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Click ‘Get Form’ to open lab 144a in the editor.
Begin by entering the name of your laboratory in the designated field. Ensure accuracy as this is crucial for identification.
Fill in your Tax ID Number and CLIA ID Number, if applicable. These identifiers are essential for regulatory compliance.
Provide the location address of your laboratory, including city, county, state, and zip code. Double-check for any typos to avoid processing delays.
Indicate whether there have been any changes in your facility since your last application by selecting 'Yes' or 'No'. If 'Yes', refer to our website for additional requirements.
Complete the ownership section by selecting the type of ownership and providing details about owners or partners as required.
Fill out contact details including email and telephone number to ensure you can be reached regarding your application.
Finally, ensure that all signatures are original and dated before submitting. Use our platform to save and send your completed form electronically if needed.
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