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and to permit CLiS Licensing staff adequate time for review and approval. The Office of Quality Assurance (OQA) offers certification for environmental testing laboratories to ensure that regulatory decisions made by federal, state, and municipal government agencies are based upon accurate and dependable analytical data. QDx Pathology Services is a fully accredited national, CLIA-certified laboratory We are licensed to perform laboratory testing for physicians, medical centers and hospitals throughout the nation, in all 50 U.S. states. Certification requests can only be submitted by the licensee and can only be sent to the licensee or the licensing authority of another state or jurisdiction. Trenton, NJ 08625-0361 APPLICATION FOR A CLINICAL LABORATORY LICENSE . / ; J K V W X Y Z g n y z { 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. 0000008108 00000 n
That commitment is embodied in our practice of the 12 essential quality control and quality management processes: QDx Pathology Services is an independent anatomical, molecular and clinical pathology laboratory. Instagram
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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. Select a profession and/or licensee type . Brief at Select a profession and/or licensee type . License Verification. Your email has been added to the limited $ 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 Full Service FDA & DEA Inspected, ISO/IEC 17025:2017 PJLA Accreditation #97233 Testing, CGMP Analytical Chemistry & Microbiology Laboratory All New Jersey Clinical Laboratory Owners or Directors: Under aforementioned New Jersey Clinical Laboratory Improvement Act (the Act), N.J.S.A. 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%)` $ $
! New Jersey State Laboratory License (CL-3) New Jersey State Ownership Form (CL-9) New Jersey State Personnel Qualification form (CL-34) Switch to Business Search . Via the Internet. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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 31 0 obj
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Governor Sheila Oliver, Improving Health Through Leadership and Innovation, If you or your organization are involved in human milk banking and wish to respond to the Departments survey, please do so via this link by May 26, 2023, Enterics and Special Bacteriology Laboratories, Chemical Terrorism, Biomonitoring, Medicinal Marijuana and Food Testing Laboratory, http://healthsurveys.nj.gov/NoviSurvey/n/zz3k4.aspx. 0000002474 00000 n
hb``g``nd`` Facility Registration Requirements. NJ Government Agency Access (within the state firewall): Via the Department of Law and Public Safety's Intranet. 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
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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
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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 . An inspection may take one or more days. [V W X Y Z g n y z { W Q
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Investigates errors and complaints which jeopardize the health and safety of patients. The Office of Quality Assurance (OQA) offers certification for environmental testing laboratories to ensure that regulatory decisions made by federal, state, and municipal government agencies are based upon accurate and dependable analytical data. 0000001011 00000 n
Certifications are added and deleted for laboratories for various reasons every day. C`RiRr(#YE"J\&9,;="Ylr^Kh"A L\&M\\#-O m`{* 'G>Ax)rUJ7G3^S(_0.%ZUbo^}Y\^MgjW.N5BEa@O?n?P2RgcZqA7WsFh. 0000000816 00000 n
The OQA currently certifies the analytical capabilities of approximately 800 laboratories. 10700 West Higgins Rd, Suite 150 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. Certification of laboratories is an ongoing process. HlTMS0g&31dbk\0%Lh%
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! 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. In addition, we are accredited in the following states that require state CLIA certification. 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). Last Modified: 10/27/2016 10:41 AM. The data, Clinical Laboratory Improvement Amendments (CLIA), U.S. Department of Health & Human Services, For windows: Hold down the control (ctrl) button to select multiple options, For Mac: Hold down the command button to select multiple options. Below, you will find state-specific information regarding licensing regulations for all mandatory laboratory positions as well as all forms and applications related to starting and running your clinical laboratory. Click on the facility you would like to submit the renewal application for. Lt. Select a profession and/or licensee type . Select a license type (optional) and/or a status (optional). 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. 0000003134 00000 n
Rosemont, IL 60018, 2022 by American Medical Technologists (AMT), You are now signed up for the AMT Employer News The Department oversees health care facilities, public health services, the state's psychiatric hospitals, the medicinal marijuana program, EMS and the Office . Certification must be renewed annually. $
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New Jersey CLIA Laboratory Application. We take your privacy seriously. x $
! Being able to verify your certification demonstrates to your team members and colleagues that you have kept your knowledge and skills up to date."
