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CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) APPLICATION FOR CERTIFICATION. I. GENERAL INFORMATION. ... Certificate of Waiver (Complete Sections I – VI and IX – X) Certificate for Provider Performed Microscopy Procedures (PPM)
Date added: June 18, 2012 - Views: 43
Clinical Laboratory Improvement Amendments (CLIA) How to Obtain a CLIA Certificate of Waiver When is a CLIA Certificate of Waiver Required? NOTE: Congress passed the Clinical Laboratory Improvement Amendments (CLIA)
Date added: July 5, 2012 - Views: 38
CLIA Waiver Application CLIA Categorization Only Previously Cleared Device HemoCue WBC System (K071652) Official Correspondent:
Date added: February 1, 2012 - Views: 35
42 CFR Part §493 – Laboratory Requirements §493.35 Application for a certificate of waiver. (c) Application format and contents. The application must--(1) Be made to HHS or its designee on a form or forms
Date added: August 30, 2014 - Views: 1
Guidance for Industry and FDA Staff: Recommendations for Clinical Laboratory Improvement Amendments of 1988 (CLIA) Waiver Applications for Manufacturers of In Vitro
Date added: September 23, 2013 - Views: 2
Maryland Department of Health and Mental Hygiene Office of Health Care Quality – Laboratory Licensing Programs ... Completed CLIA application in agreement with State application Copy of CLIA certificate and State Laboratory License, if applicable
Date added: June 23, 2012 - Views: 5
CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) APPLICATION FOR CERTIFICATION ... The CLIA application (Form CMS-116) ... Certificate of Waiver . can only perform tests categorized as waived;* •
Date added: November 14, 2012 - Views: 5
DIRECTIONS FOR THE CLIA WAIVER APPLICATION FOR EMS ORGANIZATIONS Revised March 7, 2012 To get the CLIA Waiver application, you can either contact:
Date added: April 22, 2013 - Views: 4
Instructions for Applying for a California Clinical Laboratory License Page 2 . Federal forms to complete: CMS 116 — CLIA application, unless already certified by CMS
Date added: December 30, 2011 - Views: 23
HOW DO I APPLY FOR CLIA CERTIFICATION? CLIA applies even if only one or a few basic tests are performed, and even if you are not charging for testing.
Date added: February 14, 2012 - Views: 14
and CLIA Certificate of Waiver or PPMP If your facility is performing Waived or Provider Performed Microscopy Procedures (PPMP) ... LAB 155 — Application for Clinical Laboratory Registration LAB 116 — Laboratory Personnel Report
Date added: February 5, 2012 - Views: 15
0938-0581 CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF 1988 (CLIA) APPLICATION FOR CERTIFICATION I. GENERAL INFORMATION ... The CLIA application (Form CMS-116) collects information about your laboratory’s operation which is necessary
Date added: August 16, 2013 - Views: 1
Title: Clinical Laboratory Improvement Act (CLIA) Program Information Author: Minnesota Department of Health Licensing and Certification Section
Date added: April 22, 2012 - Views: 4
CLIA Waiver Application—Where to Send Mail Applications for CLIA Certificates to: DCH/HFRD Diagnostic Services Unit 2 Peachtree St., NW.
Date added: February 15, 2012 - Views: 5
COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH Clinical Laboratory ... [CLIA] Application On February 28, 1992, the Department of Health and Human Services published regulations ... Application for Clinical Laboratory Improvement Amendments of 1998 [CLIA] Certificate - complete ...
Date added: May 11, 2012 - Views: 9
WAIVER COMPLIANCE ACCREDITATION PROVIDER PERFORMED MICROSCOPY PROCEDURES ... American Thoracic Society (Blood Gas Only) (212) 315-8808 Pennsylvania Limited Survey ... Return both CLIA and Clinical Laboratory Application to: Bureau of Laboratories P.O. Box 500 Exton, PA 19341.
Date added: February 6, 2012 - Views: 11
Certificate of Waiver MTS Application Checklist and Instructions (continued) DOH 505-039 (April 2014) 2 of 2 Note: The lab contact will receive all information that we mail to your medical test site.
