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Clia waived drug test results form

URINE INITIAL DRUG SCREEN RESULT FORM - CLIA waived 2026

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The document is a Urine Initial Drug Screen Result Form used for collecting and documenting drug test results. It includes sections for donor information, reasons for testing, specimen validity tests, initial test results for various drugs, and collector certification. The form ensures proper identification of the donor and the integrity of the specimen during the drug screening process.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Completed by Collector or Employer Representative' section. Enter the collection site or company name, address, city, state, phone, and fax number.
Provide the donor's identification details including SSN, driver's license, or employee ID number. Ensure that the ID is verified by checking the appropriate box.
Fill in the donor's name and reason for testing. Select from options such as Pre Employment, Random, Reasonable Suspicion/Cause, Post Accident, or Return to Duty.
Record the specimen temperature within four minutes and indicate whether it falls within the normal range of 90º - 100ºF (32º - 38ºC).
Complete the 'Initial Test Results' section by documenting results from on-site screening devices and specimen validity tests. Mark each drug tested as NEG (negative), PRESUMPTIVE POSITIVE, or NOT TESTED.
Finally, ensure that both collector and donor sign where indicated to certify completion of the form.

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What are four examples of Clia-waived tests?

Common CLIA-Waived Test Examples: Blood glucose testing. Fecal occult blood tests (FOBT) Urinalysis (dipstick) Rapid strep and flu tests. Pregnancy tests ()

What are Clia-waived tests?

By the CLIA law, waived tests are those tests that are determined by CDC or FDA to be so simple that there is little risk of error. Some testing methods for glucose and cholesterol are waived along with pregnancy tests, fecal occult blood tests, some tests, etc.

Are drug screens in Clia waived?

MD 12 Panel Multi-Drug Test This easy and economical way to drug test will provide results for 12 multiple drugs in the . The MD 12 Panel Multi-Drug Test kit will show results in less than five minutes with a shelf life of 12 - 24 months and is a FDA approved / CLIA Waived drug test.

Is a microscopic examination of categorized as a CLIA test?

A microscopic examination of is categorized as a moderate complexity test under CLIA, not as a CLIA-waived test. This type of test requires specialized training and must adhere to stricter quality control standards. Therefore, it cannot be performed with the simplicity and low risk associated with waived tests.

How to read a Clia waived drug test?

Drug test interpretation: The presence of a line (or any indication of a colored line) indicates a Negative result. The absence of a line indicates an abnormal or Presumptive Positive result. Each test strip within the device includes an internal procedural control (C) that ensures proper device function.

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How accurate is the CLIA waived drug test?

CLIA Waived Drug Test Cup With 99% accuracy and FDA approval, this testing kit offers rapid results in under five minutes, providing a time-efficient alternative to lab testing. Each positive test result can be medically reviewed by a medical review officer if further analysis is required.

URINE INITIAL DRUG SCREEN RESULT FORM - CLIA waived 2026

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