c l,2g#*|5Af(>[s P 0000002474 00000 n The State of NJ site may contain optional links, information, services and/or content from other websites operated by third parties that are provided as a convenience, such as Google Translate. F O R M C H E C K B O X Y e s F O R M C H E C K B O X N o I f y e s , s p e c i f y : F O R M T E X T 3 . 0 You do not need to spell the names or city in full but you must use at least 2 characters for any search option used. $ C`RiRr(#YE"J\&9,;="Ylr^Kh"A L\&M\\#-O m`{* 'G>Ax)rUJ7G3^S(_0.%ZUbo^}Y\^MgjW.N5BEa@O?n?P2RgcZqA7WsFh. Brief at Online Application Application for Doctor of Osteopathy by the State Board of Medical Examiners of New Jersey Online Application Application for Bioanalytical Lab Director Online Application Application for Resident Permit Online Application Application for an Extension for Not More than 60 Days Forms Medical Education Verification Form cl-18, laboratory, application for clinical laboratory license, clinical laboratory license application, collection station Last modified by: ewhite Created Date: 6/26/2008 6:46:00 PM 0000004165 00000 n 0000000016 00000 n / ; J K V W X Y Z g n y z { Select a profession and/or licensee type . The CAP programs are built on more than a half-century of experience, the CAPs Laboratory Accreditation Program has been the champion of laboratory excellence. P -Read Full Disclaimer. The user is on notice that neither the State of NJ site nor its operators review any of the services, information and/or content from anything that may be linked to the State of NJ site for any reason. American Medical Technologists (AMT) > Verify Verify Certification Status Check to see if an individual is currently certified through AMT. Select a profession and/or licensee type . The New Jersey Department of Health is a nationally accredited state public health agency focused on improving population health by strengthening New Jersey's health system. I $$ T H 4 \ p%) $ $ ! . Switch to Business Search . This tool allows users to searchdemographicinformation about CLIA-certified laboratories using CLIA numbers, facility names, addresses, geographic locations, or typesof CLIA certificates. for the next edition. 0000001011 00000 n Facility Registration Requirements. The datain this CDC toolareupdated regularly butthere may be delays beforelaboratoriesrecently certified by CMSappear in the database. distribution list $ The OQA currently certifies the analytical capabilities of approximately 800 laboratories. The OQA certifies laboratories in 36 states, Canada and overseas, and offers certification in: Methods offered for certification are called Department Sanctioned Analytical Methods (DSAMs) and include testing for microbiology, toxicity, physical characteristics, nutrients, inorganics, metals, volatile organics, semi-volatile organics, polynuclear aromatic hydrocarbons, polychlorinated biphenyls, dioxins, and radiochemistry. suggestions, You are now signed up for the AMT Educator FORMCHECKBOX Yes FORMCHECKBOX NoCERTIFICATIONWe the undersigned certify that all the information given on this application and on the accompanying attachments is true, correct and complete as of this date and that notification, by certified mail, of any change(s) will be made within 14 days of such change(s). The current list of DSAMs are contained in PART III of the Departments application for certification. DO NOT put a space between the comma and the first name as this will produce . document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_3" ).setAttribute( "value", ( new Date() ).getTime() ); We use cookies to ensure that we give you the best experience on our website. You will no longer receive a paper license in the mail. 12 plenary license as a bio-analytical laboratory director. JFF)Sg`N86[#1 # License Verification. : 0000007932 00000 n ( $ ! New Jersey State Laboratory License (CL-3) New Jersey State Ownership Form (CL-9) New Jersey State Personnel Qualification form (CL-34) New Jersey Department of Health 369 South Warren Street, 6th Floor Trenton, NJ 08608-2308 Top ^ Division of HIV, STD (Sexually Transmitted Diseases) and TB (Tuberculosis) Services Click here to submit an online OPRA request related to the following areas: Office of Assistant Commissioner Administration and Finance Grants Monitoring Unit New Jersey Department of Health. Switch to. 0000005536 00000 n xref $ ! hb``g``nd`` 0000003134 00000 n The State of NJ site may contain optional links, information, services and/or content from