Lab 144 2026

1. Click ‘Get Form’ to open lab 144 in the editor.
2. Begin by selecting your registration option. Choose either 'state oversight' or 'deemed status' and provide the necessary accreditation details if applicable.
3. Fill in the laboratory's name, tax ID number, address, city, telephone number, fax number, county, state, zip code, and email address in the designated fields.
4. Enter your CLIA provider number and specify the legal name of the corporation or association owning the laboratory. Ensure that any fictitious name permits are noted.
5. Indicate the type of ownership by checking the appropriate box and providing names and addresses as required for partnerships or corporations.
6. List all laboratory directors along with their contact information. Ensure that this section is completed accurately.
7. Finally, sign the declaration statement at the bottom of the form by both the laboratory director and owner to confirm accuracy.

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