F104 - Proficiency Testing Data Submission Form - American - a2la 2026

1. Click ‘Get Form’ to open the F104 form in the editor.
2. Begin by entering your Laboratory Name and City in the designated fields at the top of the form.
3. Fill in the Master Code and State information accurately to ensure proper identification.
4. Input your Certificate Number(s) in the provided space, ensuring all relevant certificates are included.
5. In the summary table, enter the PT Program Name, which identifies the completed program and specific analyses performed.
6. Record the Report Date, indicating when the final report was issued for your proficiency testing results.
7. Provide your Lab ID, which is a unique identifier assigned to your laboratory’s data in attached reports.
8. Indicate if any Outlying Results were identified by selecting 'Yes' or 'No' and attach documentation of corrective actions if applicable.

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