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LABORATORY FIELD SERVICES

California Business and Professions Code (BPC) section 1265 (e) and (g) require clinical laboratories submit a completed Initial Clinical Laboratory License Application for Out-of-State within 30 days of a major change of ownership, directorship, name, location -OR- cease engaging in clinical laboratory practice. See References.

On this page:

  • Out-of-State Major Change of Owner
  • Out-of-State Minor Change of Owner
  • Out-of-State Other Changes
  • Contact and Mailing Address

  Major Change of Owner (Out-of-State)

CHOW-MAJOR

 

A major change in ownership means the new owners own 50% or more of the ownership interest than the current owners which clinical laboratory license was issued. See BPC 1211 (f) on References.

“A major change of ownership" means a change in ownership where 50 percent or more of the ownership interest is owned by persons other than the owners to whom the current clinical laboratory license is issued.

Instructions & Requirements:

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

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  Minor Change of Owner (Out-of-State)

CHOW-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.

  1. Explanation of Change
    • Submit the form Notification of Laboratory Change (LAB 193.pdf) -OR- Submit a cover letter from the laboratory director explaining the change of ownership -- must include the effective date and dated signature of the laboratory director.
  2. Disclosure of Ownership and Control of Interest Statement (LAB 1513)
    • Download form Skip to main contentLAB 1513 (.pdf)
    • An owner is anyone with 5% or more interest in the laboratory. For a corporation, submit a list of the corporate officers. If the laboratory is a non-profit or government agency, submit a list of the board of directors as they are considered the owners.   
  3. Official Documents of Ownership Transactions
    • May include copy of Bill of Sale, Sales Agreement, Merger Agreement, Partnership Agreement or Articles of Incorporation which include all owners' names and list of the Board of Directors and home addresses.   

  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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