Date added: September 28, 2012 - Views: 7
Clinical Laboratory Improvement Amendments (CLIA) Waivers Every public school that does even one lab test needs to have a CLIA waiver. If a student is independently performing all testing, e.g. blood glucose monitoring, a
Date added: November 19, 2013 - Views: 2
Application and instructions for Clinical Laboratory RI General Law Chapter 23-16.2 ... Out-of-state laboratories provide a copy of your state license and/or your CLIA certificate. ... to the Rhode Island Division of Taxation pursuant to Chapter 76 of Title 5 of the Rhode
Date added: June 13, 2012 - Views: 3
clinical laboratory improvement amendments (clia) application for certification i. General information ... The CLIA application ... as waived mUst apply for a clia certificate of waiver.
Date added: May 29, 2013 - Views: 2
CERTIFICATE OF WAIVER PROVIDER-PREFORMED MICROSCOPY ... Return both CLIA and Clinical Laboratory Application to: Bureau of Laboratories P.O. Box 500 Exton, PA 19341 For overnight delivery services, our physical location is:
Date added: October 19, 2012 - Views: 4
CLIA Waiver Determination Decision Summary . A. Document Number: k053110/A001 – A005 . B. Purpose for Submission: Request for CLIA Waiver . C. Measurand (Analyte):
Date added: December 30, 2011 - Views: 4
How to obtain a CLIA Waiver……………………………………………… ... CLIA Application for Certification Attachment 15A: ... Connecticut Department of Public Health has a Companion Awareness Risk Education
Date added: February 25, 2012 - Views: 5
Administration (FDA), they must obtain a CLIA Certificate of Waiver. The ... Guidance/Legislation/CLIA/Downloads/waivetbl.pdf • The application form, called CMS -116, and instructions on how to fill out
Date added: December 30, 2012 - Views: 2
Clinical Laboratory Improvement Amendments (CLIA) ID Number . TESTING LOCATIONS . Location (Name and/or address) Date(s) Bureau of Laboratories Application for a Pennsylvania Clinical Laboratory Permit To Operate Screening Sites Updated 2/22/12 Page 2 of 5
Date added: February 2, 2013 - Views: 3
Directions for the CLIA Waiver Application For Blood Glucose in the Field To get the CLIA Waiver Application, go to: ... Michigan Department of Licensing and Regulatory Affairs Bureau of Health Systems, Division of Licensing & Certification
Date added: August 16, 2013 - Views: 2
Clinical Laboratory Improvement Amendments (CLIA) Background Congress passed the Clinical Laboratory Improvement Amendments (CLIA) in 1988 establishing quality standards for ... Under CLIA Application of Waiver submission, the fee
Date added: February 18, 2012 - Views: 7
obtaining a CLIA waiver Download a CLIA application at: ... You will receive your CLIA waiver number once your completed application is entered into the system. A fee coupon will be mailed in 2-3 weeks. Follow the instructions for payment of the
Date added: February 14, 2012 - Views: 9
CLIA Certificate of Waiver? Requirements include: ... Complete the CLIA application form, CMS-116, and submit it to the state agency along with a copy of the Laboratory Director’s State of Wisconsin license (see state agency contact info below).
Date added: February 14, 2012 - Views: 8
CLIA Waiver Determination Decision Summary . A. Document Number: k992140/A002 . B. Purpose for Submission: Request for Waiver . C. Measurand (Analyte):
Date added: May 22, 2012 - Views: 2
your state and ask for a CLIA application, form HCFA-116. Cholestech Technical Service can give you the address and phone ... your Certificate of Waiver, or other CLIA certificate number, on your claim for Medicare reimbursement or reimbursement will be denied.
Date added: May 11, 2012 - Views: 30
Mississippi Medicaid CLIA Certification Information Section D – 1 ... return with your provider application. ... If the CLIA number is not issued to the person/entity indicated above, please provide below a
Date added: March 12, 2012 - Views: 2
New Jersey Department of Health ... Certificate of Waiver Certificate for Provider Performed Microscopy Procedures Certificate of Compliance ... (Include CLIS ID Number on check. Include photocopy of submitted check. Attach check to application.) 1. Fee for CLIA Waived Tests Only ...
