intermediate Submitter Fax, Country Code Intermediate Submitter Fax, Area Code Intermediate Submitter Fax, Local Number Intermediate Submitter Email Intermediate Submitter Contact ID Intermediate Submitter Point of Contact Name, Prefix Intermediate Submitter Point of Contact Name, Last Intermediate Submitter Point of Contact Name, First Intermediate Submitter Point of Contact Name, Middle Initial Intermediate Submitter Point of Contact Name, Suffix Intermediate Submitter Point of Contact Name, Degree Intermediate Submitter Point of Contact Phone, Country Code Intermediate Submitter Point of Contact Phone, Area Code Intermediate Submitter Point of Contact Phone, Local Number Intermediate Submitter Point of Contact Phone, Extension Intermediate Submitter Point of Contact Email Intermediate Submitter Patient ID Intermediate Submitter Alternative Patient ID Intermediate Submitter Specimen ID Intermediate Submitter Alternative Specimen ID Brief Clinical Summary State of Illness, Symptomatic State of Illness, Asymptomatic State of Illness, Acute State of Illness, Chronic State of Illness, Convalescent State of Illness, Recovered Type of Infection, Upper respiratory Type of Infection, Lower respiratory Type of Infection, Cardiovascular Type of Infection, Gastrointestinal Type of Infection, Genital Type of Infection, Urinary tract Type of Infection, Sepsis Type of Infection, Central nervous system Type of Infection, Skin/soft tissue Type of Infection, Ocular Type of Infection, Joint/bone Type of Infection, Disseminated Type of Infection, Other Type of Infection, Other (specify) Therapeutic Agent(s) During Illness, Agent 1 Therapeutic Agent(s) During Illness, Agent 1 Start Date Therapeutic Agent(s) During Illness, Agent 1 End Date Therapeutic Agent(s) During Illness, Agent 2 Therapeutic Agent(s) During Illness, Agent 2 Start Date Therapeutic Agent(s) During Illness, Agent 2 End Date Therapeutic Agent(s) During Illness, Agent 3 Therapeutic Agent(s) During Illness, Agent 3 Start Date Therapeutic Agent(s) During Illness, Agent 3 End Date Extent, Isolated Case Extent, Carrier Extent, Contact Extent, Outbreak Extent, Outbreak Text Extent, Family Extent, Community Extent, Healthcare-associated Extent, Epidemic Travel Travel, Start Date Travel, End Date Travel: Foreign (Countries) 1 Travel: Foreign (Countries) 2 Travel: Foreign (Countries) 3 Foreign Residence (Country) Travel: United States (States) 1 Travel: United States (States) 2 Travel: United States (States) 3 United States Residence (State) Exposure Date of Exposure Animal Exposure Animal Type of Exposure Animal Common Name Animal Scientific Name Arthropod Exposure Arthropod Type of Exposure Arthropod Common Name Arthropod Scientific Name Immunization 1 Immunization 1, Date Received Immunization 2 Immunization 2, Date Received Immunization 3 Immunization 3, Date Received Immunization 4 Immunization 4, Date Received Previous Laboratory Results Comments Delivered to Unit # Date received at CDC Specimen Received at STAT Date (STAT only) Condition, Outer Package, STAT Laboratory (STAT only) Condition, Specimen container, STAT Laboratory (STAT only) Condition, Specimen, STAT Laboratory (STAT only) CDC Local Aliquot ID Specimen Received in Lab Date (Unit only) Condition, Outer Package, Testing Laboratory (Unit only) Condition, Specimen container, Testing Laboratory (Unit only) Condition, Specimen, Testing Laboratory (Unit only) Additional ID 1 Additional Type 1 Additional ID 2 Additional Type 2 Suspected Agent Category Case Id Date 01 Date 02 Numeric 01 Numeric 02 Decimal 01 Alpha Numeric 01 Alpha Numeric 02 Alpha Numeric 03 Alpha Numeric 04 Alpha Numeric 05 Volume Unit of Measure Container Type Storage Locations - Location Storage Locations - Building Storage Locations - Room Storage Locations - Storage Unit Storage Locations - Shelf Storage Locations - Rack Storage Locations - Box Storage Locations - Absolute Position Storage Locations - Custodian
(User ID)
Storage Locations - Comment CDC EVENT ID CDC CASE ID Date Subsample Received in Lab Subsample Comment Date Aliquot Received in Lab Aliquot Comment Additional Aliquot ID Is Subsample Parent CUID

