CMS588 Form Fillable Blank to Download in PDF
Cms Form 116. The cms 116 clia applications may be completed for any changes. Clinical laboratory improvement amendments (clia) application for certification all applicable sections of this form must be completed.
Web what is the cms 116 form and its purpose? Web the cms 116 clia application and enclosure a disclosure of ownership is completed for change of ownership and tax id. State agency contact information can be found at: Enclosure a disclosure of ownership. Do not send any payment with your completed 116 application. Contact health facility compliance at infohflc@hhs.texas.gov with any questions. Completed 116 applications must be sent to your local state agency. The cms 116 clia applications may be completed for any changes. National provider identifier (npi) application/update form. Enclosure i methodology test list.
Enclosure i methodology test list. Do not send any payment with your completed 116 application. State agency contact information can be found at: National provider identifier (npi) application/update form. Enclosure a disclosure of ownership. Enclosure i methodology test list. All applicable sections must be completed.incomplete applications cannot be processed. The cms 116 clia applications may be completed for any changes. Contact health facility compliance at infohflc@hhs.texas.gov with any questions. Clinical laboratory improvement amendments (clia) application for certification all applicable sections of this form must be completed. Web the cms 116 clia application and enclosure a disclosure of ownership is completed for change of ownership and tax id.
