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This manual was developed to assist the users of the Michigan Department of Health and Human Services (MDHHS) Bureau of Laboratories (BOL) in the proper collection and submission of specimens for testing and in the interpretation of results. The format was chosen for ease of use and for ease of updating. As tests are modified, deleted, or added, information is updated. This guide is intended to be used by all submitters of specimens including, but not limited to, Michigan physicians, licensed laboratories, health care facilities, local health departments, veterinarians, animal control officers and law enforcement officers.
I. Specimen Submission Guidelines
III. Reporting Results
V. Suggestions
VI. Specimen Collection and Shipping Containers
I. Specimen Submission Guidelines
Any Michigan local health department, licensed physician's office, licensed laboratory, or licensed health care facility may submit specimens for testing. Animal heads may be submitted for rabies testing by veterinarians, animal control officers, law enforcement agencies, etc.
The MDHHS BOL provides collection supplies for a portion of the tests that it performs and packaging/shipping supplies for the majority of testing. The Data and Specimen Handling (DASH) Central Receiving Warehouse disseminates these supplies. A list of available collection and shipping kits can be found on the Clinical Specimen Collection and Shipping Containers page. Supplies can be requested by creating an account in the Laboratory Kit Order Tracking System (LKOTS) or by filling out the Specimen Shipping Units Requisition form (DCH-0568) and submitting via email to MDHHSLab@michigan.gov.
Guidelines for Collection
*Please refer to Specimen Collection and Shipping Instructions for specific test instructions.
Techniques used for the collection and submission of the specimens influence the outcome of testing results as the accuracy and clinical usefulness of all laboratory analyses are limited by the submitted specimen. The quality of the specimen is not under the control of the laboratory, it is the responsibility of the submitter.
1. Use containers and mailing units provided by the MDHHS BOL for the collection and transport of specimens.
2. The specimen must be properly identified using two unique identifiers. The patient's first and last name, along with a second identifier (hospital number or another unique identifier) must be clearly written on the specimen container. The appropriate test request form must accompany the specimen. The patient identification on the specimen must match exactly the identifier on the test request form. Unlabeled or mislabeled specimens will not be tested.
3. If the patient (or a family member) is to collect the specimen, it may be necessary to write the patient's name on the container prior to providing the container. Please instruct the patient on the proper specimen collection method.
4. Specimens must be submitted in the appropriate transport container. Do not submit cultures in petri plates as they are easily broken.
Electronic Test Orders and Reporting (ETOR)
ETOR Manual
In January 2014, the MDHHS BOL instituted a web portal for electronic test ordering and results delivery. ETOR is an alternate, voluntary method for clients to order laboratory tests and receive test results. Participating clients log into the web portal and electronically fill out their test request forms, print packing lists to be submitted with the sample to the MDHHS BOL for testing, track samples through the MDHHS BOL, and look up, download, or print pdf copies of final reports. Clients selecting this option no longer have to hand write or submit test request forms. This information is collected in the web portal and imported into the MDHHS BOL Laboratory Information Management System (LIMS) upon arrival of the specimen. Access to the ETOR web portal is through a State of Michigan MILogin account. Complete instructions can be found in the ETOR manual, linked above.
Guidelines for Shipping
1. Specimens must be properly packaged while in transit to the laboratory. To ensure the quality of the laboratory test results, sometimes it is critical that specimens are frozen, kept cool, or placed in a fixative prior to their arrival at the laboratory. If indicated, use an ice pack to keep specimens cold. Do not use wet ice. Wet ice will melt and may leak, compromising the integrity of the specimen.
2. Refer to Specimen Collection and Shipping Instructions for instructions on how to properly package specimens.
3. Specimens must be delivered to the laboratory in a timely manner. Delays in transit may render the specimen unsuitable for testing. Mail or ship specimens as early as possible after collection and avoid shipping across a weekend or holiday.
4. Specimens must not arrive at the laboratory in a condition which poses a hazard to laboratory staff. Leaking specimens will not be tested.
5. Please contact the MDHHS BOL at MDHHSLab@michigan.gov prior to submitting a large number of specimens.
6. All packages containing biological specimens and/or infectious agents must conform to regulations for the transporting of specimens of this type. These regulations are subject to change!
