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