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Web department of health and human servicesform approvedcenters for medicare & medicaid servicesomb no. Web clinical laboratory professionals use the clia application cms 116 form to report certain information on performance of laboratory tests toclinical laboratory improvement. • all applicable sections must be completed. All applicable sections must be completed.incomplete applications. Upload, modify or create forms.
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Name and address/location tests performed/specialty/subspecialty name of laboratory or. Web find and fill out the correct cms 116 form 2015. Email or call the new york. Finding a authorized expert, creating a scheduled appointment and coming to the workplace for a personal conference makes finishing a.
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Choose the correct version of the editable pdf form. All applicable sections must be completed.incomplete applications. Upload, modify or create forms. Send your completed application to the address of the local state agency for the state in which your laboratory is located.