Sheet 4: Animal FA Template

Package ID CSID CUID Origin
(This field is required)
Test Order Name Suspected Agent Date Sent to CDC At CDC, bring to the attention of: CDC Patient ID CDC Local Patient ID Animal Arthropod Common Name Scientific Name Animal Name Animal Category Sex Birthdate Age Age units Clinical Diagnosis Date of onset Fatal Date of Death Specimen collected date Specimen collected time Material submitted Specimen source (Type) (Required for Specimens Only) Specimen source modifier Specimen source site Specimen source site modifier Collection method Treatment of specimen Transport medium/Specimen preservative Specimen handling SPHL Submitter ID SPHL Submitter Institution Name SPHL Submitter Point of Contact Name, Prefix SPHL Submitter Point of Contact Name, Last SPHL Submitter Point of Contact Name, First SPHL Submitter Point of Contact Name, Middle Initial SPHL Submitter Point of Contact Name, Suffix SPHL Submitter Point of Contact Name, Degree SPHL Submitter Point of Contact Phone, Country Code SPHL Submitter Point of Contact Phone, Area Code SPHL Submitter Point of Contact Phone, Local Number SPHL Submitter Point of Contact Phone, Extension SPHL Submitter Point of Contact Email SPHL Submitter Animal ID SPHL Submitter Alternative Animal ID SPHL Submitter Specimen ID SPHL Submitter Alternative Specimen ID Original Submitter ID Original Submitter Lab Director or Designee Name, Prefix Original Submitter Lab Director or Designee Name, Last Original Submitter Lab Director or Designee Name, First Original Submitter Lab Director or Designee Name, Middle Initial Original Submitter Lab Director or Designee Name, Suffix Original Submitter Lab Director or Designee Name, Degree Original Submitter Institution Name Original Submitter Address, Street Address Line 1 Original Submitter Address, Street Address Line 2 Original Submitter Address, City Original Submitter Address, Zip/Postal Code Original Submitter Address, State Original Submitter Address, Country Original Submitter Fax, Country Code Original Submitter Fax, Area Code Original Submitter Fax, Local Number Original Submitter Email Original Submitter Contact ID Original Submitter Point of Contact Name, Prefix Original Submitter Point of Contact Name, Last Original Submitter Point of Contact Name, First Original Submitter Point of Contact Name, Middle Initial Original Submitter Point of Contact Name, Suffix Original Submitter Point of Contact Name, Degree Original Submitter Point of Contact Phone, Country Code Original Submitter Point of Contact Phone, Area Code Original Submitter Point of Contact Phone, Local Number Original Submitter Point of Contact Phone, Extension Original Submitter Point of Contact Email Original Submitter Animal ID Original Submitter Alternative Animal ID Original Submitter Specimen ID Original Submitter Alternative Specimen ID Intermediate Submitter ID Intermediate Submitter Lab Director or Designee Name, Prefix Intermediate Submitter Lab Director or Designee Name, Last Intermediate Submitter Lab Director or Designee Name, First Intermediate Submitter Lab Director or Designee Name, Middle Initial Intermediate Submitter Lab Director or Designee Name, Suffix Intermediate Submitter Lab Director or Designee Name, Degree Intermediate Submitter Institution Name Intermediate Submitter Address, Street Address Line 1 Intermediate Submitter Address, Street Address Line 2 Intermediate Submitter Address, City Intermediate Submitter Address, Zip/Postal Code Intermediate Submitter Address, State Intermediate Submitter Address, Country Intermediate Submitter Fax, Country Code Intermediate Submitter Fax, Area Code Intermediate Submitter Fax, Local Number Intermediate Submitter Email Intermediate Submitter Contact ID Intermediate Submitter Point of Contact Name, Prefix Intermediate Submitter Point of Contact Name, Last Intermediate Submitter Point of Contact Name, First Intermediate Submitter Point of Contact Name, Middle Initial Intermediate Submitter Point of Contact Name, Suffix Intermediate Submitter Point of Contact Name, Degree Intermediate Submitter Point of Contact Phone, Country Code Intermediate Submitter Point of Contact Phone, Area Code Intermediate Submitter Point of Contact Phone, Local Number Intermediate Submitter Point of Contact Phone, Extension Intermediate Submitter Point of Contact Email Intermediate Submitter Animal ID Intermediate Submitter Alternative Animal ID Intermediate Submitter Specimen ID Intermediate Submitter Alternative Specimen ID Owner Name, Last Owner Name, First Owner Name, Middle Initial Owner Name, Suffix Owner Address, Street Address Line 1 Owner Address, Street Address Line 2 Owner Address, City Owner Address, State Owner Address, Zip/Postal Code Owner Address, Country Owner Phone, Country code Owner Phone, Area code Owner Phone, Local Number Field Collection Address, Street Address Line 1 Field Collection Address, Street Address Line 2 Field Collection Address, City Field Collection Address, State Field Collection Address, Zip/Postal Code Field Collection Address, Country Field Collection, Latitude Field Collection, Longitude Field Collection UTM Coordinates, Grid zone designator Field Collection UTM Coordinates, Easting Field Collection UTM Coordinates, Northing Brief Clinical Summary State of Illness, Symptomatic State of Illness, Asymptomatic State of Illness, Acute State of Illness, Chronic State of Illness, Convalescent State of Illness, Recovered Type of Infection, Upper respiratory Type of Infection, Lower respiratory Type of Infection, Cardiovascular Type of Infection, Gastrointestinal Type of Infection, Genital Type of Infection, Urinary tract Type of Infection, Sepsis Type of Infection, Central nervous system Type of Infection, Skin/soft tissue Type of Infection, Ocular Type of Infection, Joint/bone Type of Infection, Disseminated Type of Infection, Other Type of Infection, Other (specify) Therapeutic Agent(s) During Illness, Agent 1 Therapeutic Agent(s) During Illness, Agent 1 Start Date Therapeutic Agent(s) During Illness, Agent 1 End Date Therapeutic Agent(s) During Illness, Agent 2 Therapeutic Agent(s) During Illness, Agent 2 Start Date Therapeutic Agent(s) During Illness, Agent 2 End Date Therapeutic Agent(s) During Illness, Agent 3 Therapeutic Agent(s) During Illness, Agent 3 Start Date Therapeutic Agent(s) During Illness, Agent 3 End Date Extent, Isolated Case Extent, Carrier Extent, Contact Extent, Outbreak Extent, Epizootic Extent, Other Extent, Other (specify) Herd Size No. in herd affected No. in herd dead Exposure Animal Exposure Animal Type of Exposure Animal Common Name Animal Scientific Name Arthropod Exposure Arthropod Type of Exposure Arthropod Common Name Arthropod Scientific Name Human Exposure Human Type of Exposure Travel Travel, Start Date Travel, End Date Travel: Foreign (Countries) 1 Travel: Foreign (Countries) 2 Travel: Foreign (Countries) 3 Foreign Residence (Country) Travel: United States (States) 1 Travel: United States (States) 2 Travel: United States (States) 3 United States Residence (State) Immunization 1 Immunization 1, Date Received Immunization 2 Immunization 2, Date Received Immunization 3 Immunization 3, Date Received Immunization 4 Immunization 4, Date Received Previous Laboratory Results Comments Delivered to Unit # Date received at CDC Specimen Received at STAT Date (STAT only) Condition, Outer Package, STAT Laboratory (STAT only) Condition, Specimen container, STAT Laboratory (STAT only) Condition, Specimen, STAT Laboratory (STAT only) CDC Local Aliquot ID Specimen Received in Lab Date (Unit only) Condition, Outer Package, Testing Laboratory (Unit only) Condition, Specimen container, Testing Laboratory (Unit only) Condition, Specimen, Testing Laboratory (Unit only) Additional ID 1 Additional Type 1 Additional ID 2 Additional Type 2 Suspected Agent Category Case Id Date 01 Date 02 Numeric 01 Numeric 02 Decimal 01 Alpha Numeric 01 Alpha Numeric 02 Alpha Numeric 03 Alpha Numeric 04 Alpha Numeric 05 Volume Unit of Measure Container Type Storage Locations - Location Storage Locations - Building Storage Locations - Room Storage Locations - Storage Unit Storage Locations - Shelf Storage Locations - Rack Storage Locations - Box Storage Locations - Absolute Position Storage Locations - Custodian
(User ID)
Storage Locations - Comment CDC EVENT ID CDC CASE ID Date Subsample Received in Lab Subsample Comment Date Aliquot Received in Lab Aliquot Comment Additional Aliquot ID Is Subsample Parent CUID

Sheet 5: FEMB FA Template

Package ID CSID CUID Origin
(This field is required)
Test Order Name Suspected Agent Date Sent to CDC At CDC, bring to the attention of: Specimen collected date Specimen collected time Material submitted Specimen source (Type) (Required for Specimens Only) Specimen source site Specimen source site modifier Collection method Treatment of specimen Transport medium/Specimen preservative Specimen handling SPHL Submitter ID SPHL Submitter Institution Name SPHL Submitter Point of Contact Name, Prefix SPHL Submitter Point of Contact Name, Last SPHL Submitter Point of Contact Name, First SPHL Submitter Point of Contact Name, Middle Initial SPHL Submitter Point of Contact Name, Suffix SPHL Submitter Point of Contact Name, Degree SPHL Submitter Point of Contact Phone, Country Code SPHL Submitter Point of Contact Phone, Area Code SPHL Submitter Point of Contact Phone, Local Number SPHL Submitter Point of Contact Phone, Extension SPHL Submitter Point of Contact Email SPHL Submitter Sample ID SPHL Submitter Alternative Sample ID SPHL Submitter Specimen ID SPHL Submitter Alternative Specimen ID Original Submitter ID Original Submitter Lab Director or Designee Name, Prefix Original Submitter Lab Director or Designee Name, Last Original Submitter Lab Director or Designee Name, First Original Submitter Lab Director or Designee Name, Middle Initial Original Submitter Lab Director or Designee Name, Suffix Original Submitter Lab Director or Designee Name, Degree Original Submitter Institution Name Original Submitter Address, Street Address Line 1 Original Submitter Address, Street Address Line 2 Original Submitter Address, City Original Submitter Address, Zip/Postal Code Original Submitter Address, State Original Submitter Address, Country Original Submitter Fax, Country Code Original Submitter Fax, Area Code Original Submitter Fax, Local Number Original Submitter Email Original Submitter Contact ID Original Submitter Point of Contact Name, Prefix Original Submitter Point of Contact Name, Last Original Submitter Point of Contact Name, First Original Submitter Point of Contact Name, Middle Initial Original Submitter Point of Contact Name, Suffix Original Submitter Point of Contact Name, Degree Original Submitter Point of Contact Phone, Country Code Original Submitter Point of Contact Phone, Area Code Original Submitter Point of Contact Phone, Local Number Original Submitter Point of Contact Phone, Extension Original Submitter Point of Contact Email Original Submitter Sample ID Original Submitter Alternative Sample ID Original Submitter Specimen ID Original Submitter Alternative Specimen ID Intermediate Submitter ID Intermediate Submitter Lab Director or Designee Name, Prefix Intermediate Submitter Lab Director or Designee Name, Last Intermediate Submitter Lab Director or Designee Name, First Intermediate Submitter Lab Director or Designee Name, Middle Initial Intermediate Submitter Lab Director or Designee Name, Suffix Intermediate Submitter Lab Director or Designee Name, Degree Intermediate Submitter Institution Name Intermediate Submitter Address, Street Address Line 1 Intermediate Submitter Address, Street Address Line 2 Intermediate Submitter Address, City Intermediate Submitter Address, Zip/Postal Code Intermediate Submitter Address, State Intermediate Submitter Address, Country Intermediate Submitter Fax, Country Code Intermediate Submitter Fax, Area Code Intermediate Submitter Fax, Local Number Intermediate Submitter Email Intermediate Submitter Contact ID Intermediate Submitter Point of Contact Name, Prefix Intermediate Submitter Point of Contact Name, Last Intermediate Submitter Point of Contact Name, First Intermediate Submitter Point of Contact Name, Middle Initial Intermediate Submitter Point of Contact Name, Suffix Intermediate Submitter Point of Contact Name, Degree Intermediate Submitter Point of Contact Phone, Country Code Intermediate Submitter Point of Contact Phone, Area Code Intermediate Submitter Point of Contact Phone, Local Number Intermediate Submitter Point of Contact Phone, Extension Intermediate Submitter Point of Contact Email Intermediate Submitter Sample ID Intermediate Submitter Alternative Sample ID Intermediate Submitter Specimen ID Intermediate Submitter Alternative Specimen ID Brand/Manufacturer Specific Product Name Lot Number Expiration Date Quantity Sample purchased or collected at, Business name Sample purchased or collected at, Street Address Line 1 Sample purchased or collected at, Street Address Line 2 Sample purchased or collected at, City Sample purchased or collected at, Zip/Postal Code Sample purchased or collected at, State Sample purchased or collected at, Country Sample Location, Sample collected at: Sample Location, Latitude Sample Location, Longitude UTM Coordinates, Grid Zone Designator UTM Coordinates, Easting UTM Coordinates, Northing Environmental Temperature Additional Sample Information Previous Laboratory Results Comments Date received at CDC Specimen Received at STAT Date (STAT only) Condition, Outer Package, STAT Laboratory (STAT only) Condition, Specimen container, STAT Laboratory (STAT only) Condition, Specimen, STAT Laboratory (STAT only) Delivered to Unit # CDC Local Aliquot ID Specimen Received in Lab Date (Unit only) Condition, Outer Package, Testing Laboratory (Unit only) Condition, Specimen container, Testing Laboratory (Unit only) Condition, Specimen, Testing Laboratory (Unit only) Additional ID 1 Additional Type 1 Additional ID 2 Additional Type 2 Suspected Agent Category Case Id Date 01 Date 02 Numeric 01 Numeric 02 Decimal 01 Alpha Numeric 01 Alpha Numeric 02 Alpha Numeric 03 Alpha Numeric 04 Alpha Numeric 05 Volume Unit of Measure Container Type Storage Locations - Location Storage Locations - Building Storage Locations - Room Storage Locations - Storage Unit Storage Locations - Shelf Storage Locations - Rack Storage Locations - Box Storage Locations - Absolute Position Storage Locations - Custodian
(User ID)
Storage Locations - Comment CDC EVENT ID Event Name (Only displays for 1 event ID) CDC CASE ID Date Subsample Received in Lab Subsample Comment Date Aliquot Received in Lab Aliquot Comment Additional Aliquot ID Is Subsample Parent CUID

Sheet 6: Global Submitters

Submitter ID Submitter Name ADDRESS 1 Address 2 CITY STATE ZIP COUNTRY EMAIL CONTACTID Contact Type FULLNAME PHONE # FAX EMAIL2 Send to email 1 Send to email 2 Send to email 3







SPHL-000001 MO State Public Health Laboratory 101 north Chestnut P.O. Box 570 Jefferson City Missouri 65101 United States [email protected] 8469 Designee Dr Laura Naught PhD 1-573-751-3334 1-573-526-2754 [email protected] [email protected] NULL NULL







SPHL-000002 ID Bureau of Laboratories 2220 Old Penitentiary Road Boise Idaho 83712-8299 United States [email protected] 8470 Designee Dr Christopher L. Ball PhD 1-208-334-2235 1-208-334-4067 [email protected] [email protected] NULL NULL







SPHL-000003 MT Public Health Laboratory 1400 Broadway Cogswell Building Helena Montana 59601 United States [email protected] 129740 Designee Ms Debbie Gibson MT(ASCP), MPH 1-406-444-3444 1-406-444-1802 [email protected] [email protected] [email protected] NULL







SPHL-000004 OK Public Health Laboratory, Oklahoma State DOH 4615 West Lakeview Road Stillwater Oklahoma 74075 United States [email protected] 242357 Designee Dr Tamar Baruch-Finkel MD 1-405-564-7750 1-405-900-7611 [email protected] [email protected]









SPHL-000005 TN Division of Laboratory Services 630 Hart Lane Nashville Tennessee 37216 United States [email protected] 241922 Designee Dr Kara Levinson PhD, MPH, D(ABMM) 1-615-262-6300 1-615-262-6393 [email protected] [email protected] NULL NULL







SPHL-000006 MS Public Health Laboratory 570 East Woodrow Wilson Thompson Building Jackson Mississippi 39216 United States [email protected] 8478 Designee Dr Daphne Ware PhD 1-601-576-7582 1-601-576-7037 [email protected] [email protected] NULL NULL







SPHL-000007 NM Dept. Health, Scientific Laboratory Division 1101 Camino de Salud NE Albuquerque New Mexico 87102 United States [email protected] 8480 Designee Dr Michael Edwards PhD 1-505-383-9001 1-505-383-9011 [email protected] [email protected] NULL NULL







