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PRINTED: 08/29/2019 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X3) DATE SURVEY COMPLETED08/28/2019STREET
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How to fill out waived initial clia 116
How to fill out waived initial clia 116
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Obtain a copy of the waived initial clia 116 form.
02
Fill out all required sections on the form accurately and completely, including personal information and testing facility details.
03
Provide any necessary supporting documentation or test results as requested on the form.
04
Review the completed form for any errors or omissions before submitting it.
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Submit the filled out form to the appropriate regulatory or certifying agency for processing.
Who needs waived initial clia 116?
01
Individuals or facilities that perform waived laboratory testing procedures are typically required to fill out the waived initial clia 116 form.
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What is waived initial clia 116?
Waived initial clia 116 refers to the form used to apply for a Clinical Laboratory Improvement Amendments (CLIA) waiver for certain laboratory tests.
Who is required to file waived initial clia 116?
Any laboratory that wants to perform waived tests under CLIA must file a waived initial clia 116 form.
How to fill out waived initial clia 116?
To fill out the waived initial clia 116 form, laboratories need to provide information about the tests they will be performing and their facility.
What is the purpose of waived initial clia 116?
The purpose of waived initial clia 116 is to ensure that laboratories meet the requirements for performing waived tests under CLIA.
What information must be reported on waived initial clia 116?
The waived initial clia 116 form requires information about the laboratory tests to be performed, facility details, and personnel qualifications.
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