CA CDPH LAB 155 2018 free printable template
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Ca.gov NOTE State registration fees schedule http //www. cdph. ca.gov/programs/lfs/Documents/A-License-FeeSchedules. Use supplementary sheet if necessary. Unincorporated Association District City County or State Other specify if nonprofit submit proof of nonprofit status Name Address LAB 155 8/16 Laboratory Director s M. 05D State Type of Certificate Certificate of Waiver Provider Performed Microscopy Procedure Individual Partnership general or limited. I choose deemed status with the...
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How to fill out CA CDPH LAB 155
How to fill out CA CDPH LAB 155
01
Obtain the CA CDPH LAB 155 form from the California Department of Public Health website.
02
Fill in the laboratory's name and address at the top of the form.
03
Provide the contact information of the laboratory director.
04
Specify the type of laboratory services provided.
05
Include the samples types that are tested in the laboratory.
06
Indicate the laboratory's certification status and any applicable accreditation.
07
Complete the section regarding the laboratory's quality assurance protocols.
08
Sign and date the form, certifying that the information provided is accurate.
09
Submit the completed form to the appropriate regulatory body as instructed.
Who needs CA CDPH LAB 155?
01
Laboratories that are seeking certification or compliance with California's public health regulations.
02
Laboratory personnel who are responsible for maintaining quality assurance and regulatory compliance.
03
Healthcare providers or organizations utilizing laboratory services in California.
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What is CA CDPH LAB 155?
CA CDPH LAB 155 is a form used by laboratories in California to report certain test results and findings to the California Department of Public Health.
Who is required to file CA CDPH LAB 155?
All laboratories in California that perform specific clinical tests on patients are required to file CA CDPH LAB 155 as part of their reporting obligations.
How to fill out CA CDPH LAB 155?
To fill out CA CDPH LAB 155, laboratories need to provide accurate patient information, test results, and any other relevant data as required by the form's instructions.
What is the purpose of CA CDPH LAB 155?
The purpose of CA CDPH LAB 155 is to ensure that critical health information is reported to state health authorities, facilitating public health monitoring and disease control.
What information must be reported on CA CDPH LAB 155?
The information that must be reported on CA CDPH LAB 155 includes patient demographics, the specific tests performed, test results, and any pertinent clinical information associated with those results.
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