Date added: February 13, 2012 - Views: 6
CLIA FAQs What is a CLIA certificate of waiver? The CLIA certificate of waiver is a registration with the U.S. Department of Health and Human Services that allows
Date added: December 30, 2012 - Views: 2
APPLICATION TYPE CHANGE ... Currently certified as: Compliance. Waiver. Accreditation PPM Proposed certified as: Compliance. Waiver. Accreditation PPM Effective ... \MSOFFICE\Word\Labs\CLIA Change Form.doc . May 14, 2012 . LIST OF TESTS PERFORMED
Date added: April 6, 2012 - Views: 2
CLIA CLIA Update CLIAC March 2011 Harriet Walsh Deputy Director. Division of Laboratory Services. CLIA Topic Areas ... Waiver Non-exempt Laboratories by Application Type Number of Laboratories CLIA Year. CLIA CMS Waived Project-Complaint Scenario
Date added: March 27, 2012 - Views: 4
CLIA Certificate of Waiver. The fee for the Certificate of Waiver is $150 and is valid for two years. How to I get a CLIA Certificate of Waiver? - Download the file “CLIA Application,” found on the Unicity Start Up Kit web page and print it out.
Date added: June 7, 2012 - Views: 7
Please complete and submit 3 forms: Application for Certification (CLIA 116), the Health Screen Testing Permit Application and the Director Qualification
Date added: July 14, 2013 - Views: 3
CLIA # _____ Date: _____ Laboratory Name ... _____ Waiver _____ PPM _____ Compliance _____Accreditation If requesting an accreditation certificate, please specify the accrediting agency:
Date added: January 16, 2013 - Views: 4
CLIA WAIVER STATE REGULATORY STATE RECOGNIZED OTHER REQUIREMENTS/RESTRICTIONS ENTITY (CLIA) ADDRESS TELEPHONE. MARYLAND NO No trig or glucose testing permitted Dept. of Health BB Building, Laboratory Unit 410-402-8025
Date added: April 19, 2012 - Views: 4
CLIA #: Certificate Type: II. SCREENING PROGRAM INFORMATION ... “WAIVED” HIV Special Projects Waiver Application . Training Program . Copy of training program / material . Ongoing competency protocol . Training records for current testing personnel .
Date added: November 8, 2012 - Views: 5
Clinical Laboratory Improvement Act (CLIA) CLIA WAIVER PROCEDURES MO HealthNet providers possessing a “Certificate of Waiver” are allowed to perform the following procedures. Laboratories/providers with this type of certificate can bill only the
Date added: May 6, 2014 - Views: 2
Clinical Laboratory Improvement Amendments (CLIA) 493.39 Notification requirements for laboratories issued a certificate of waiver Subpart C--Registration Certificate, Certificate for
Date added: September 26, 2012 - Views: 13
Point-of-Care Testing ... Waiver Non-exempt Laboratories by Application Type. Number of Laboratories. ... Clinical Laboratory Improvement Amendments (CLIA) Equivalent Quality Control Procedures. Brochure #4. What are they, and when can I use them?
Date added: July 20, 2012 - Views: 8
In-House CLIA Waived Point-of-Care Diagnostic Testing Presented by: Ann Hinson, MT (ASCP) CHCANYS Annual Conference, October 5, 2010
Date added: March 24, 2013 - Views: 8
STATE SURVEY AGENCIES (CLIA CONTACT LIST) ALABAMA DEPARTMENT OF PUBLIC HEALTH Division of Health Care Facilities CLIA Program P.O. Box 303017 Montgomery, AL 36130-3017
Date added: October 22, 2011 - Views: 10
NORTH CAROLINA STATE LABORATORY OF PUBLIC HEALTH CLIA CONTRACT PROGRAM 2009 INTRODUCTION: The Clinical Laboratory Improvement Amendments (CLIA) ... NOTE: The technical consultant must review and approve the application and/or
Date added: June 14, 2012 - Views: 5
CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF 1988 (CLIA) APPLICATION FOR CERTIFICATION I. GENERAL INFORMATION Facility Name Federal Tax Identification Number ... Certificate of Waiver (Complete Sections I - VI and VIII - X)
Date added: April 6, 2012 - Views: 10