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Laboratory field services

Laboratory Field Services Forms

 

LAB 114 (pdf) - Biologics License Application

LAB 116 (pdf) - Laboratory Personnel Report

LAB 116 OS (pdf) - Laboratory Personnel Report,  Out-of-State Laboratory

LAB 118 (pdf) - Blood Bank Personnel Report

LAB 139 (pdf) - Application for Approval to Keep and Use Laboratory Animals

LAB 144 (pdf) - Application for Initial Clinical Laboratory License

LAB 144 A (pdf) - Laboratory Testing Declaration

LAB 144 B (pdf) - Application for Additional Clinical Laboratory Testing Sites-Form B

LAB 144 OS (pdf) - Application for Initial Clinical Laboratory License for Laboratories Located In States Other Than California

LAB 144 R (pdf) - Application for Renewal Clinical Laboratory License

LAB 144 ROS (pdf) - Application for Renewal Clinical Laboratory License for Laboratories Located In States Other Than California

LAB 155 (pdf) - Application for Initial Clinical Laboratory Registration

LAB 155 R (pdf) - Application for Renewal Clinical Laboratory Registration

LAB 158 (pdf) - Continuing Education Waiver Request

LAB 163 (pdf) - Complaint Information

LAB 167 (pdf) - Annual Test Volume of Test Performed

LAB 167 OS (pdf) - Annual Test Volume of California Specimens, Out-of-State Laboratory

LAB 168 OS (pdf) - Laboratory Personnel Qualification

LAB 169 (pdf) - Tissue Bank Personnel Report

LAB 170 (pdf) - Assisted Reproductive Technology (ART) Questionnaire

LAB 171 (pdf) - Tissue Bank License Renewal Application

LAB 172 (pdf) - Tissue Bank License New Application

LAB 175 (pdf) - Application for Renewal of License for the Production of Biologics

LAB 176 (pdf) - Application for Duplicate License

LAB 178 (pdf) - Application for Continuing Education Accrediting Agency

LAB 183 (pdf) - Director's Attestation

LAB 184 (pdf) - Tissue Bank Contact Person Date Sheet

LAB 192 (pdf) - Request for Facilities' and/or Personnel Record

LAB 193 (pdf) - Notification of Laboratory Change

LAB 1513 (pdf) - Disclosure of Ownership and Control Interest Statement

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