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Mail-in Application Requirements

Please note:
There are upcoming changes to this page soon.
Please check back to be updated on these changes.

​ Stop and Read: If you have already mailed-in an application, do not submit another application online as this will cause delays. If renewing, do not click "Start New Application" to avoid a gap in licensure which may affect your billing. All forms must be completely filled out and dated.

New License Application

If mailing your new license application, complete and submit the following forms. After review, we may request more information.

Type of License:

• Registration or Waived/PPMP - Certificate of Waiver (COW) -OR- Certificate for Provider Performed Microscopy Procedures (PPMP)
  

• License or Non-Waived - Certificate of Compliance -OR- Certificate of Accreditation

Additional Requirements:

For Out-of-State new license application, view the requirements on the Out-of-State webpage.

Renewal Application

If mailing your renewal application, complete and submit the following forms. After review, we may request more information.

Renewing by Mail (with changes)

Example of changes: laboratory name, laboratory director, ownership, tax ID,
address, certificate type, or oversight type.

(If reporting changes only and not renewing, go to Submit Changes webpage to view the requirements.)

Renewing by Mail (no changes)

For Out-of-State renewal application, view the requirements on the Out-of-State webpage.

Multiple Sites

All primary and secondary sites under the same license must submit one set of application forms.
Add these additional requirements if renewing, updating, or adding secondary sites:

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