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Form Cms 116. Web find and fill out the correct cms 116 form 2015. • all applicable sections must be completed.
The following provides access and/or information for many cms forms. Send your completed application to the address of the local state agency for the state in which your laboratory is located. Choose the correct version of the editable pdf form. All forms (cms 116 clia application, enclosure a disclosure of ownership and enclosure i methodology test list) must be completed and signed and appropriate. Web clinical laboratory professionals use the clia application cms 116 form to report certain information on performance of laboratory tests toclinical laboratory improvement. Web clia certificate of waiver. Email or call the new york. You may also use the search feature to more quickly locate information. Web cms 116 | cms back to cms forms list cms 116 form # cms 116 form title clinical laboratory improvement amendments of 1988 (clia). Web department of health and human servicesform approvedcenters for medicare & medicaid servicesomb no.
Choose the correct version of the editable pdf form. The following provides access and/or information for many cms forms. All forms (cms 116 clia application, enclosure a disclosure of ownership and enclosure i methodology test list) must be completed and signed and appropriate. Try it for free now! Web clia certificate of waiver. Web find and fill out the correct cms 116 form 2015. All applicable sections must be completed.incomplete applications. Name and address/location tests performed/specialty/subspecialty name of laboratory or. Web department of health and human servicesform approvedcenters for medicare & medicaid servicesomb no. • all applicable sections must be completed. Choose the correct version of the editable pdf form.