SPHL-000008 NC State Laboratory of Public Health 4312 District Drive PO Box 28047 Raleigh North Carolina 27611-8047 United States [email protected] 8482 Designee Dr Scott M Shone Ph.D, HCL(ABB) 1-919-733-7834 1-919-733-8695 [email protected] [email protected] NULL NULL







SPHL-000009 IL Dept. of Public Health Springfield Laboratory 825 N. Rutledge St. NULL Springfield Illinois 62702 United States [email protected] 242686 Designee Dr Muhammad Amjad PhD 1-312-793-7213 1-217-524-7924 [email protected] [email protected] NULL NULL







SPHL-000010 UT-Unified State Labs: Public Health Utah DOH 4431 South 2700 West Taylorsville Utah 84129 United States [email protected] 8485 Designee Dr Alessandro Rossi PhD 1-801-965-2400 1-801-536-0473 [email protected] [email protected] NULL NULL







SPHL-000011 IA State Hygienic Laboratory 2490 Crosspark Road Coralville Iowa 52241 United States [email protected] 8487 Designee Dr Wade Aldous PhD. 1-319-335-4500 1-319-335-4555 [email protected] [email protected] NULL NULL







SPHL-000012 AZ SPHL, Arizona Department of Health Services 250 N. 17th Ave Phoenix Arizona 85007 United States [email protected] 8489 Designee Dr Victor G Waddell PhD 1-602-542-1188 1-602-542-0760 [email protected] [email protected] NULL NULL







SPHL-000013 OH Department of Health Laboratory 8995 East Main Street Building 22 Reynoldsburg Ohio 43068 United States [email protected] 8490 Designee Dr Tammy Bannerman PhD 1-614-644-4596 1-614-387-1505 [email protected] [email protected] NULL NULL







SPHL-000014 CO Dept. of Public Health and Environment, Lab Services Division 8100 Lowry Blvd. Denver Colorado 80230 United States [email protected] 8492 Designee Dr Emily Travanty PhD 1-303-692-3090 1-303-691-4911 [email protected] [email protected] NULL NULL







SPHL-000015 DE Public Health Laboratory 30 Sunnyside Road Smyrna Delaware 19977 United States [email protected] 8493 Designee Mr Sergio Huerta 1-302-223-1520 1-302-653-2877 [email protected] [email protected] [email protected] [email protected]







SPHL-000016 SC- South Carolina Department of Health & Environmental Control - Public Health Laboratory 8231 Parklane Rd NULL Columbia South Carolina 29223 United States [email protected] 8494 Designee Dr Nicolas Epie Ph.D,HCLD,TS(ABB),MT(ASCP) 1-803-896-0800 1-803-896-0657 [email protected] [email protected] NULL NULL







SPHL-000017 WY Public Health Laboratory 208 S. College Dr. Cheyenne Wyoming 82002 United States [email protected] 8496 Designee Dr Cari Sloma PhD 1-307-777-7431 1-307-777-6422 [email protected] [email protected] [email protected] [email protected]







SPHL-000018 FL Bur. of Public Health Laboratories-Jacksonville 1217 Pearl Street Jacksonville Florida 32202 United States [email protected] 8498 Designee Ms Susanne Crowe 1-904-791-1550 1-904-791-1567 [email protected] [email protected] [email protected] [email protected]







SPHL-000019 VA-Division of Consolidated Laboratory Services 600 North 5th Street NULL Richmond Virginia 23219 United States [email protected] 8500 Designee Dr Denise L Toney PhD 1-804-648-4480 1-804-225-4070 [email protected] [email protected] NULL NULL







SPHL-000020 MI - Michigan Department of Health and Human Services - Bureau of Laboratories 3350 N. Martin Luther King Jr. BLVD Lansing Michigan 48906 United States [email protected] 8502 Designee Dr Sandip H. Shah Ph.D., HCLD(ABB) 1-517-335-8373 1-517-335-9871 [email protected] [email protected] [email protected] NULL







SPHL-000021 HI Dept. of Health, State Laboratories Division 2725 Waimano Home Road NULL Pearl City Hawaii 96782 United States [email protected] 8504 Designee Dr Edward P Desmond Ph.D, D(ABMM) 1-808-453-6652 1-808-453-6662 [email protected] [email protected] [email protected] [email protected]







SPHL-000022 IN State Department of Health Laboratory Services 550 West 16th Street Suite B Indianapolis Indiana 46202 United States [email protected] 8506 Designee Dr Lixia Liu PhD 1-317-921-5832 1-317-927-7801 [email protected] [email protected] [email protected] [email protected]







SPHL-000023 NYSDOH Wadsworth Center Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8508 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000024 NYSDOH Wadsworth Center, Bacteriology Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8509 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000025 NYSDOH Wadsworth Center, Virology Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8511 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000026 NYSDOH Wadsworth Center, Diag. Immunology Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8513 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000027 NYSDOH Wadsworth Center, Tuberculosis Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8515 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000028 NYSDOH Wadsworth Center, Biodefense Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8517 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000029 NYSDOH Wadsworth Center, Parasitology Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8519 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000030 NYSDOH Wadsworth Center, Mycology Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8521 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000031 NYSDOH Wadsworth Center, Bloodborne Virus Lab Axelrod Institute 120 New Scotland Avenue Albany New York 12208 United States [email protected] 8523 Designee Dr Kimberlee A Musser PhD 1-518-474-4177 1-518-486-7971 [email protected] [email protected] NULL NULL







SPHL-000032 KS Health and Environmental Laboratories 6810 SE Dwight Street NULL Topeka Kansas 66620 United States [email protected] 8525 Designee Mr N. Myron Gunsalus M.S 1-785-296-0801 1-785-296-1641 [email protected] [email protected] [email protected] NULL







SPHL-000033 KY State Public Health Lab 100 Sower Blvd Suite 204 Frankfort Kentucky 40601 United States [email protected] 8527 Designee Dr Vaneet Arora MD/MPH 1-502-564-4446 1-502-564-7019 [email protected] [email protected] [email protected] NULL







SPHL-000034 MN PHL Division, Minnesota Department of Health 601 Robert St. N. St. Paul Minnesota 55164-0899 United States [email protected] 8529 Designee Dr Sara Vetter PhD 1-651-201-5200 1-651-201-5070 [email protected] [email protected] NULL NULL







SPHL-000035 AR Dept. of Health-Public Health Lab 201 S. Monroe Little Rock Arkansas 72205 United States [email protected] 8530 Designee Dr Katie Seely PhD 1-501-661-2490 1-501-280-4050 [email protected] [email protected] [email protected] NULL







SPHL-000036 AR Dept. of Health-Pub. Health Lab, Immunology Lab 201 S. Monroe Little Rock Arkansas 72205 United States [email protected] 8531 Designee Dr Katie Seely PhD 1-501-661-2490 1-501-280-4050 [email protected] [email protected] [email protected] NULL







SPHL-000037 AR Dept. of Health-PHL, Clinical Micro Lab 201 S. Monroe Little Rock Arkansas 72205 United States [email protected] 8533 Designee Dr Katie Seely PhD 1-501-661-2538 1-501-661-2863 [email protected] [email protected] [email protected] NULL







