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Laboratory Field Services

California Business and Professions Code (BPC) section 1265 (e) and (g) require clinical laboratories to notify Laboratory Field Services within 5 days of a qualified interim director. The laboratory must submit a completed Initial Clinical Laboratory License Application for Out-of-State within 30 days of a major change of directorship, ownership, name, location. Failure of the laboratory owners and directors to notify the department within 30 days of any change in laboratory directors, including any additions or deletions, shall result in the automatic revocation of the clinical laboratory’s license or registration. See References.

On this page:

  • Out-of-State Major Change of Laboratory Director
  • Out-of-State Minor Change of Laboratory Director
  • Out-of-State Other Changes
  • Contact and Mailing Address
  • References

 

  Major Change of Director (Out-of-State)

CHOD-MAJOR

 

A major change in laboratory directorship means less than half of the laboratory directors will remain after the change. See BPC 1211 (j) on References

“A major change in laboratory directorship” means a change in laboratory director or directors resulting in the situation where less than 50 percent of the laboratory directors to whom the current laboratory license is issued remain after the change. 

Instructions & Requirements:

Provide original signatures and dates on all forms. Copies are not acceptable.

(Click each line to expand)

  Minor Change of Director (Out-of-State)

CHOD-MINOR

 

No fees will be charged for applications submitted with minor changes only.

Instructions & Requirements:

Provide original signatures and dates on all forms. Copies are not acceptable.

  • Resignation Letter
    • Include effective date and original signatures of departing director (if applicable).
  • Letter of Addition
    • Include effective date and original signatures of incoming director (if applicable).
  • Notification of Laboratory Change form (LAB 193)
    • This is the easiest choice because it offers “filling in / checking off” the appropriate information. The form must be signed and dated by a laboratory director.
    • Download form Skip to main contentLAB 193 (.pdf)
  • Adding a Director
    • Please submit a copy of the following items with the form "Notification of Laboratory Change" 
      • CV / Resume for the M.D. or PhD director
      • M.D. license for the state in which the lab is located
      • PhD diploma OR transcript

  Other Changes

Download and submit Skip to main contentLAB 193 (.pdf) Notification of Laboratory Change form, for other changes (other than the major or minor changes mentioned above) such as change in location address, mailing address, telephone/fax number, closure of laboratory, and accreditation change. No fee is required for these changes. Provide original signatures and dates on all forms. Copies are not acceptable.

reminder

Important Reminders

All forms must be completed, filled out and dated. Signatures must be original to prevent delays in processing. Supporting documents may be submitted in an electronic format.

 Complete all applicable sections of the forms and provide dated signatures where required. All signatures must be originals. Supporting documents may be submitted in an electronic format. Incomplete forms, missing information, and/or insufficient documentation will delay processing.

After our initial review, applicants will be given 30 days to correct any deficiencies. Failure to satisfy the Department's requirements will result in the abandonment of the application and/or termination of the license.

 The application fee is non-refundable and will not be credited to your account if the application is abandoned, denied, or withdrawn.

mail


Please mail all forms, supporting documents, and fee to the address below:

California Department of Public Health
Laboratory Field Services
Attn: Out-of-State Laboratory Licensing Program
850 Marina Bay Parkway, Bldg. P, 1st Floor
Richmond, CA 94804

questions

Contact Details

For questions please contact:
By email: LFSFacOutofState@cdph.ca.gov 
By telephone: (510) 620-3800

References

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