Details | Last Recertification Date | Update | Recertification | 5/15/2024 7:26:37 AM | 5/5/2025 4:28:19 PM | 5/5/2025 4:28 PM |
Details | Nature of Support: Support Received From Date | Update | Change Request | 1/1/2020 12:00:00 AM | 1/1/2025 12:00:00 AM | 3/24/2025 5:29 PM |
Details | Nature of Support: Support Received To Date | Update | Change Request | 12/31/2024 12:00:00 AM | 12/31/2029 12:00:00 AM | 3/24/2025 5:29 PM |
Details | Grant Number | Update | Group Change Request | NU52PS910221 | NU52PS910277 | 3/18/2025 12:03 PM |
Details | NOFO Number | Update | Group Change Request | CDC-RFA-PS20-2001 | CDC-RFA-PS25-0003 | 3/18/2025 12:03 PM |
Contacts | Authorizing Official | Update | Group Change Request | Pecha, Monica
TB Controller
Washington Department of Health
2064185544 | Hutton, Scott C
WA State TB Controller/TB Program Manager
WA State Dept of Health - TB Program
5642003178 | 6/3/2024 4:19 PM |
Contacts | Primary Contact | Update | Recertification | Law, Lisa
Lead TB RN
Clallam County Health and Human Services – Public Health
3604172428 | Gallentine, Madison
RN, TB program Coordinator
Clallam County Health and Human Services
3605652612 | 5/15/2024 7:26 AM |
Details | Last Recertification Date | Update | Recertification | 5/11/2023 7:44:51 AM | 5/15/2024 7:26:37 AM | 5/15/2024 7:26 AM |
Details | Nature of Support: Support Received From Date | Update | Recertification | 1/1/2021 12:00:00 AM | 1/1/2020 12:00:00 AM | 5/11/2023 7:44 AM |
Contacts | Primary Contact | Update | Recertification | McLane, Karissa Garland
Public Health Nurse Supervisor
Clallam County Health & Human Services
3605652612 | Law, Lisa
Lead TB RN
Clallam County Health and Human Services – Public Health
3604172428 | 5/11/2023 7:44 AM |
Details | Last Recertification Date | Update | Recertification | 5/18/2022 7:28:46 AM | 5/11/2023 7:44:51 AM | 5/11/2023 7:44 AM |
Details | Grant Number | Update | Recertification | 6NU52PS910221 | NU52PS910221 | 5/11/2023 7:44 AM |
Addresses | Main Address | Update | Recertification |
223 E 4TH ST
SUITE 14
PORT ANGELES, WA 98362 |
111 E. 3rd St.
Port Angeles, WA 98362 | 5/18/2022 7:28 AM |
Details | Nature of Support: Support Received To Date | Update | Recertification | 12/31/2021 12:00:00 AM | 12/31/2024 12:00:00 AM | 5/18/2022 7:28 AM |
Details | Last Recertification Date | Update | Recertification | 5/27/2021 2:02:32 PM | 5/18/2022 7:28:46 AM | 5/18/2022 7:28 AM |
Details | Grant Number | Update | Recertification | 5NU52PS910221-02-00 | 6NU52PS910221 | 5/18/2022 7:28 AM |
Details | Nature of Support: In Kind Support Description | Update | Recertification | | The Washington State TB Program receives 317 funding from the CDC Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications. | 5/27/2021 2:02 PM |
Details | Nature of Support: Support Received From Date | Update | Recertification | | 1/1/2021 12:00:00 AM | 5/27/2021 2:02 PM |
Details | Nature of Support: Support Received To Date | Update | Recertification | | 12/31/2021 12:00:00 AM | 5/27/2021 2:02 PM |
Contacts | Primary Contact | Update | Recertification | Johnson, Ann M
CHN
Clallam County Health Department
3604172439 | McLane, Karissa Garland
Public Health Nurse Supervisor
Clallam County Health & Human Services
3605652612 | 5/27/2021 2:02 PM |
Details | Last Recertification Date | Update | Recertification | 6/4/2020 6:58:03 AM | 5/27/2021 2:02:32 PM | 5/27/2021 2:02 PM |
Details | Grant Number | Update | Recertification | 6NU52PS910221-01-01 | 5NU52PS910221-02-00 | 5/27/2021 2:02 PM |
Details | NOFO Number | Update | Recertification | | CDC-RFA-PS20-2001 | 5/27/2021 2:02 PM |
Details | Last Recertification Date | Update | Recertification | 5/22/2019 10:15:43 AM | 6/4/2020 6:58:03 AM | 6/4/2020 6:58 AM |
Details | Grant Number | Update | Recertification | 5NU52PS004674-05-00 | 6NU52PS910221-01-01 | 6/4/2020 6:58 AM |
Details | Entity Subname | Update | Recertification | | TB Program | 6/4/2020 6:58 AM |
Details | Nature Of Support | Delete | Recertification | Direct Funding (dollars received from CDC or an intermediate organization) ()-() | | 5/22/2019 10:15 AM |
Details | Last Recertification Date | Update | Recertification | 5/16/2018 6:47:51 AM | 5/22/2019 10:15:43 AM | 5/22/2019 10:15 AM |