SPHL-000038 AR Dept. of Health-PHL, TB/Mycology Lab 201 S. Monroe Little Rock Arkansas 72205 United States [email protected] 8535 Designee Dr Katie Seely PhD 1-501-661-2448 1-501-671-1811 [email protected] [email protected] [email protected] NULL







SPHL-000039 AR Dept. of Health-PHL, Molecular Diagnostics 201 S. Monroe Little Rock Arkansas 72205 United States [email protected] 8537 Designee Dr Katie Seely PhD 1-501-661-2490 1-501-661-2270 [email protected] [email protected] [email protected] NULL







SPHL-000040 AR Dept. of Health-PHL/Chemical Terrorism 201 S. Monroe Little Rock Arkansas 72205 United States [email protected] 8539 Designee Dr Katie Seely PhD 1-501-940-3208 1-501-661-2972 [email protected] [email protected] [email protected] NULL







SPHL-000041 SD Public Health Laboratory 615 East Fourth Street NULL Pierre South Dakota 57501 United States [email protected] 8541 Designee Dr Tim Southern 1-605-773-3368 1-605-773-8201 [email protected] [email protected] NULL NULL







SPHL-000042 NH Dept. of Health and Human Services Public Health Labs 29 Hazen Drive Concord New Hampshire 03301-6504 United States [email protected] 8542 Designee Dr Christine Bean PhD 1-603-271-4657 1-603-271-4760 [email protected] [email protected] NULL NULL







SPHL-000043 NJ Public Health and Environmental Laboratories 3 Schwarzkopf Drive Ewing New Jersey 08628 United States [email protected] 8544 Designee Dr Thomas Kirn MD, PhD 1-609-406-6860 1-609-530-8410 [email protected] [email protected] [email protected] NULL







SPHL-000044 NYC Department of Health and Mental Hygiene Public Health Laboratory 455 First Avenue New York New York 10016 United States [email protected] 241362 Designee Dr Scott Hughes PhD 1-212-447-2578 1-212-447-2587 [email protected] [email protected] [email protected] [email protected]







SPHL-000045 MA State Public Health Laboratory 305 South Street NULL Jamaica Plain Massachusetts 02130 United States [email protected] 8547 Designee Dr Sandra Smole PhD. 1-617-983-6200 1-617-983-6211 [email protected] [email protected] [email protected] [email protected]







SPHL-000046 ME Health and Environmental Testing Laboratory 221 State Street House Station 12 Augusta Maine 04333 United States [email protected] 241425 Designee Dr Daniel Jones MD 1-207-287-2727 1-207-287-6832 [email protected] [email protected] [email protected] [email protected]







SPHL-000047 AK State Public Health Lab, State Health Department 5455 Dr. Martin Luther King Jr Avenue Anchorage Alaska 99507 United States [email protected] 8550 Designee Jayme Parker PhD 1-907-334-2109 1-907-334-2161 [email protected] [email protected] [email protected] [email protected]







SPHL-000048 CDPH, Viral and Rickettsial Disease Laboratory 850 Marina Bay Parkway Rm. E-361 Richmond California 94804 United States [email protected] 241186 Designee Dr Debra Wadford PhD 1-510-307-8585 1-510-307-8599 [email protected] [email protected] NULL NULL







SPHL-000049 PR Public Health Lab Periferal St. Bldg. A, 2nd Fl. Call Box 70184 San Juan Puerto Rico 00936 United States [email protected] 8552 Designee Lcdo Rafael L Gonzalez Pena BS, MT 1-787-765-2929 1-787-274-7708 [email protected] [email protected] [email protected] [email protected]







SPHL-000050 RI State Health Laboratories 50 Orms Street NULL Providence Rhode Island 02904 United States [email protected] 242487 Designee Dr Glen Gallagher Ph.D. 1-401-222-5600 1-401-222-4572 [email protected] [email protected] [email protected] [email protected]







SPHL-000051 AL Dept. of Public Health Bureau of Clinical Laboratories P. O. Box 1000 204 Legends Court Prattville Alabama 36067-9901 United States [email protected] 8556 Designee Dr Sharon P. Massingale PhD 1-334-260-3400 1-334-285-6642 [email protected] [email protected] NULL NULL







SPHL-000052 DC Public Health Lab/ Dept. of Forensic Sciences 401 E Street SW 4th Floor Washington District of Columbia 20024 United States [email protected] 241814 Designee Dr Jocelyn R Hauser PhD 1-202-727-6929 1-202-724-3927 [email protected] [email protected] [email protected] [email protected]







SPHL-000053 CDPH, Microbial Diseases Laboratory 850 Marina Bay Parkway MS E-164 Richmond California 94804 United States [email protected] 241189 Designee Dr Zenda Berrada PhD 1-510-412-3700 1-510-412-3706 [email protected] [email protected] NULL NULL







SPHL-000054 ND Dept. of Health Laboratory Services-Microbiology 2635 East Main Ave PO Box 5520 Bismarck North Dakota 58506 United States [email protected] 8559 Designee Dr Christie Massen PhD 1-701-328-6288 1-701-328-6280 [email protected] [email protected] NULL NULL







SPHL-000055 CT-Dr. Katherine A. Kelley State Public Health Lab 395 West Street PO Box 1689 Rocky Hill Connecticut 06067 United States [email protected] 63648 Designee Dr Jafar L Razeq PhD 1-860-920-6500 1-860-920-6718 [email protected] [email protected] [email protected] NULL







SPHL-000056 LA Office of Public Health Laboratories 1209 Leesville Avenue NULL Baton Rouge Louisiana 70802 United States [email protected] 8563 Designee Dr Beverly Ogden MD 1-225-219-5235 1-225-219-4903 [email protected] [email protected] [email protected] [email protected]







SPHL-000057 VT Dept. of Health Laboratory 359 South Park Drive NULL Colchester Vermont 05446 United States [email protected] 8564 Designee Ms Helen Reid MPH 1-802-338-4740 1-802-338-4706 [email protected] [email protected] NULL NULL







SPHL-000058 NE Public Health Laboratory University of Nebraska Medical Center 985900 Nebraska Medical Center Omaha Nebraska 68198-5900 United States [email protected] 8566 Designee Dr Peter Iwen PhD 1-402-559-9444 1-402-559-7838 [email protected] [email protected] [email protected] NULL







SPHL-000059 WI State Laboratory of Hygiene 2601 Agriculture Drive Madison Wisconsin 53718 United States [email protected] 8568 Designee Dr James D Schauer PhD 1-800-862-1013 1-844-390-6233 [email protected] [email protected] NULL NULL







SPHL-000060 MD DOH Laboratories Administration 1770 Ashland Avenue NULL Baltimore Maryland 21205 United States [email protected] 8569 Designee Dr Robert A. Myers PhD 1-443-681-3800 1-443-681-4501 [email protected] [email protected] [email protected] NULL







SPHL-000061 WVDHHR - Office of Laboratory Services 167 11th Avenue South Charleston West Virginia 25303 United States [email protected] 40976 Designee Ms Christi D Clark MPH, M(ASCP)CM 1-304-558-3530 1-304-558-2006 [email protected] [email protected] [email protected] [email protected]







