div class=ts-pagebutton class=gotoPage data-page=1Page 1button div class=ts-imageimg data-url=dhhrwvgov-clinical-laboratory-improvement-amendments-clia-application-forhtmlpage=1 data-page=1 class=ts-thumb lazyload alt=Page 1: dhhrwvgovCLINICAL LABORATORY IMPROVEMENT AMENDMENTS CLIA APPLICATION FOR CERTIFICATION Form Approved OMB No 0938-0581 l GENERAL INFORMATION Initial Application Change in Certificate loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader035vdocumentsusreader035viewer20220708175f1267ba63ac0f01c50e5e17html5thumbnails1jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=2Page 2button div class=ts-imageimg data-url=dhhrwvgov-clinical-laboratory-improvement-amendments-clia-application-forhtmlpage=2 data-page=2 class=ts-thumb lazyload alt=Page 2: dhhrwvgovCLINICAL LABORATORY IMPROVEMENT AMENDMENTS CLIA APPLICATION FOR CERTIFICATION Form Approved OMB No 0938-0581 l GENERAL INFORMATION Initial Application Change in Certificate loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader035vdocumentsusreader035viewer20220708175f1267ba63ac0f01c50e5e17html5thumbnails2jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=3Page 3button div class=ts-imageimg data-url=dhhrwvgov-clinical-laboratory-improvement-amendments-clia-application-forhtmlpage=3 data-page=3 class=ts-thumb lazyload alt=Page 3: dhhrwvgovCLINICAL LABORATORY IMPROVEMENT AMENDMENTS CLIA APPLICATION FOR CERTIFICATION Form Approved OMB No 0938-0581 l GENERAL INFORMATION Initial Application Change in Certificate loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader035vdocumentsusreader035viewer20220708175f1267ba63ac0f01c50e5e17html5thumbnails3jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=4Page 4button div class=ts-imageimg data-url=dhhrwvgov-clinical-laboratory-improvement-amendments-clia-application-forhtmlpage=4 data-page=4 class=ts-thumb lazyload alt=Page 4: dhhrwvgovCLINICAL LABORATORY IMPROVEMENT AMENDMENTS CLIA APPLICATION FOR CERTIFICATION Form Approved OMB No 0938-0581 l GENERAL INFORMATION Initial Application Change in Certificate loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader035vdocumentsusreader035viewer20220708175f1267ba63ac0f01c50e5e17html5thumbnails4jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=5Page 5button div class=ts-imageimg data-url=dhhrwvgov-clinical-laboratory-improvement-amendments-clia-application-forhtmlpage=5 data-page=5 class=ts-thumb lazyload alt=Page 5: dhhrwvgovCLINICAL LABORATORY IMPROVEMENT AMENDMENTS CLIA APPLICATION FOR CERTIFICATION Form Approved OMB No 0938-0581 l GENERAL INFORMATION Initial Application Change in Certificate loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader035vdocumentsusreader035viewer20220708175f1267ba63ac0f01c50e5e17html5thumbnails5jpg width=140 height=200 divdiv
