Enter the data in this section EXACTLY as it appears on your CLIA certificate. If the information on your certificate is outdated or incorrect, please do not proceed with this application until the information has been updated!
Contact your state's CLIA office or accrediting organization, if applicable, to make any necessary changes.
CLIA contact information can be found at https://www.cms.gov/regulations-and-guidance/legislation/clia/downloads/cliasa.pdf.