other websites operated by third parties that are provided as a convenience, such as Google Translate. If you are uncertain of the spelling or if abbreviation is possible, try a . L o c a t i o n o f C ollection Station FORMCHECKBOX Store FORMCHECKBOX Residence FORMCHECKBOX Mobile FORMCHECKBOX Physician Office FORMCHECKBOX Professional Building FORMCHECKBOX Other, specify: FORMTEXT 2 . Saving Lives, Protecting People, information about CLIA-certified laboratories using CLIA number, the search function, enter laboratory names. [V W X Y Z g n y z { W Q ! Real-Time Lists of Certified Laboratories $ $ ! Complete the Application for Certification Form (CMS-116), unless you're: A New York state non-physician office laboratory applicant. 8:45-1.3(b), laboratories that have not submitted their 2022 License Renewal Application(s) (CL-3 and/or CL-18 . Governor Sheila Oliver, Improving Health Through Leadership and Innovation, Enterics and Special Bacteriology Laboratories, Chemical Terrorism, Biomonitoring, Medicinal Marijuana and Food Testing Laboratory, Chapter 44 - State Regulations [N.J.A.C. All information these cookies collect is aggregated and therefore anonymous. Lt. Trenton, NJ 08625-0361 APPLICATION FOR A CLINICAL LABORATORY LICENSE . 0000006138 00000 n https://www.americanmedtech.org/cv/cgi-bin/utilities.dll/openpage?wrp=employerSearch.htm. 0000003451 00000 n In addition, we are accredited in the following states that require state CLIA certification. N N ` b b N N N N ` @ N N ` R `db b " X New Jersey Department of Health Clinical Laboratory Improvement Services PO Box 361 Trenton, NJ 08625-0361APPLICATION FOR A CLINICAL LABORATORY LICENSE (COLLECTION STATION ONLY-$200) Type of Application FORMCHECKBOX Initial FORMCHECKBOX RenewalFOR STATE USE ONLY:Date ReceivedReceived By FORMCHECKBOX ApprovedCheck NumberAmountCheck Date Name of Collection Station FORMTEXT N a m e o f P a r e n t L a b F O R M T E X T S t r e e t A d d r e s s F O R M T E X T S t r e e t A d d r e s s F O R M T E X T C i t y , S t a t e , Z i p C o d e F O R M T E X T C i t y , S t a t e , Z i p C o d e F O R M T E X T C L I S I D N u m b e r F O R M T E X T N o r m a l H o u r s o f O p e r a t i o n o f C o l l e c t i o n S t a t i o n [ I n d i c a t e s p e c i f i c h o u r s E A C H d a y ] : N a m e o f C o n t a c t P e r s o n F O R M T E X T M o n d a y F O R M T E X T T u e s d a y F O R M T E X T T e l e p h o n e N u m b e r ( F O R M T E X T ) F O R M T E X T W e d n e s d a y F O R M T E X T T h u r s d a y F O R M T E X T F a x N u m b e r ( F O R M T E X T ) F O R M T E X T F r i d a y F O R M T E X T S a t u r d a y F O R M T E X T E - M a i l A d d r e s s F O R M T E X T S u n d a y F O R M T E X T P H Y S I C A L P L A N T 1 . N Inspections are conducted by clinical laboratory evaluators to ensure that the operations of the laboratories and collection stations comply with the respective New Jersey Administrative Code; and. 5CJ OJ QJ U j 5CJ OJ QJ U OJ QJ 5CJ OJ QJ CJ OJ QJ j 5CJ OJ QJ UmH j 5CJ OJ QJ U j4 5CJ OJ QJ U*8 : X B I $$ T H 4 \ p%)` $ $ ! Your email has been added to the limited 8:45-1.3(b), laboratories that have not submitted their 2021 License Renewal Application(s) (CL-3 and/or CL-18) with the applicable fees by December 31, 2020 may be subject to late fees. 0000004007 00000 n Lab Regulations by State State-by-State Laboratory Licensing Information Our state licensing map resource was built to help our clinical laboratory clients and medical laboratory scientists find all of the information they need to attain the necessary state personnel and facility licensing. CJ OJ QJ Uj CJ OJ QJ Uj $ j 5CJ OJ QJ U jH 5CJ OJ QJ U j 5CJ OJ QJ U j\ 5CJ OJ QJ U OJ QJ j 5CJ OJ QJ UmH j 5CJ OJ QJ U j 5CJ OJ QJ U CJ OJ QJ 5CJ OJ QJ 1 Is there a sign on the exterior of the building and is the laboratorys collection station listed on the building directory? Now click on the applications tab. H Certifications are added and deleted for laboratories for various reasons every day. startxref In accordance with N.J.A.C. Email or call the Washington State Agency at 253-395-6746 for guidance. 3. License Verification Online Access: General Public: Via the Internet NJ Government Agency Access (within the state firewall): Via the Department of Law and Public Safety's Intranet Written Verifications If you need written verification of a licensee's status, either write or fax the Board at: State Board of Medical Examiners
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