Clinical Labs
Join the SalivaDirect designated lab network!
SalivaDirect is a PCR test that uses saliva to detect SARS-CoV-2. Our flexible, extraction-free method is designed to be a cost-effective and easy-to-use option for laboratories, enabling them to achieve higher throughput and faster results.
We invite laboratories across the U.S. to join our network designated to conduct testing under the SalivaDirect Emergency Use Authorization (EUA). The comprehensive Instructions for Use include full asymptomatic labeling, a variety of reagents and instruments, alternative workflows, sample pooling, unsupervised collection, and the use of the SalivaDirect Direct-to-Consumer and At-Home Collection Kits—available for individuals two years and older. *The U.S. FDA granted the SalivaDirect Emergency Use Authorization (EUA 202097) in August 2020. To support pandemic response, FDA also authorized SalivaDirect, Inc. to extend its EUA to CLIA labs across the country.
Interested in offering SalivaDirect?
With all documents in hand, most labs complete the designation process within one week.
Start here:
How SalivaDirect™ is helping communities
Our team at SalivaDirect, Inc. strongly supports access to diagnostic testing.
Labs are invited to join our network of more than 190 laboratories across 41 U.S. states that have been designated to test under the SalivaDirect™ EUA*. The versatile Instructions for Use offered include full asymptomatic labeling, numerous reagents and instruments, alternative workflows, sample pooling, unsupervised collection, as well as use of the SalivaDirect™ Direct-to-Consumer and At-Home Collection Kits – all for individuals two years and older.
*The U.S. FDA granted the SalivaDirect™ Emergency Use Authorization (EUA 202097) in August 2020. To support pandemic response, FDA also authorized the Yale School of Public Health to extend its EUA to other labs.
Laboratory designation process
Clinical laboratories that meet the criteria above and are interested in being designated as authorized laboratories to offer SalivaDirect™ to their consumers as part of their laboratory services under the EUA 202097 must follow these steps:
Step 1
Initial Request for Designation
Step 2
Review and Designation Process
Step 3
Training and Onboarding Process
The SalivaDirect Protocol
The SalivaDirect protocol is authorized for emergency use by the U.S. Food and Drug Administration to diagnose COVID-19 in both symptomatic and asymptomatic individuals.
The SalivaDirect protocol is one of the first diagnostic approaches to offer reagent and instrument-flexible capabilities, allowing labs to use several commercially available reagents and instruments from different suppliers. Validated across a wide range of reagents and instruments, the protocol can be seamlessly integrated into many existing lab setups reducing the barrier to entry for labs to begin providing COVID-19 diagnostic testing.
Testing is limited to laboratories designated by SalivaDirect, Inc. that are certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C. §263a and meet the requirements to perform high-complexity tests.
How Does the SalivaDirect Protocol Work?
The SalivaDirect protocol utilizes a nucleic acid extraction-free workflow paired with real-time reverse transcription polymerase chain reaction (RT-PCR) technology to detect SARS-CoV-2 RNA in saliva. The process involves the following steps:
Patients provide a saliva sample by passively drooling into a sterile container or collection tube. Patients are advised not to eat or drink for 30 minutes before sample collection. Saliva self-collection instructions can be accessed here.
The SalivaDirect protocol validated three sample preparation workflow options that utilize a combination of Proteinase K and/or heat pre-treatments. These treatments break down proteins in the saliva and help release viral RNA, thereby removing the need for lengthy and costly RNA extraction steps. Labs are able to use the workflow that best integrates with their operations.
After sample preparation, the sample is analyzed using one-step RT-PCR amplification to detect any SARS-CoV-2 RNA present. Fluorescently labeled primers and probes from various vendors have been evaluated and selected to ensure optimal sensitivity and specificity in detecting viral RNA. Several different PCR instruments have also been validated. See the vendors below.
Technical Requirements
Sample Collection
The SalivaDirect protocol has received EUA approval for three sample collection methods.
