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PRINTED: 09/08/2020 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION

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How to fill out clia certificate of registration

01

Gather all necessary information and documents, including facility information, owner information, and testing personnel information.

02

Complete the CMS-116 form online or on paper, providing accurate and up-to-date information for each section.

03

Pay the required fee for the certificate of registration.

04

Submit the completed form and fee payment to the address indicated on the form.

05

Wait for confirmation of receipt and processing of the application by the CLIA program.

Who needs clia certificate of registration?

01

Any entity or individual performing laboratory testing on human specimens for health assessment, diagnosis, treatment, or prevention purposes needs a CLIA certificate of registration.

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What is clia certificate of registration?

The CLIA Certificate of Registration is a document issued by the Centers for Medicare & Medicaid Services (CMS) that allows clinical laboratories to perform testing on human specimens.

Who is required to file clia certificate of registration?

Any clinical laboratory that performs testing on human specimens for the purpose of diagnosis, prevention, treatment, or monitoring of health conditions is required to file a CLIA Certificate of Registration.

How to fill out clia certificate of registration?

To fill out the CLIA Certificate of Registration, the laboratory must provide information about the ownership, personnel, testing performed, quality control procedures, and laboratory settings.

What is the purpose of clia certificate of registration?

The purpose of the CLIA Certificate of Registration is to ensure that clinical laboratories meet specific quality standards and regulations to provide accurate and reliable test results.

What information must be reported on clia certificate of registration?

The CLIA Certificate of Registration requires information such as laboratory name and address, testing performed, laboratory director information, quality control procedures, and personnel qualifications.

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