Federal Postal Regulations
United Parcel Service
Federal Express
Specimens for the Centers for Disease Control and Prevention (CDC)
Additional tests for diseases of public health importance are offered by the U.S. Public Health Service, Centers for Disease Control and Prevention. CDC accepts specimens and cultures under the following circumstances:
1. From an outbreak.
2. From an uncommon or exotic disease.
3. An isolate which cannot be identified, is atypical, shows multiple antibiotic resistance, or from a normally sterile site.
4. From a disease for which reliable diagnostic reagents or expertise are unavailable at this laboratory.
5. With select MDHHS epidemiologist approval.
All specimens to be sent to the CDC must be accompanied by a CDC specimen submission form (CDC 50.34) and routed through the MDHHS BOL, unless otherwise advised. A link to the CDC specimen submission form can be found in the Test Request Forms section of the MDHHS BOL website. The MDHHS BOL will assign tracking to the specimens.
If specimens or etiologic agents submitted to the MDHHS BOL require further studies at the CDC for any of the above listed reasons, a request will be sent to the submitter asking that a CDC specimen submission form be completed. Please respond in a timely fashion because the specimen or etiologic agent cannot be forwarded to CDC without a completed form.
For more information on submitting specimens and for a complete list of tests performed at the CDC, visit the CDC website. For additional guidance, please contact your local epidemiologist or the MDHHS BOL. There is no charge for testing performed at CDC.
1. If a specimen is received without a completed test requisition form, testing will not be performed, and the submitter will be contacted.
2. Specimens of any type will be subject to rejection if they:
a. Are of insufficient quantity.
b. Are of insufficient quality.
c. Are received past the acceptable time after collection for the type of examination requested.
d. Are received unlabeled or information on the specimen label does not match the requisition form.
e. Are submitted in an inappropriate manner, i.e., are not shipped according to the applicable regulations.
f. Are leaking. Every attempt will be made to salvage leaking or improperly submitted samples of cerebrospinal fluid, biopsy tissues, aspirates, and other specimens attained through surgical means providing that the safety of the laboratory worker is not compromised.
g. Are sent in incorrect or expired media.
3. Serum specimens will be rejected if they are in glass tubes.
4. Specimens for culture will be rejected if:
a. They are submitted in an improper transport medium (i.e., transport medium that could compromise results).
b. They are not received within a time frame optimal for the organisms for which isolation is being attempted.
c. They are submitted in petri plates.
d. If culture is from a priority specimen or is a suspect bioterrorism agent, please call Kim McCullor (517-335-9641) or Jason Wholehan (517-335-9653) for consult and guidance.
5. The reporting of cultures submitted for identification, but which are not pure isolates, will be delayed and may not be attempted.
III. Reporting Results
The MDHHS BOL will make every effort to process and test specimens as quickly as possible. Turnaround time is an important indicator of our Quality Assurance program. The respective turnaround times (analytic time) are listed for each procedure in the Laboratory Services Guide A-Z Test Listing.
To improve the time to receive results, the MDHHS BOL offers the option of receiving laboratory reports by fax transmission. Fax reporting will provide a 24-72 hour improvement in result receipt by avoiding the additional time required by using a mail carrier service. If you are interested in converting your agency to an automatic fax transmission agency, please contact Matthew Bashore (517-335-8373), Adam Silverman (517-335-4725) or MDHHSLab@michigan.gov and see the instructions below:
Automatic Fax Agency Instructions and Statement of Understanding
The Bureau of Laboratories also provides a web portal for Electronic Test Ordering and Results (ETOR) Delivery. See Electronic Test Orders and Reporting (ETOR) information in the Specimen Submission Guidelines section above.
Reporting for all non-clinical testing performed at the MDHHS BOL is available through encrypted electronic mail. If you are interested in receiving non-clinical specimen reports via email, please see the instructions below:
Automatic Email Agency Instructions and Statement of Understanding (for non-clinical specimens only)
If you have any questions concerning turnaround time or reporting in general, call the Data and Specimen Handling Unit (517-335-8059). Before you call for results, please consider transit time for the specimen and turnaround time for testing. Some test procedures are batched and run on specific days of the week. Please refer to the appropriate test information in the Laboratory Services Guide A-Z Test Listing to determine if this is the case before contacting the laboratories.
