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Public Health and Environmental Laboratories
Phone: 609-406-6830

Clinical Laboratory Improvement Service
Martha M. Smith, MPA, MT (ASCP), Director
Phone: 609-406-6830

Clinical Laboratory Licensure,
Proficiency Testing (PT), Complaints and
Regulatory Compliance Program

Joan Mikita, M.S., Coordinator
Public Health and Environmental Laboratories
3 Schwarzkopf Drive
West Trenton, New Jersey 08628
Phone: 609-406-6830
Fax: 609- 406-6863


Rules and Statutes

Laboratory Reporting Requirements

Forms

Form#
Title
PDF Word Instructions
CL-3 Application for a Clinical Laboratory License (Onsite Testing Only) 73k
415k
Laboratory Personnel Excel Spread Sheet
CL-9 Disclosure of Ownership and Control Interest 44k
36k
 
CL-18 Application for Clinical Laboratory License
(Collection Station Only)
13k
40k
 
CL-34 Laboratory Personnel Qualification Appraisal 18k
122k
 

Documents listed with the [pdf #k] indicator can be viewed in Adobe Acrobat PDF Version 4 format. To view them you must have a PDF viewer which is available free from Adobe. Click here to learn more about Adobe Acrobat or to download the latest version of the Adobe Acrobat viewer from the Adobe Web site.

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Department of Health and Senior Services

P. O. Box 360, Trenton, NJ 08625-0360
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Last Modified: Thursday, 13-Oct-11 14:36:25