SPHL-000062 GA Department of Public Health Laboratory 1749 Clairmont Road NULL Decatur Georgia 30033-4050 United States [email protected] 242992 Designee Dr Tonia Parrott Ph.D., HCLD 1-404-327-7900 1-404-327-7919 [email protected] [email protected] NULL NULL







SPHL-000063 OR State PHL-Virology/Immunology Section PO Box 275 Portland Oregon 97207-0275 United States [email protected] 155971 Designee Dr Jon Fontana 1-503-693-4100 1-503-693-5604 [email protected] [email protected] NULL NULL







SPHL-000064 OR State PHL-General Microbiology Section 7202 NE Evergreen Parkway Suite 100 Hillsboro Oregon 97124 United States [email protected] 155970 Designee Dr John Fontana 1-503-693-4100 1-503-693-5604 [email protected] [email protected] NULL NULL







SPHL-000065 TX DSHS, Lab Services Section MC 1947 1100 W. 49th Street P.O. Box 149347 Austin Texas 78714-9347 United States [email protected] 8577 Designee Dr Grace Kubin Ph.D. 1-512-776-7318 1-512-776-7294 [email protected] [email protected]









SPHL-000066 PA Department of Health, Bureau of Laboratories 110 Pickering Way P.O. Box 500 Exton Pennsylvania 19341-1310 United States [email protected] 8578 Designee Dr Dongxiang Xia MD 1-610-280-3464 1-610-450-1932 [email protected] [email protected] NULL NULL







SPHL-000067 NV State Public Health Laboratory 1660 N. Virginia St. MS0385 Reno Nevada 89503 United States [email protected] 8580 Designee Dr Mark W Pandori PhD, HCLD(ABB) 1-775-682-6205 1-775-327-2155 [email protected] [email protected] [email protected] NULL







SPHL-000068 WA State Department of Health 1610 NE 150th Street Shoreline Washington 98155-9701 United States [email protected] 8582 Designee Dr Romesh Gautom PhD 1-206-418-5458 1-206-364-0339 [email protected] [email protected] NULL NULL







SPHL-000069 FL Bureau of Public Health Laboratories-Tampa 3602 Spectrum Blvd Tampa Florida 33612 United States [email protected] 8742 Designee Dr Andrew C Cannons Ph.D., HCLD(ABB) 1-813-974-4002 1-813-233-2379 [email protected] [email protected] NULL NULL







SPHL-000071 NV-Southern Nevada Public Health Laboratory 700 Martin Luther King Jr. Blvd. Las Vegas Nevada 89106 United States [email protected] 241244 Designee Dr Horng-Yuan Kan PhD, HCLD(ABB) 1-702-759-1020 1-702-759-1444 [email protected] [email protected]
NULL







SPHL-000072 NV-Southern Nevada Health Dist. Office of Epidemiology 600 Shadow Lane Suite 206 Las Vegas Nevada 89106 United States [email protected] 8766 Designee Dr John Middaugh PhD 1-702-759-1300 1-702-759-1470 [email protected] NULL NULL NULL







SPHL-000073 CDC Occupational Health Clinic 1600 Clifton Rd Building 16, Room 1105, Mailstop A-29 Atlanta Georgia 30329 United States [email protected] 8768 Designee Dr Leah Gilbert MD 1-404-639-3385 1-404-639-3166 [email protected] [email protected]









SPHL-000074 DC -Bureau of Medical Services , US Dept. of State 2401 E. St. NW (SA-1) Rm L219 Washington District of Columbia 20522 United States [email protected] 8828 Designee Ms Carolyn Mermon MA,MLS(ASCP) 1-202-663-1735 1-202-663-1736 [email protected] [email protected] [email protected] NULL







SPHL-000075 NIH Clinical Center, Dept. of Laboratory Medicine 9000 Rockville Pike, Bldg. 10, Room 2C306 Bldg. 10, Room 2C306 Bethesda Maryland 20892 United States [email protected] 8830 Designee Dr Karen Frank M.D., Ph.D., D(ABMM), 1-301-402-0317 1-301-402-1886 [email protected] [email protected] [email protected] NULL







SPHL-000076 CAN-The Toronto Hospital, Tropical Disease Unit 200 Elizabeth St. 13NU rm. 1350 Toronto NULL M5G 2C4 Canada [email protected] 8832 Designee Dr Andrea Boggild MD 1-416-340-3675 1-416-340-3260 [email protected] NULL NULL NULL







SPHL-000077 CAN-British Columbia PH Microbiology and Ref. Laboratory Zoonotic Diseases & Emerging Pathogens Program 655 West 12th Avenue Vancouver NULL V5Z 4R4 Canada [email protected] 8834 Designee Dr Muhammad Morshed PhD 1-604-707-2628 1-604-707-2602 [email protected] [email protected] [email protected] [email protected]







SPHL-000078 CAN-Natl Reference Centre for Parasitology (NRCP) 1001 Decarie Blvd. RM EM3-3244 Montreal NULL H4A 3J1 Canada [email protected] 8884 Designee Dr Ndao Momar DVM, PhD 1-514-934-1934 1-514-934-8347 [email protected] NULL NULL NULL







SPHL-000079 CA-Santa Clara County Public Health Laboratory 2220 Moorpark Avenue 2nd floor San Jose California 95128 United States [email protected] 8956 Designee Dr Brandon J Bonin DrPH 1-408-885-4272 1-408-885-4275 [email protected] [email protected] [email protected] NULL







SPHL-000080 AUS-Centre for ID and Microbiology Lab Services Level 3, ICPMR, Institute Road, Westmead Hospital Westmead NULL 2145 Australia [email protected] 8958 Designee Dr Rogan Lee 61-2-98456255 61-2-98938659 [email protected] [email protected] NULL NULL







SPHL-000081 DC-The Parasitology Laboratory of Washington 2141 K St NW Suite 408 Washington District of Columbia 20037 United States [email protected] 8960 Designee Dr Martin S Wolfe MD. 1-202-466-8109 1-202-331-0290 [email protected] NULL NULL NULL







SPHL-000082 OH-Cincinnati Childrens Hospital Medical Center 3333 Burnet Ave. 3333 Burnet Ave. Cincinnati Ohio 45229 United States [email protected] 9050 Designee Dr Paul Steele 1-513-636-3061 1-513-636-8850 [email protected] [email protected] NULL NULL







SPHL-000083 MA-Tufts Medical Center, Send-out Department 800 Washington Street Boston Massachusetts 02111 United States [email protected] 9052 Designee James Roger 1-617-636-7205 1-617-636-8113 [email protected] NULL NULL NULL







SPHL-000084 FL Bureau of Public Health Laboratories-Miami 1325 NW 14th Avenue Miami Florida 33125 United States [email protected] 9087 Designee Dr Stephen White PhD 1-305-324-2432 1-305-325-2560 [email protected] [email protected] [email protected] [email protected]







SPHL-000087 IL Department of Public Health Chicago Laboratory 2121 West Taylor 2nd floor Chicago Illinois 60612 United States [email protected] 242692 Designee Dr Kamalijit Singh M.D., D(ABMM), ABPath 1-312-793-4760 1-312-793-0426 [email protected] [email protected] [email protected] [email protected]