Details | Grant Number | Update | Recertification | 6NU52PS04674-04-01 | 5NU52PS004674-05-00 | 5/22/2019 10:15 AM |
Contacts | Authorizing Official | Update | Change Request | Carlson, Sherry
TB Controller
WA State Dept of Health
3602363528 | Pecha, Monica
TB Controller
Washington Department of Health
2064185544 | 6/28/2018 7:00 PM |
Contacts | Primary Contact | Update | Recertification | Doran, David
TB
3605652612 | Johnson, Ann M
CHN
Clallam County Health Department
3604172439 | 5/16/2018 6:47 AM |
Details | Last Recertification Date | Update | Recertification | 4/28/2017 12:00:00 AM | 5/16/2018 6:47:51 AM | 5/16/2018 6:47 AM |
Details | Grant Number | Update | Recertification | 5NU52PS004674-03-00 | 6NU52PS04674-04-01 | 5/16/2018 6:47 AM |
Contacts | Authorizing Official | Update | | Carlson, Sherry
TB Controller
3602363528 | Carlson, Sherry
TB Controller
WA State Dept of Health
3602363528 | 1/8/2018 10:36 AM |
Contacts | Authorizing Official | Update | | Allen, Sheanne
TB CONTROLLER
3602363423 | Carlson, Sherry
TB Controller
3602363528 | 5/17/2017 7:34 AM |
Addresses | Main Address | Insert | | |
223 E 4TH ST
SUITE 14
PORT ANGELES, WA 98362 | 4/28/2017 2:15 PM |
Contacts | Primary Contact | Update | | Johnson, Ann
TB
3604172439 | Doran, David
TB
3605652612 | 4/28/2017 2:15 PM |
Details | Last Recertification Date | Update | | 3/1/2016 12:00:00 AM | 4/28/2017 12:00:00 AM | 4/28/2017 2:15 PM |
Details | Grant Number | Update | | TB-WA | 5NU52PS004674-03-00 | 4/28/2017 2:15 PM |
Contacts | Authorizing Official | Insert | | | Allen, Sheanne
TB CONTROLLER
3602363423 | 6/3/2016 7:20 AM |
Addresses | Shipping Address | Insert | | | Seattle King County Public Health Downtown Pharmacy
2124 4th Ave
Seattle, WA 98121 | 3/1/2016 10:37 AM |
Details | Nature Of Support | Insert | | | In-Kind products or services (see note below; must have been purchased with section 317 funds) | 3/1/2016 10:37 AM |
Details | Last Recertification Date | Update | | 2/5/2015 12:00:00 AM | 3/1/2016 12:00:00 AM | 3/1/2016 10:37 AM |
Details | Nature Of Support | Insert | | | Direct Funding (dollars received from CDC or an intermediate organization) | 2/5/2015 9:23 AM |
Contacts | Primary Contact | Update | | BURKS, IVE
DIRECTOR
3604172329 | Johnson, Ann
TB
3604172439 | 2/5/2015 9:23 AM |
Details | Last Recertification Date | Update | | 2/10/2014 12:00:00 AM | 2/5/2015 12:00:00 AM | 2/5/2015 9:23 AM |
Contacts | Primary Contact | Insert | | | BURKS, IVE
DIRECTOR
3604172329 | 2/10/2014 11:03 AM |
Details | Last Recertification Date | Update | | 1/1/2012 12:00:00 AM | 2/10/2014 12:00:00 AM | 2/10/2014 11:03 AM |
Details | Last Recertification Date | Update | | 1/1/2011 12:00:00 AM | 1/1/2012 12:00:00 AM | 11/7/2011 4:54 PM |
Details | Last Recertification Date | Insert | | | 1/1/2011 12:00:00 AM | 10/22/2010 6:37 PM |
Details | Grant Number | Insert | | | TB-WA | 10/22/2010 6:37 PM |
Details | 340B ID | Insert | | | TB983622 | 10/22/2010 6:37 PM |
Details | Is Authorizing Official EHB Data | Insert | | | | 10/22/2010 6:37 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | | | | 10/22/2010 6:37 PM |
Details | Medicare Provider Number | Insert | | | | 10/22/2010 6:37 PM |
Details | Entity Name | Insert | | | CLALLAM COUNTY HEALTH & HUMAN SERVICES | 10/22/2010 6:37 PM |
Details | Program Code | Insert | | | TB | 10/22/2010 6:37 PM |
Details | Entity Subname | Insert | | | | 10/22/2010 6:37 PM |
Dates | Participating Approval Date | Insert | | | 11/12/2004 12:00:00 AM | 10/22/2010 6:37 PM |
Details | State | Insert | | | Active | 10/22/2010 6:37 PM |
Dates | Registration Date | Insert | | | 4/1/1996 12:00:00 AM | 10/22/2010 6:37 PM |
Dates | Signed By Date | Insert | | | 1/1/2011 12:00:00 AM | 10/22/2010 6:37 PM |
Dates | Start Date | Insert | | | 4/1/1996 12:00:00 AM | 10/22/2010 6:37 PM |
Terminations | Termination Comments | Insert | | | | 10/22/2010 6:37 PM |
Terminations | Termination Date | Insert | | | | 10/22/2010 6:37 PM |
Terminations | Termination Effective Date | Insert | | | | 10/22/2010 6:37 PM |
Terminations | Termination Reason | Insert | | | | 10/22/2010 6:37 PM |