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Get CLIA Form 1513 2005

I(b) of this form. Failure to submit requested information may result in the suspension or revocation of any CLiA cert)ficate or denial of application for prospective laboratories. General Instructions For definitions, procedures and requirements, appropriate Regulations: CLiA Title XVIII Title XIX Title XX refer to the -42CFR 493 -42CFR 420 200-206 -42CFR455100-106 -45CFR 228 72-73 Please answer all questions as of the current date. If the yes block for any item is checked, list requested a.

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