Cms Form 116
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Cms Form 116
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Web Complete the Application for Certification Form CMS 116 unless you re A New York state non physician office laboratory applicant Email or call the New York State Department of Health at 518 485 5378 for guidance A Washington state applicant Email or call the Washington State Agency at 253 395 6746 for guidance STEP 1: . Download and . Complete Form CMS-116. Include information based on thedate of form completion. All applicable sections must be completed.Incomplete applications cannot be processed. Print legibly or type. To find out if the testing your laboratoryis performing is categorized as waived,moderate, or high complexity-refer to theFDA website.
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Cms Form 116;First, download the CMS-116 Clinical Laboratory Improvement Amendments (CLIA) application form ( https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS116.pdf ). Section I. In section I of this CMS-116 form, complete the basic information regarding your laboratory and director. Section II. Web Apr 1 2020 nbsp 0183 32 CMS 116 Form Title CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF 1988 CLIA APPLICATION FOR CERTIFICATION Revision Date 2020 04 01 O M B 0938 0581 O M B Expiration Date 2024 03 31 Special Instructions N A Downloads
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