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! NOTE: If you are unable to see the facility you are assigned to, please call us at (609) 292-6552 or email us at HFSPortal@doh.nj.gov. American Medical Technologists (AMT) > Verify Verify Certification Status Check to see if an individual is currently certified through AMT. "New medical discoveries and the rapid development of new laboratory technologies requires laboratory professionals to maintain and enhance their skills. 0000004165 00000 n
You can opt out of receiving the Employer News If you are searching for a business licensee (i.e., accountancy firms; architects and engineers certificates of authorization; barber shops; cemeteries; cosmetology and hairstyling shops; electrical contractor businesses; funeral homes; home improvement contractors; manicuring shops; pharmacies; public movers and warehousemen and skin care You will be subject to the destination website's privacy policy when you follow the link. exactly as they appear on the CLIA certificate. Email or call the Washington State Agency at 253-395-6746 for guidance. 2021, c. 454 as amended by P.L. $
! Saving Lives, Protecting People, information about CLIA-certified laboratories using CLIA number, the search function, enter laboratory names. If you are searching for a business licensee (i.e., accountancy firms; architects and engineers certificates of authorization; barber shops; cemeteries; cosmetology and hairstyling shops; electrical contractor businesses; funeral homes; home improvement contractors; manicuring shops; pharmacies; public movers and warehousemen and skin care I $$ T H 4 \ p%) $ $
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Complete the Application for Certification Form (CMS-116), unless you're: A New York state non-physician office laboratory applicant. A Washington state applicant. A r e q u a r t e r s s h a r e d w i t h a n y o t h e r e n t e r p r i s e ? Twitter
Welcome to the New Jersey Division of Consumer Affairs License Verification System. We further certify that testing will not be performed until all applicable State and Federal certificates, licenses and required approvals have been obtained.Signature of DirectorDateSignature of OwnerDateSignature of OwnerDateSignature of OwnerDate
APPLICATION FOR A CLINICAL LABORATORY LICENSE, Continued
CL-18
JUL 12
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To improve search accuracy. If you are uncertain of the spelling or if abbreviation is possible, try a . c l,2g#*|5Af(>[s Increase your testing confidence Utilize AMT study resources. General Public Access: Via the Internet. Explore a rich library of content on registering, hiring, funding, and more. https://www.americanmedtech.org/cv/cgi-bin/utilities.dll/openpage?wrp=employerSearch.htm. PO Box 361. Brief. $
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The information in this database isprovided bythe Centers for Medicare & Medicaid Services (CMS), which is theagency withauthorityfor CLIA certificate information. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 6 8 I $$ T H 4 \ p%)` $ $
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$ & ( 2 4 6 8 : X Z n p r | ~ # $ % 5 6 D E F Z [ i y j CJ OJ QJ Uj DO NOT put a space between the comma and the first name as this will produce . If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. H Email or call the New York State Department of Health at (518) 485-5378 for guidance. Is there a sign on the exterior of the building and is the laboratorys collection station listed on the building directory? Section 8:45-1.1 - Initial licensure (a) Application for an initial license to conduct a clinical laboratory, as required under the provisions of Chapter 166, P.L. & f < P 609-913-5105 Clinical Laboratory Licensing Program Contact Us Email: Joan.Mikita@doh.nj.gov Phone: 609-406-6830 Fax: 609-406-6863 Mailing/Shipping Addresses: By USPS, mail/ship to- Public Health & Environmental Laboratories NJ Department of Health ATTN: Joan Mikita Clinical Laboratory Licensing Program PO Box 361 Trenton, NJ 08625-0361 37 the clinical laboratory license under the "New Jersey Clinical 38 Laboratory Improvement Act," P.L.1975, c.166 (C.45:9-42.26 et 39 seq.). $ Cookies used to make website functionality more relevant to you. JFF)Sg`N86[#1 # 0000007932 00000 n
These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 0000007370 00000 n
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: Thank you for taking the time to confirm your preferences. California Clinical Lab License. You can review and change the way we collect information below. J 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. View Resources $
! ; J K L V W y z { for the next edition. 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. 0000006138 00000 n
Now click on the applications tab. They help us to know which pages are the most and least popular and see how visitors move around the site. Start If you are searching for a business licensee (i.e., accountancy firms; architects and engineers certificates of authorization; barber shops; cemeteries; cosmetology and hairstyling shops; electrical contractor businesses; funeral homes; home improvement contractors; manicuring shops; pharmacies; public movers and warehousemen and skin care speciality shops) select Business Search below. L 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 In accordance with N.J.A.C. Verify Credentials. Facebook
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f Real-Time Lists of Certified Laboratories QDx is CAP accredited and subscribes to CAPs proficiency testing program that includes verification of testing performance and professional proficiency against pre-analyzed samples.