License Renewal Instructions for California Clinical Laboratories
These license renewal instructions apply to clinical laboratories and facilities performing
non-waived moderate and/or high complexity testing with state LAB IDs beginning with CLF, CLA, CLM, CDF, CDA, CDM.
Original signatures and dates must be on all forms. Copies are not acceptable.
Forms can be accessed on the
Laboratory Field Services (LFS) forms page.
LAB 144R (PDF) — Renewal Application for Clinical Laboratory License
LAB 116 (PDF) — Laboratory Personnel Report Form (this form should list all persons directing, supervising, performing testing, and releasing results of testing performed on specimens from California). If you submit a database printout, please fill out the top of the form and state that a list of personnel is attached.
LAB 167 (PDF) — Annual Test Volume of California Specimens (this form should also include the total volume of tests).
LAB 183 (PDF) — Director's Attestation (each director or co-director must file a separate attestation)
For changes in your site since the last renewal, please complete and mail the required federal form, CMS 116 to the address below. This form is not necessary if there are no changes in your site since the last renewal.
CMS 116 (PDF) -- CLIA application for new or for changes in your site such as change in laboratory director, ownership, change in certificate type, address, etc.
Attention Licensed Clinical Laboratories & Facilities:
On September 28, 2017, Governor Brown signed
Assembly Bill 658 into law. This bill temporarily suspends the annual renewal fee for
licenses from January 1, 2018, until January 1, 2020.
As of January 1, 2018, the annual renewal fee for
licenses will be suspended for two years. This means that if your laboratory renews its laboratory license on or after January 1, 2018, you do not need to pay a renewal fee. You still need to submit your renewal application, which LFS will process. You will be issued a renewed license for 2018 as usual.
Please note that this fee suspension does NOT apply to clinical laboratory registration renewals, or to new clinical laboratory license or registration applications.
California Department of Public Health
Laboratory Field Services
850 Marina Bay Pkwy, Bldg. P-1st Floor
Richmond, CA 94804-6403
For additional information or assistance you may email