Office of Laboratory Services: LAB-PLUS Registration Code Request

Office of Laboratory Services: LAB-PLUS Registration Code Request
Welcome to the new LAB-PLUS online licensing system!

Complete this form to verify your identity and request the one-time registration code needed to access your online account and dashboard. Once your information is verified, you will receive an email containing the code.

Please allow one week for processing due to an anticipated high volume of requests.

If you have questions, please email us at dholsclp@wv.gov.
Do you have an existing laboratory practitioner license in West Virginia?*

YesNo
This form is only used to provide access to individuals who have a WV laboratory practitioner license (MLT, MLS, PA, CT, H, POCT, Trainee). If you need to apply for a license, please visit the LAB-PLUS page and select the applicable option.
Name as Displayed on License*

First NameLast Name
Previous Name(s), if applicable
Last 4 of SSN*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address on File*

Street Address

CityState / Province

Postal / Zip Code
License Category*
WV Lab Practitioner License Number (type 0 if trainee)*
Expiration Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty: