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How to use or fill out cms 209 with our platform
- Click ‘Get Form’ to open the cms 209 in the editor.
- Begin by entering the laboratory name in the designated field at the top of the form.
- Next, input the laboratory address, including number and street, city, state, and zip code.
- Provide the CLIA identification number and telephone number, ensuring all details are accurate.
- In section 4(a), list all technical personnel by name. Check the appropriate column for each position held (D, CC, TC, TS, GS, TP).
- Indicate the highest level of testing for which personnel are qualified using (M) for moderate complexity or (H) for high complexity.
- If additional space is needed for listing personnel, check the box provided and attach continuation sheets as necessary.
- Finally, ensure that the laboratory director signs and dates the form before submission.
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