WebDec 17, 2024 · CMS-116, CLIA Application Form) to the state (SA Contacts) where the laboratory is located. We want to ensure that laboratories located in the United States …

CLINICAL LABORATORY IMPROVEMENT …

WebThe Clinical Laboratory Improvement Amendments (CLIA) were passed by Congress in 1988 establishing quality standards for all laboratory testing to ensure the accuracy, reliability and timeliness of patient test results regardless of where the test was performed. ... Forms. All forms (CMS 116 CLIA Application, Enclosure A Disclosure of Ownership ... WebF Form . LAB 182 Attestation of each Owner F Form . LAB 183 Attestation of each Laboratory Director . F Form. LAB 116 Laboratory Personnel Report (if PPMP, or Moderate/High Complexity) F Form . CMS 116 CLIA Application for Certification. F Proof of accreditation or letter of enrollment from accrediting agency (if applicable) B For … northern lights in september

Clinical Laboratory (CLIA) Licensing and Certification Program

WebApplication. On behalf of the CMS CLIA program, HHSC uses Form 3225, Application for Certification – Supplement to CMS 116 to process CLIA certificate applications. Fees. Do not send payment for CLIA fees to HHSC. Follow the instructions on the user fee coupon generated by CMS to make a payment. When submitting a check, always include the ... WebAPPLICATION FOR A CLIA CERTIFICATE: FORM CMS-116. The Centers for Medicare & Medicaid Services (CMS) has made available the Clinical Laboratory Improvement Amendments of 1988 (CLIA) Application for Certification Form, CMS -116. This form should be completed and mailed to the address of the local. State Agency (PDF) for the … WebCMS Form 116 to apply for certification as a CLIA approved laboratory northern lights in usa 2021