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Facility Services Division
NEW! Medical Facilities Complaint Form, effective 01.06.2017
Link to the CMS Interpretive Guidelines: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/som107c07.pdf
Link to the Electronic Code of Federal Regulations: http://www.ecfr.gov/cgi-bin/ECFR?page=browse
Oklahoma State Department of Health
All licensing fees must accompany the completed application form and be mailed to the following address: Financial Management-Receipting Unit, OSDH, PO Box 268823, Oklahoma City, OK 73126-8816, Failure to do so may result in a delay in the processing of your license application.
Q: Where do I mail my CLIA fee?
A: NEW ADDRESS: CLIA Laboratory Program, PO Box 530882, Atlanta, GA 30353-0882; NOTE: CHECKS ONLY-No Cash or Credit Cards and you MUST include the CLIA Fee Coupon with your check. Q: Where do I get a CLIA application (CMS Form 116)?
A: Go to the website at www.cms.hhs.gov/clia/ in the left hand column select "How to apply for a CLIA certificate" then scroll down and select "CMS-116 and Instructions" Q: Where do I mail my application for CLIA (CMS Form 116)?
A: OSDH/Medical Facilities/CLIA, 1000 NE 10th Street, Oklahoma City, OK 73107-1299 Q: How do I notify CLIA of an address change, phone number change, facility name change, etc.?
A: Fax a request on your letterhead to OSDH/Medical Facilities/CLIA at 405-271-1141. Please include the CLIA number on your request as well as a contact person and their phone number. Please be aware a new certificate will not be issued automatically. If a new certificate is needed, please see below. Q: If I have lost or misplaced my CLIA certificate, how can I get a replacement?
A: Fax a written request to OSDH/Medical Facilities/CLIA at 405-271-1141 for a replacement certificate. Please include the CLIA number as well as the name of a contact person and their phone number. Q: When will I receive my CLIA certificate once my payment has been made and my check has cleared the bank?
A: Your new CLIA certificate will arrive approximately 2-3 weeks prior to your expiration date.
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