Health Unit appointment excuse form.
To obtain CLIA certification for laboratory testing in the state of Louisiana, you must complete the Clinical Laboratory Improvement Amendments (CLIA) Application for Certification, Form CMS-116 along with the List of Tests Performed in the Facility. Both forms are required in order to approve your facility for testing.
The instructions and forms in this packet are designed to assist providers in submitting the required information to add a transplant unit.
Effective July 1, 2010 the Louisiana Department of Health and Hospitals, Health Standards Section will license Adult Residential Care Providers.