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NC Department of Health and Human Services
State Laboratory of Public Health
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Coronavirus Disease 2019 (COVID-19)

Clinical Laboratory Guidance

  • The following guidance only applies to testing at the NCSLPH. Refer to any commercial laboratory guidance when using those services. Commercial laboratory testing is available. Prior authorization is not required for commercial laboratory testing but individuals will be considered a Person Under Investigation (PUI).
  • NCSLPH is currently conducting testing to detect COVID-19 using the CDC 2019-nCoV real-time RT-PCR Diagnostic Panel which has been granted Emergency Use Authorization (EUA) from the FDA.

Testing Criteria

  • Patients must meet the testing criteria given in the currently posted provider memo (updated 03/29/2020).
  • Clinicians can submit specimens to the State Laboratory of Public Health for person with symptoms compatible with COVID-19* who are in one of the following four categories:
    1. Hospitalized patients;
    2. Healthcare workers or first responders (PDF, 1.2 MB) (e.g. EMS, law enforcement, fire department);
    3. Patients who live or have regular contact with a high-risk setting (e.g. long-term care facility, homeless shelter, correctional facility, migrant farmworker camp);
    4. Persons who are at higher risk of severe illness and for whom a clinician has determined that results would inform clinical management.
  • To discuss testing for patients not meeting these criteria, contact the Division of Public Health epidemiologist on-call line at 919-733-3419.
  • In order to systematically monitor COVID-19 virus activity in North Carolina, NCSLPH will also perform testing on specimens submitted from sites participating in the U.S. Outpatient Influenza-like Illness Surveillance Network.

* Most patients with confirmed COVID-19 have developed fever (subjective or objective) and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).

Specimen Collection

Handout for Collecting and Sending COVID-19 Specimens to the NCSLPH (PDF, 1.1 MB) - Last updated 03/31/2020

  • The specimen should be collected as soon as possible once a PUI is identified, regardless of the time of symptom onset.
  • Health care providers or public health personnel collecting specimens should wear recommended PPE as described by NCDHHS.
  • COVID-19 testing is ordered using the new COVID-19 Form (PDF, 122 KB).
  • Local Health Departments requesting specimen collection kits must do so through their County Emergency Management, who will submit the request through WebEOC. Kits come with the following Kit Instructions (PDF, 181 KB; updated 03/30/2020).
  • Additional guidance on collection, handling, and testing of clinical specimens is provided on the CDC's Coronavirus: Information for Laboratories page.

Specimen Shipment

  • Specimens should be packaged and shipped as UN3373 Category B.
  • Do not use the State Courier for shipping COVID-19 specimens.
  • Specimen deliveries will be received at the NCSLPH loading dock from 8am-5pm Monday through Friday, and 8am-12pm on Saturday and Sunday.
  • We no longer require an email with tracking information or the number of specimens being shipped.

Specimen Rejection Criteria

  • Specimens not kept at 2-8°C (≥72 hrs) or if specimens have not been frozen at -70°C and they are >72 hrs old.
  • Incomplete specimen labeling or documentation. Unlabeled vials containing the NP swab will be rejected.
  • Inappropriate specimen type.
  • Insufficient specimen volume for testing.

Result Reporting

  • Turnaround time for testing will be dependent on testing volumes.
  • NCSLPH electronic reports are posted on our CELR online system.
  • Specimens testing positive at the NCSLPH will be reported as "Positive 2019-nCoV."
  • Specimens testing negative at the NCSLPH will be reported as 2019-nCoV "Not Detected."

Clinical Laboratory Safety Guidance

Additional Information for Clinical Laboratory Testing

Requests for Additional Information from NCSLPH

  • For general information, non-urgent laboratory questions about specimen collection, testing, and reporting please email the NCSLPH COVID-19 helpdesk at slph.covid19@dhhs.nc.gov.
  • For critical laboratory-related questions during normal business hours (8am - 5pm, Monday - Friday) please call the SLPH Customer Service line at 919-733-3937.
  • Please refer to our Frequently Asked Questions.

External Resources