- Saliva collection is performed in the presence of a trained observer
- Saliva collection is performed at home using the SalivaDirect At-home Collection Kit
- Saliva collection is performed at home using the SalivaDirect Unsupervised Collection Kit
Reagents and Instruments
The SalivaDirect protocol has been validated for a wide range of reagents and instruments:
Reagents
Reagent |
Vendor |
Item |
Catalog Number(s) |
Proteinase K |
ThermoFisher Scientific |
MagMAX Viral/Pathogen Proteinase K |
A42363 |
New England Biolabs |
Proteinase K |
P8107S |
|
AmericanBio |
Proteinase K |
AB00925 |
|
RT-qPCR Kit |
New England Biolabs |
Luna Universal Probe One-Step RT qPCR (2x) Kit |
E3006S, E3006L, E3006X, E3006E |
Luna Probe One-Step RT-qPCR 4x Mix with UDG |
M3019S, M3019L, M3019X, M3019E |
||
Bio-Rad |
Reliance One-Step Multiplex RT-qPCR Supermix |
12010176, 12010220, 12010221 |
|
Quantabio |
UltraPlex 1-Step ToughMix |
95166-100, 95166-500, 95166-01K |
|
ThermoFisher Scientific |
TaqPath 1-Step RT-qPCR Master Mix, GC |
A15299, A15300 |
|
Primer/Probes |
Eurofins Genomics |
SalivaDirect™ primer and probe set |
12YS-010YST (Cy5), 12YS-010YS3 (HEX), 12YS-010YS2 (FAM) |
Lighthouse Lab Services |
SalivaNow SARS-CoV-2 Assay (primers/probes pre-mixed) |
9731816-S |
|
Integrated DNA Technologies |
nCOV_N1 Forward Primer |
10006821, 10006830 |
|
nCOV_N1 Reverse Primer |
10006822, 10006831 |
||
nCOV_N1 Probe |
10006823, 10006832 |
||
RNase P Forward Primer |
10006827, 10006836 |
||
RNase P Reverse Primer |
10006828, 10006837 |
||
RNase P Probe |
Custom order (Cy5) 10007061, 10007062 (ATTO647) |
||
Nuclease-free water |
Integrated DNA Technologies |
Nuclease-free water |
11-04-02-01, 11-05-01-14, 11-05-01-04 |
New England Biolabs |
Nuclease-free water |
B1500S, B1500L |
|
Controls |
Twist Bioscience |
Synthetic SARS-CoV-2 RNA Control 2 |
102024 |
Lighthouse Lab Services |
Positive CoV-2 Control |
9731816PC |
|
Negative Control |
9731816EC |
||
|
|
|
|
For a more comprehensive list of all reagents and instruments, review the full EUA, available at FDA.gov.
Instruments
Vendor |
Model(s) |
Bio-Rad |
CFX96 Touch, CFX384 Touch, CFX Opus Real-Time PCR Detection System |
ThermoFisher |
ABI StepOne/StepOne Plus |
Agilent |
AriaMX Real-Time PCR System |
Ubiquitome |
Liberty 16, Liberty 16 Pro |
Analytik Jena |
qTower |
Roche |
Cobas Z480, LightCycler 480 |
CHAI |
Open qPCR |
Bio Molecular Systems |
Mic, Mic qPCR/Q |
OnsiteGene |
XDiveTM Superfast Real-Time PCR System |
For a more comprehensive list of all instruments and validated software versions, review the full EUA, available at FDA.gov.
Workflows
The SalivaDirect protocol has been validated for use in three different nucleic acid extraction-free sample preparation workflows. See image below.
