Clinical Laboratory Improvement Amendments (CLIA): Forms

This page includes forms related to clinical laboratories in Wisconsin. Email dhsdqaclia@dhs.wisconsin.gov if you have questions about these resources.

Forms

• CLIA Application for Certification - CMS-116 (PDF) (also see the Federal CMS CLIA website)

Licensing information

• Alcohol, Controlled Substance, and Controlled Substance Analog Testing Permits for Analysts
• Alcohol, Controlled Substance, and Controlled Substance Analog Testing Permits for Laboratories