SPHL-000088 IL Dept. of Public Health Carbondale Laboratory 1155 S. Oakland Ave PO Box 2797 Carbondale Illinois 62902-2797 United States [email protected] 242694 Designee Dr Muhammad Amjad PhD 1-618-457-5131 1-618-457-6995 [email protected] [email protected] NULL NULL







SPHL-000089 CAN-British Columbia PH Micro and Ref. Lab, PHSA, Parasitology Sec (Room 4029) 655 West 12th Avenue Vancouver NULL V5Z 4R4 Canada [email protected] 9185 Designee Dr Muhammad Morshed PhD 1-604-707-2629 1-604-707-2654 [email protected] [email protected] [email protected] [email protected]







SPHL-000090 DNK-Tech. University of Denmark, Natl Food Institute Kemitorvet Bldg. 204ST DK-2800 Lyngby NULL Denmark [email protected] 9216 Designee Dr Frank Aarestrup PhD 45-35-88 62 88 - - [email protected] NULL NULL NULL







SPHL-000092 NY-Jacobi Med. Ctr.-Parasitic and Trop. Disease Lab 1400 Pelham Parkway Bldg. # 1, 5 floor, Rm 5NW-9 South Bronx New York 10461 United States [email protected] 9275 Designee Dr Stephen Apfelroth MD, PhD. 1-718-918-4455 1-718-918-7908 [email protected] NULL NULL NULL







SPHL-000095 TTO-The Caribbean Public Health Agency (CARPHA) 16-18 Jamaica Blvd NULL St. Clair NULL NULL Trinidad and Tobago [email protected] 9390 Designee Dr Gabriel M Gonzalez-Escobar MD 1-868-622 4261 1-868-628 9302 [email protected] [email protected] [email protected] [email protected]







SPHL-000096 TX-Houston Health Department Laboratory 2250 Holcombe Blvd NULL Houston Texas 77030 United States [email protected] 9501 Designee Dr Larry Seigler Ph.D.,DABCC 1-832-393-3956 1-832-393-3992 [email protected] NULL [email protected] [email protected]







SPHL-000097 FDA-Northeast Regional Laboratory, U.S. FDA 158-15 Liberty Avenue Jamaica New York 11433-1034 United States [email protected] 9502 Designee Dr Michael Palmieri 1-718-662-5450 1-718-662-5439 [email protected] [email protected] NULL NULL







SPHL-000100 IA-Natl Ctrs. for Animal Hlth, Nat. Vet Svcs. Lab Diagnostic Bacteriology Laboratory 1920 Dayton Ave Ames Iowa 50010 United States [email protected] 242977 Designee Dr Suelee Robbe-Austerman DVM, PhD 1-515-337-7565 1-515-337-7569 [email protected] NULL NULL NULL







SPHL-000121 HTI-Laboratoire National de Sante Publique Delmas 33 et Rue Charbonnier No 2 NULL Port au Prince NULL NULL Haiti [email protected] 10049 Designee Dr Jacques Boncy MD 509-3-701 8692 -- [email protected] [email protected] [email protected] NULL







SPHL-000124 FDA-Natl Center for Toxicological Research 3900 NCTR Road Jefferson Arkansas 72079 United States [email protected] 10383 Designee Dr Ashraf Kahn PhD 1-870-543-7601 1-870-543-7307 [email protected] [email protected]







SPHL-000126 FRA-Institut Pasteur, Enteric Bacterial Pathogens Unit 28 Rue du Docteur Roux cedex 15 Paris NULL 75724 France [email protected] 10524 Designee Dr Francois-Xavier Weill MD, PhD 33-1-45-68-80-37 33-1-40-61-31-37 [email protected] [email protected]







SPHL-000127 CAP-College of American Pathologists PT Survey Program 325 Waukegan Road Northfield Illinois 60093 United States [email protected] 300010704 Designee David Lonsway 1-800-323-4040 -- [email protected] NULL NULL NULL







SPHL-000128 WHO/NICD, External Quality Assessment Reference Unit Private Bag X4 NULL Sandringham NULL 2131 South Africa [email protected] 42163 Designee Dr Olga Perovic 27-0-11 555 0344 27-0-11 555 0430 [email protected] [email protected] [email protected] NULL







SPHL-000129 USDA ARS WRRC, Produce Safety and MicroBio Research 800 Buchanan Street NULL Albany California 94710 United States [email protected] 42167 Designee Dr Lisa Gorsky PhD 1-510-559-5986 1-510-559-6162 [email protected] [email protected] [email protected] NULL







SPHL-000130 CDPH-Vector-Borne Disease Section 850 Marina Bay Parkway MS E-164 Richmond California 94804 United States [email protected] 42173 Designee Dr Kerry Padgett 1-510-412-6252 1-510-412-3706 [email protected] [email protected] NULL NULL







SPHL-000131 TX DSHS, Zoonosis Control Branch 1100 W. 49th Street MC-1956 Austin Texas 78756 United States [email protected] 42177 Designee Ms Bonny Mayes MA, RYT 1-512-776-6545 1-512-776-7454 [email protected] [email protected] [email protected] [email protected]







SPHL-000132 CDPH-Vector-Borne Disease Section - Ontario 2151 Convention Center Way Suite 218B Ontario California 91764 United States [email protected] 42187 Designee Dr Marco Metzger PhD 1-909-937-3448 1-909-937-3456 [email protected] [email protected] [email protected] NULL







SPHL-000133 AR Dept. of Health-PHL, Zoonotic Disease Section 201 S. Monroe NULL Little Rock Arkansas 72205 United States [email protected] 46426 Designee Dr Katie Seely PhD 1-870-405-0707 1-501-280-4431 [email protected] [email protected] [email protected] NULL







SPHL-000134 USDA/FSIS/OPHS/EL/MCB 950 College Station Rd NULL Athens Georgia 30605 United States [email protected] 53611 Designee Dr Glenn Tillman PhD 1-706-546-2428 1-706-546-3144 [email protected] [email protected] NULL NULL







SPHL-000135 ETH-Public Health Institute/Virology Research Team Arbegnoch Street P.O.Box 1242 Addis Ababa NULL NULL Ethiopia [email protected] 60916 Designee Ms Beyene Berhane BSc,MBA 252-911-214969 251-211-754744 [email protected] [email protected] [email protected] [email protected]







SPHL-000136 CAN-PH Agency of Canada, National Microbiology Lab 1015 Arlington St. H1590 NULL Winnipeg Manitoba R3E 3R2 Canada [email protected] 75796 Designee Dr Celine Nadon PhD 1-202-784-7507 1-202-789-5012 [email protected] [email protected] [email protected] NULL







SPHL-000137 VI-US Virgin Islands Department of Health 3500 Estate Richmond NULL Christiansted Virgin Islands of the U.S. 00820 United States [email protected] 120036 Designee Dr Brett Ellis PhD 1-340-718-1311 1-340-718-1508 [email protected] [email protected] [email protected] [email protected]







SPHL-000138 CO-United States Olympic Committee 1 Olympic Plaza NULL Colorado Springs Colorado 80909 United States [email protected] 145553 Designee William J Moreau 719-306-5588 719-866-4093 [email protected] [email protected] [email protected] [email protected]







