Instructions for Submitting Diagnostic Specimens for Testing by the Rickettsial Reference Diagnostic Laboratory

Our laboratory serves as a national reference diagnostic laboratory for rickettsial pathogens. Our testing is provided free-of-charge to approved agencies. Rickettsial diseases can be rapidly progressive, so prompt treatment of the patient should not be delayed while waiting upon our test results. Routine testing should be performed by state or commercial laboratories when possible.

View Sample Specifications and Packaging Guidelines for Rickettsial Disease pdf icon[PDF – 1 page] for information about appropriate clinical lab specimens for Rickettsial diseases.

Specimen submission guidelines

Samples should be sent through your state public health laboratory or with their approval. Final reports of test results are returned to the state public health laboratory that is responsible for providing these reports to the primary submitter.

There are currently two methods for submitters to submit specimens to CDC for testing:

  1. The CDC Test Order and Reporting (CSTOR) Web Portal (preferred)
  2. The CDC 50.34 Specimen Submission Formexternal icon

Specimens must be accompanied by the CDC Specimen Submission Form (CDC 50.34). One form for each sample and each test type requested (Molecular Detection or Serology) should be submitted. If more than one organism is requested for testing, select the primary organism under the suspected agent drop down menu in the top left corner of the 50.34 form, and write additional pathogens requested in the Comments section on the bottom right corner of the second page of the 50.34 form.

Information required on the CDC 50.34 Specimen Submission Form for specimen acceptance and testing:

  • Test order name (one per submission form)
  • SPHL point of contact including phone number of the person responsible for sample submission and follow-up
  • Patient full name, sex, birth date
  • Date of onset (of symptoms)
  • Specimen collected date
  • Specimen source (type, e.g., serum, whole blood, swab, tissue, etc.)
  • Therapeutic agent and dates (specific antibiotic therapy and initiation date)
  • State of illness
  • Brief clinical summary (include signs, symptoms, and underlying illnesses if known)

Requested additional information:

  • Previous laboratory results (physical exam findings and pertinent laboratory values)
  • Travel history (within 4 weeks of symptom onset), denote with “No” or “Unknown” if no travel occurred or travel history is unknown
  • Exposure history (including animals and arthropods)

Samples should be sent directly to the Specimen Triage and Tracking (STATT) lab at this address:
Centers for Disease Control and Prevention
ATTN: Reference Diagnostic Laboratory, Rickettsial Zoonoses Branch (unit 78)
1600 Clifton Road, NE
Atlanta, GA 30329-4027

*Packages should be mailed for receipt Tuesday-Friday, and should take into consideration U.S. Federal holidays. Exceptions can be made for urgent samples with prior approval.

Test codes for rickettsial samples*:

Test codes for rickettsial samples
Anaplasma Molecular Detection CDC-10290
Anaplasma Serology CDC-10292
Coxiella burnetii Molecular Detection CDC-10304
Coxiella burnetii Serology CDC-10305
Ehrlichia Molecular Detection CDC-10499
Ehrlichia Serology CDC-10311
Orientia Molecular Detection CDC-10359
Orientia Serology CDC-10360
Rickettsia Molecular Detection CDC-10402
Rickettsia Serology Spotted Fever Group (RMSF) Serology CDC-10403
Rickettsia Serology Typhus Group Serology CDC-10404

*Please review details on the acceptable sample types and storage conditions carefully under each test code. Any submissions not meeting these requirements will be rejected by CDC.

For diagnostic test questions, please email,; and for all other questions.