Certificate of Waiver Medical Test Site (MTS) Application Packet: Fill out & sign online

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How to use or fill out Certificate of Waiver Medical Test Site (MTS) Application Packet

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Click ‘Get Form’ to open the Certificate of Waiver Medical Test Site Application Packet in our editor.
Begin with the Index Page (505-038) to familiarize yourself with the contents and structure of the application. This page outlines all necessary documents.
Refer to the Application Instructions Checklist (505-039). Ensure you have all required documentation ready, including your UBI and FEIN numbers.
Fill out Section 1: Demographic Information. Enter your business details clearly, including legal owner/operator entity name, mailing address, and contact information.
Proceed to Section 2: Facility Specific Information. Indicate your site type and hours of operation for laboratory testing.
Complete Section 3: Key Individuals by providing names and contact details for the lab director and lab contact person.
In Section 4, list any waived tests you plan to perform. Be specific about test manufacturers and systems used.
Finally, review Section 5 for any additional licensure information needed. Sign and date the application before submission.

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