Contact Us :: Washington State Department of Health 2026

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The document outlines the process for credentialing changes at Medical Test Sites (MTS), including a Credential Status Change Form for updating contact information and facility details. It specifies qualifications required for personnel overseeing moderate and high complexity testing, detailing acceptable credentials for laboratory directors and clinical consultants. The form must be signed by the MTS director to certify the accuracy of the provided information.

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Click ‘Get Form’ to open the Contact Us form in the editor.
Begin by entering your MTS Name and the Effective Date of Change. This information is crucial for identifying your request.
Fill in the MTS License # and CLIA #, ensuring accuracy as these are essential for processing your changes.
Indicate the Type of Change you are making, such as Address Change or Facility Name Change. Provide the current and new details as required.
For contact changes, enter the new phone number, fax number, and email addresses for relevant contacts. Make sure to double-check these entries for correctness.
If applicable, complete pages two and three only if you are changing the director of a categorized or accredited license. Fill in qualifications as per the instructions provided.
Finally, ensure that you sign and date the form at the bottom to certify that all information is accurate before submitting it.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (189 Votes)
2016	4.3 Satisfied (274 Votes)
2014	4.4 Satisfied (553 Votes)
2012	4.2 Satisfied (61 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I email the Washington State Healthcare Authority?

Send your question/issue to the MC Programs Mailbox at hcamcprograms@hca.wa.gov and we will forward your email to the correct subject matter experts for resolution.

What does the Washington state Department of Health do?

DOH provides comprehensive public health services and programs to the community through a workforce of approximately 2,000 public health professionals all dedicated to improving the health and well-being of Washingtonians and the communities in which they live, learn, work, worship, and play.

What is the email format for the Department of health WA health?

Department of Health (WA Health)s email format typically follows the pattern of First.Last@health.wa.gov.au; this email format is used 98% of the time. Other contacts within LeadIQs database had email formats such as Last.First@health.wa.gov.auFirst.Middle@health.wa.gov.au.

How do I contact the DOL in Washington state?

Contact our customer contact center at 360-902-3900 (TTY: call 711).

How do I contact the Washington State Department of Health?

Call the DOH Information Line at 1-800-525-0127. For faster service, follow the prompts and leave a message with the appropriate program.

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How to file a complaint with Washington State Department of Health?

Health Facility Complaints offered by Washington State Department of Healths Quality Assurance Division 111 Israel Road Southeast, Tumwater, WA 98501. M-F, 8am-5pm. (360) 236-4700. . hsqacomplaintintake@doh.wa.gov. Fill out a complaint form online or call.