SPHL-000139 PER-NAMRU-6 Venezuela Avenue, Bellavista Callao NULL Callao NULL 051 Peru [email protected] 156981 Designee Dr Jimena Rivera PhD 051--6144414 051--6144174 [email protected] NULL NULL NULL







SPHL-000140 CA-Los Angeles County Public Health Laboratory 12750 Erickson Ave NULL Downey California 90242 United States [email protected] 196009 Designee Dr Nicole Green PhD 1-562-658-1488 -- [email protected] [email protected] [email protected] NULL







SPHL-000141 FDA-Arkansas Regional Laboratory-Denver Analyst Denver Federal Center, Building 20 NULL Denver Colorado 80225 United States [email protected] 196011 Designee Dr Michael Wichman PhD 1-303-236-9675 -- [email protected] [email protected] NULL NULL







SPHL-000142 TX Brooke Army Medical Center 3951 Roger Brooke Dr. NULL San Antonio Texas 78234 United States [email protected] 200453 Designee Dr Edward Ager 1-210-916-1817 1-210-916-5696 [email protected] [email protected] NULL NULL







SPHL-000143 CAN-Cadham Provincial Lab P.O.BOX 8450 750 William Ave. Winnipeg Manitoba R3C 3Y1 Canada [email protected] 200455 Designee Dr Kamran Kadkhoda 1-204-945-7545 1-204-786-4770 [email protected] [email protected] NULL NULL







SPHL-000146 OH-Wright-Patterson AFB USAFSAM/PHE Epi Lab Service, Bldg. 20840, Rm. W308E 2510 Fifth Street Dayton Ohio 45433-7913 United States [email protected] 200463 Designee Dr Elizabeth Macias 1-937-938-3175 -- [email protected] [email protected] NULL NULL







SPHL-000147 COL-Instituto Nacional de Salud Avenida calle 26 #51-20 Zona 6 CAN NULL Bogotá
111321 Colombia [email protected] 201964 Designee Carolina Duarte Valderrama 57-1-220 7700 -- [email protected] NULL NULL NULL







SPHL-000148 CA-Veterans Affairs Palo Alto Healthcare System 3801 Miranda Ave Bldg MB4 Room 416 Palo Alto California 94304 United States [email protected] 300042372 Designee Mark Holodniy MD 1-650-493-5000 -- [email protected] [email protected] NULL NULL







SPHL-000149 CAN-Public Health Agency of Canada, Zoonotic and Special Pathogens Division 1015 Arlington St. H1590 NULL Winnipeg Manitoba R3E 3R2 Canada [email protected] 203968 Designee Ms Dimitrova Kristina 1-204-789-2106 -- [email protected] [email protected] NULL NULL







SPHL-000150 NGA-Nigeria Centre For Disease Control Plot 801, Ebitu Ukiwe Street, Jabi NULL Abuja
NULL Nigeria [email protected] 205916 Designee Dr Chikwe Ihekweazu PhD 234-803-355-9994 -- [email protected] [email protected] NULL NULL







SPHL-000151 CSTOR Public Health Lab 2220 Old Penitentiary Road NULL Boise Idaho 83712-8299 United States [email protected] 209187 Designee Vidya Ramachandra 1-208-334-2235 1-208-334-4067 [email protected] [email protected] [email protected] NULL







SPHL-000152 DC - Peace Corps Headquarters 1275 First Street NE NULL Washington District of Columbia 20526 United States [email protected] 241507 Designee Dr Prachi Ranade MD 1-202-692-2082 1-202-692-1501 [email protected] [email protected] [email protected] NULL







SPHL-000154 OH - Wright Patterson AFB HIV CLIA Activity USAFSAM/PHE Epi Lab Service 2510 Fifth St. Bldg. 20840 Dayton Ohio 45433-7951 United States [email protected] 300000799 Designee Ms. Jennifer Voehringer MT(ASCP) 1-937-938-3227 -- [email protected] [email protected] NULL NULL







SPHL-000156 University of Minnesota 420 Delaware Street SE 1260 Mayo Building Minneapolis Minnesota 55454-1075 United States [email protected] 300000976 Designee Dr Claudia Munoz-Zani PhD 1-612-625-3182 1-612-624-3229 [email protected] [email protected] [email protected] NULL







SPHL-000157 PR- Biological and Chemical Emergencies Laboratory Office of Public Health Preparedness and Response 1334 Calle Canada Bosque San Patricio San Juan Puerto Rico 00920 United States [email protected] 300010706 Designee Marangely Olivero 1-787-765-2929 -- [email protected] [email protected] [email protected] NULL







SPHL-000159 GU - Guam Public Health Laboratory 761 S. Marine Corps Drive RanCare Bldg.,3rd floor, West Wing Tamuning Guam 96913 United States [email protected] 240098 Designee Mrs Anne Marie G Santos BS. MT 1-671-300-9085 1-671-300-9989 [email protected] [email protected] [email protected] [email protected]







SPHL-000160 MP - Commonwealth Health Center 1 Lower Navy Hill Road P.O. Box 500409 Saipan Northern Mariana Islands 96950 United States [email protected] 240100 Designee Dr Philip A Dauternan MD 1-670-236-8395 1-670-236-8612 [email protected] [email protected] [email protected] NULL







SPHL-000161 FDA-Occupational Health Services 10903 New Hampshire Ave NULL Silver Spring Maryland 20993 United States [email protected] 241589 Designee Dr Sacha Gutierrez MD, MS, FACOEM 1-301-796-2331 -- [email protected] [email protected] [email protected] [email protected]







SPHL-000162 WA Madigan Army Medical Center 9040 Jackson Avenue Department of Pathology Tacoma Washington 98406 United States [email protected] 242425 Designee Dr Benjamin Rosen MD 1-253-968-1751 1-253-968-3152 [email protected] [email protected] [email protected] [email protected]







SPHL-000163 JAM - National Public Health Laboratory 21 Slipe Pen Road NULL Kingston
NULL Jamaica [email protected] 242925 Designee Hillary Mitchell 1-876-317-8202 -- [email protected] NULL NULL NULL







SPHL-000164 NIH - Occupational Medical Services Clinic 10 Center Drive Clinical Center Bldg.10, Rm.6C306 Bethesda Maryland 20892 United States [email protected] 243090 Designee Heike Bailin MD 1-301-496-4411 1-301-402-0673 [email protected] [email protected] [email protected] [email protected]








Sheet 7: FastLookup

Test Order Name Suspected Agent Clinical Diagnosis Material Submitted Specimen Source Type Human/Animal Specimen Source Type FEMB Specimen Source Modifier Specimen Source Site Specimen Source site modifier Collection Method Human/Animal Collection Method FEMB Treatment of Specimen Transport Medium Treatment CDC User: This Field is for the Animal Tab Common Name Animal/Arthropod Common Name CDC User: This field is for the Animal Tab Scientific Name Animal/Arthropod Scientific Name Animal Common Name Animal Scientific Name Arthropod Common Name Arthropod Scientific Name Immunization - Human Immunization - Animal Conditions Additional Type Private Submitter ID Storage Locations - Room Storage Locations - Storage Unit Storage Locations - Shelf Storage Locations - Rack Storage Locations - Box Event ID Event Name
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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