SalivaDirect, Inc. is actively working toward obtaining FDA De Novo approval for the SalivaDirect SARS-CoV-2 assay. The protocol will initially include a single workflow using Proteinase K and focus on the following reagents and instruments:
Reagent |
Vendor |
Item |
Catalog Number(s) |
Proteinase K |
ThermoFisher Scientific |
MagMAX Viral/Pathogen Proteinase K |
A42363 |
RT-qPCR Kit |
New England Biolabs |
Luna Probe One-Step RT-qPCR 4x Mix with UDG |
M3019S, M3019L, M3019X, M3019E |
Primer/Probes |
Integrated DNA Technologies |
nCOV_N1 Forward Primer |
10006821, 10006830 |
nCOV_N1 Reverse Primer |
10006822, 10006831 |
||
nCOV_N1 Probe |
10006823, 10006832 |
||
RNase P Forward Primer |
10006827, 10006836 |
||
RNase P Reverse Primer |
10006828, 10006837 |
||
RNase P Probe |
Custom order (Cy5) 10007061, 10007062 (ATTO647) |
||
Nuclease-free water |
New England Biolabs |
Nuclease-free water |
B1500S, B1500L |
Controls |
Twist Bioscience |
Synthetic SARS-CoV-2 RNA Control 2 |
102024 |
Vendor |
Model(s) |
Bio-Rad |
CFX96 Touch Real-Time PCR Detection System |
ThermoFisher |
ABI QuantStudio 6 Pro Real-Time PCR System |
In development: SalivaDirect+
While the SalivaDirect protocol focuses exclusively on detecting SARS-CoV-2, SalivaDirect+ is in development. Utilizing the SalivaDirect extraction-free protocol, SalivaDirect+ will be able to detect SARS-CoV-2, Influenza A, Influenza B, and Respiratory Syncytial Virus (RSV) in a single saliva sample. By combining the detection of multiple viruses, SalivaDirect+ will provide a more comprehensive tool for diagnosing and differentiating between various respiratory infections – ensuring providers and patients are empowered with comprehensive health information, reducing the use of inappropriate antibiotic treatment, and improving infectious disease surveillance data for public health agencies.
SalivaDirect, Inc. is currently conducting a prospective clinical validation study to obtain emergency use authorization for the SalivaDirect+. If you or your laboratory are interested in joining the study and supporting our assay development work, contact us at [email protected]
SalivaDirect Inc. Publications
- Scalable solutions for global health: the SalivaDirect model
- Diagnostic testing preferences can help inform future public health response efforts: Global insights from an international survey
- Evaluation of saliva self-collection devices for SARS-CoV-2 diagnostics | BMC Infectious Diseases | Full Text
- Evaluation of the Liberty16 mobile real time PCR device for use with the SalivaDirect assay for SARS-CoV-2 testing
- Method versatility in RNA extraction-free PCR detection of SARS-CoV-2 in saliva samples.
- Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe,
- SalivaDirect: A simplified and flexible platform to enhance SARS-CoV-2 testing capacity | medRxiv; SalivaDirect: A simplified and flexible platform
- Saliva as a gold-standard sample for SARS-CoV-2 detection – The Lancet Respiratory Medicine
- Sequencing SARS-CoV-2 Genomes from Saliva
- Stability of SARS-CoV-2 RNA in Nonsupplemented Saliva
- The potential of saliva as an accessible and sensitive sample type for the detection of respiratory pathogens and host immunity
- Saliva-based methods for SARS-CoV-2 testing in low- and middle-income countries – PubMed
- Covid Testing in the Workplace, pre-print Feb 2022, internal
- Evaluation of saliva self-collection devices, March 2022, internal
- Saliva or Nasopharyngeal Swab Specimens for Detection of SARS-CoV-2 – PubMed
- Exploring the potential of a saliva-based, RNA-extraction-free PCR test for the multiplexed detection of key respiratory pathogens | medRxiv
- Benefits of Saliva feat. Anne, 2022
- Saliva vs. Rapid Antigen feat. Anne, 2022
International Validation
- Australia
- Bahamas
- Bangladesh
- Brazil
- Colombia
- India
- Ireland
- Italy
- Mexico
- New Zealand
- Evaluation of the Liberty16 Mobile Real Time PCR Device for Use With the SalivaDirect Assay for SARS-CoV-2 Testing
- ESR and Air New Zealand partner on COVID-19 saliva testing study
- Saliva sample for detection of SARS-CoV-2: A possible alternative for mass testing | PLOS ONE (SD cited as example: 14, 52)
- COVID-19: Why Nigeria should adopt Saliva-Based testing technology – Experts (opinion article)
- Philippines
- Portugal
- United Arab Emirates
- United States
- US Virgin Islands