How to Apply for a Clia Certificate

HOW TO APPLY FOR A CLIA CERTIFICATE

1. Go to the CLIA website www.cms.hhs.gov/CLIA 2. On the left side of the page under the title “Clinical Laboratory Improvement Amendments (CLIA) you will see a list of topics. 3. Select the first topic “How to Apply for a CLIA Certificate” 4. Using the right scroll bar, scroll down to “Related Links” -- CMS 116 5. Once you select the CMS 116, the CLIA application will appear. At this point you can either type in the formation and then print out the completed application, or print out the blank application and hand write the information. All four pages of the application must be completed before it will be able to be processed.  If applying for a Certificate of Waiver Certificate—no additional information is required.  If applying for a Certificate for Provider Performed Microscopy Procedures (PPM)—a copy of the director’s medical license must accompany the application.  If applying for a Certificate of Compliance or a Certificate of Accreditation, a copy of director’s credentials must be included (CV are not acceptable). If you have questions regarding the director’s credentials please contact the program manager at (517) 241- 2645. 6. Once the application is completed, it can be faxed to (517) 241-3354 or mailed to the address listed under the contact section. 7. Once the completed application is received by our office, it will be processed in 3-5 business days. 8. Once the application is processed, a confirmation E-mail or letter will be sent to the facility. 9. A fee coupon will be generated by the federal contractor and sent to the facility. Once the fee coupon is received, payment can only be made by check to the address listed. 10. Once payment has been received, the laboratory is able to start testing and billing for the tests performed.