Michigan Department of Health and Human Services
Bureau of Laboratories
3350 North Martin Luther King Jr. Blvd.
Lansing, Michigan 48906
General E-mail: MDHHSLab@michigan.gov
Laboratory Director
Sandip Shah, Ph.D., HCLD(ABB), 517-335-8063, ShahS@michigan.gov
Laboratory Safety Officer
Jason Wholehan, 517-335-8850, WholehanJ@michigan.gov
Quality Assurance Section
Mary Bonifas, Manager, 517-335-8074, BonifasM@michigan.gov
Data and Specimen Handling, 517-335-8059, fax 517-335-9871
DASH Central Receiving Unit
Matthew Bashore, Manager, 517-335-8373, BashoreM@michigan.gov
DASH Data Handling Unit
Adam Silverman, Manager, 517-335-4725, SilvermanA@michigan.gov
Laboratory Systems Section
Julie Kusey, Manager, 517-335-9604, KuseyJ@michigan.gov
Bioterrorism Training Coordinator
Vacant
Chemical Threat Response Training Coordinator
Vacant
Biosafety Officer
Carrie Anglewicz, 517-335-9654, AnglewiczC@michigan.gov
LABORATORIES
Division of Chemistry and Toxicology
Matthew Geiger, DrPH, M.S., Director, 517-335-8344, GeigerM@michigan.gov
Environmental Chemistry Section
Keri Fisher, MLS (ASCP)CM, ASQ CQPA, LSSGB, Manager, 517-335-9489, FisherK@michigan.gov
Environmental Inorganic Unit
Kelley Freed, Manager, 517-335-8357, FreedK1@michigan.gov
Environmental Organic Unit
Adam Bush, Manager, 517-335-9602, BushA6@michigan.gov
Clinical Chemistry Section
Jessica Pruett, Manager, 517-335-5433, PruettJ@michigan.gov
Clinical Inorganic Unit
Sarah Lockwood-O'Brien, Ph.D., Manager, 517-335-0168, LockwoodobrienS@michigan.gov
Clinical Organic Unit
Timothy Karrer, M.S., Manager, 517-241-6364, KarrerT@michigan.gov
Newborn Screening Section
Shawn Moloney, MPH, MLS(ASCP)CM, Manager, 517-335-5097, MoloneyS1@michigan.gov
Metabolic Unit
Eric Wotring, B.S., Manager, 517-335-9754, WotringE@michigan.gov
Endocrine Unit
Joseph Hill, Ph.D., Manager, 517-335-9381, HillJ43@michigan.gov
Operations and Analytics Unit
Heather Wood, M.S., Manager, 517-335-8048, WoodH5@michigan.gov
Division of Infectious Disease
Marty Soehnlen, Ph.D., MPH, HCLD(ABB), Director, 517-335-8064, SoehnlenM@michigan.gov
Microbiology Section
Kimberly McCullor, Ph.D., Manager, 517-335-9641, McCullorK@michigan.gov
Mycobacteria and Mycology Unit
Angie Schooley, Manager, 517-335-9637, SchooleyA@michigan.gov
Bacteriology Unit
Kelly Jones, B.S., MT(ASCP), Manager, 517-335-9638, JonesK42@michigan.gov
Food, Enteric, and STI Unit
Nicole Ayres, MPA, Manager, 517-335-2432, AyresN@michigan.gov
Virology Section
Vacant
Bacterial and Viral Serology Unit
Kristine W. Smith, B.S., MT(ASCP), Manager, 517-335-8100, SmithK8@michigan.gov
Viral Isolation and Molecular Testing Unit
Katie Margulieux, Ph.D., Manager, 517-335-8098
Genomics Section
Heather Blankenship, Ph.D., Manager, 517-335-0095, BlankenshipH@michigan.gov
Genomic Sequencing Unit
Rebecca Kramer, Manager, 517-335-0181, KramerR1@michigan.gov
Bioinformatics and Genomic Epidemiology Unit
Arianna Miles-Jay, Ph.D., MPH, Manager, 517-335-0156, MilesjayA@michigan.gov
V. Suggestions
For suggestions concerning the Laboratory Services Guide, please e-mail MDHHSLab@michigan.gov
VI. Specimen Collection and Shipping Containers
List of Clinical Specimen Collection and Shipping Containers kits and components
Request supplies through the Online Laboratory Kit Order Tracking System (LKOTS)
Request supplies with the Specimen Shipping Units Requisition form (DCH-0568)
Mailing Regulations:
Federal Postal Regulations
United Parcel Service
Federal Express
Rev. 2/28/2025