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PRINTED: 12/1/2019 FORM APPROVED OMB NO. 09380391DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
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How to fill out clinical laboratory improvement

01
Gather all necessary information and documents, such as the laboratory's CLIA number, the type of certificate you are applying for, and any supporting documentation required.
02
Complete the appropriate application form provided by the Centers for Medicare and Medicaid Services (CMS). Be sure to fill out all the required sections accurately and thoroughly.
03
Submit the completed application form along with any supporting documentation to the appropriate CMS regional office or designated CLIA State agency.
04
Pay the applicable fees for the certificate application. The fees may vary depending on the type of laboratory and certificate being applied for.
05
Await notification from the CMS or CLIA State agency regarding the status of your application. This may include a site visit or inspection to ensure compliance with CLIA regulations.
06
Once approved, you will receive your CLIA certificate. Be sure to display it prominently within your laboratory and comply with all ongoing regulatory requirements.

Who needs clinical laboratory improvement?

01
Clinical laboratories of various types, including those performing diagnostic testing, research studies, or drug testing, need clinical laboratory improvement (CLIA).
02
Healthcare providers, hospitals, medical clinics, and other facilities that perform laboratory tests also require CLIA certification to ensure their testing practices meet quality standards.
03
CLIA regulations apply to both public and private laboratories, serving patients of all ages, and cover a wide range of testing disciplines such as chemistry, microbiology, hematology, and genetics.
04
Additionally, any laboratory that accepts Medicare or Medicaid reimbursement for laboratory services must comply with CLIA requirements.
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Clinical Laboratory Improvement Amendments (CLIA) establish quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient results.
Any facility or individual that performs laboratory testing, including waived testing, must comply with CLIA regulations and file for clinical laboratory improvement.
Facilities can fill out the necessary forms and comply with CLIA regulations by following the guidelines provided by the Centers for Medicare & Medicaid Services (CMS).
The purpose of CLIA is to ensure the accuracy and reliability of laboratory testing to protect the health and safety of patients.
Facilities must report information regarding their testing procedures, quality control measures, personnel qualifications, and proficiency testing results.
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