New Facility Application Checklist
2 TO BE UPLOADED: F Form . LAB 182 Attestation of each Owner F Form . LAB 183 Attestation of each Laboratory Director . F Form. LAB 116 Laboratory Personnel Report (if PPMP, or Moderate/High Complexity) F Form . CMS 116 CLIA Application for Certification. F Proof of accreditation or letter of enrollment from accrediting agency (if applicable) B
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