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Click ‘Get Form’ to open the Clinical Laboratory Improvement Amendments (CLIA) Application in our editor.
Begin with Section I: General Information. Fill in details such as 'Initial Application', anticipated start date, and facility name. Ensure your email address is valid for future notifications.
Proceed to Section II: Type of Certificate Requested. Select the appropriate certificate type based on the complexity of tests performed at your laboratory.
In Section III: Type of Laboratory, check the box that best describes your facility type, ensuring accurate representation.
For Section IV: Hours of Laboratory Testing, list the operational hours in HH:MM format or check if testing is available 24/7.
Complete Sections VI to VIII regarding testing types and estimated annual test volumes. Be specific about each test performed and its corresponding manufacturer.
Review all sections for completeness before submitting. Incomplete applications cannot be processed.
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