CLINICAL LABORATORY IMPROVEMENT AMENDMENTS …Aug 18, 2018  · centers for medicare & medicaid...

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CENTERS FOR MEDICARE & MEDICAID SERVICES CLINICAL LABORATORY IMPROVEMENT AMENDMENTS CERTIFICATE OF C0. 4iPLIANCE LABORATORY NAME AND ADDRESS CLIA ID NUMBER CHEMATOX LABORATORY, INC 06D1106932 5401 WESTERN AVE BOULDER, CO 80301 EFFECTIVE DATE f 08/19/ 2016 41.. LABORATORY DIRECTOR EXPIRATION DATE DEBORAH G JOHNSON M. D. 08/18/ 2018 Pursuant to Section 353 of the Public Health Services Act ( 42 U. S. C. 263a) as revised by the Clinical Laboratory Improvement Amendments ( CLIA), the above named laboratory located at the address shown hereon ( and other approved locations) may accept human specimens for the purposes of performing laboratory examinations or procedures. This certificate shall be valid until the expiration date above, but is subject to revocation, suspension, limitation, or other sanctions for violation of the Act or the regulations promulgated thereunder. Karen W Dyer, Acjfng Director C Division and Certification Services Survey and Certification Group Center for Clinical Standards and Quality t 00110, 111W! 0" 241 Certs2 081676 If you currently hold a Certificate of Compliance or Certificate of Accreditation, below is a list of the laboratory specialties/ subspecialties you are certified to perform and their effective date: LAB CERTIFICATION ( CODE) EFFECTIVE DATE LAB CERTIFICATION ( CODE) EFFECTIVE DATE ROUTINE CHEMISTRY ( 310) 03/ 11/ 2014 URINALYSIS ( 320) 01/ 18/ 2012 TOXICOLOGY ( 340) 08/19/ 2010 FOR MORE INFORMATION ABOUT CLIA, VISIT OUR WEBSITE AT WWW. CMS. GOV/ CLIA OR CONTACT YOUR LOCAL STATE AGENCY. PLEASE SEE THE REVERSE FOR YOUR STATE AGENCY' S ADDRESS AND PHONE NUMBER PLEASE CONTACT YOUR STATE AGENCY FOR ANY CHANGES TO YOUR CURRENT CERTIFICATE.

Transcript of CLINICAL LABORATORY IMPROVEMENT AMENDMENTS …Aug 18, 2018  · centers for medicare & medicaid...

Page 1: CLINICAL LABORATORY IMPROVEMENT AMENDMENTS …Aug 18, 2018  · centers for medicare & medicaid services clinical laboratory improvement amendments certificate of c0.4ipliance laboratory

CENTERS FOR MEDICARE & MEDICAID SERVICES

CLINICAL LABORATORY IMPROVEMENT AMENDMENTS

CERTIFICATE OF C0.4iPLIANCE

LABORATORY NAME AND ADDRESS CLIA ID NUMBER

CHEMATOX LABORATORY, INC 06D1106932

5401 WESTERN AVE

BOULDER, CO 80301EFFECTIVE DATE

f 08/19/2016

41..

LABORATORY DIRECTOR EXPIRATION DATE

DEBORAH G JOHNSON M.D. 08/18/2018

Pursuant to Section 353 of the Public Health Services Act (42 U.S.C. 263a) as revised by the Clinical Laboratory Improvement Amendments (CLIA),

the above named laboratory located at the address shown hereon (and other approved locations) may accept human specimensfor the purposes of performing laboratory examinations or procedures.

This certificate shall be valid until the expiration date above, but is subject to revocation, suspension, limitation, or other sanctions

for violation of the Act or the regulations promulgated thereunder.

Karen W Dyer, Acjfng Director

CDivision

and CertificationServices

Survey and Certification GroupCenter for Clinical Standards and Quality

t

00110, 111W!0"

241 Certs2 081676

Ifyou currently hold a Certificate of Compliance or Certificate of Accreditation, below is a list of the laboratory

specialties/subspecialties you are certified to perform and their effective date:

LAB CERTIFICATION (CODE) EFFECTIVE DATE LAB CERTIFICATION (CODE) EFFECTIVE DATE

ROUTINE CHEMISTRY (310) 03/11/2014

URINALYSIS (320) 01/18/2012

TOXICOLOGY (340) 08/19/2010

FOR MORE INFORMATION ABOUT CLIA, VISIT OUR WEBSITE AT WWW.CMS.GOV/CLIA

OR CONTACT YOUR LOCAL STATE AGENCY. PLEASE SEE THE REVERSE FOR

YOUR STATE AGENCY'S ADDRESS AND PHONE NUMBER

PLEASE CONTACT YOUR STATE AGENCY FOR ANY CHANGES TO YOUR CURRENT CERTIFICATE.

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