Arkansas

Arkansas State Licensing Requirements

State-Specific CLIA Applications

Arkansas Health Authority, Public Health Division. Clinical Laboratories. 

(1) Application: https://www.cms.gov/Medicare/CMS-Forms/CMSForms/downloads/cms116.pdf Requests for New Provider Applications (CMS116) or Change of Ownership (CHOW) Applications should be submitted via mail, email or fax to the ADH Health Facility Services office, listed below.

(a) Completed applications for New Providers or Change of Ownership should be submitted to Health Facility Services via mail (5800 W. 10th St., Suite 400 Little Rock, AR 72204), email (adh.hfs@arkansas.gov) or fax (501-661- 2165). Application review typically takes one month.

Online Access to CLIA Certificates

CMS is now making CLIA certificates available online at no cost via the QCOR Lookup Tool.  All certificates generated after September 27, 2023 should be available for download.  Click HERE to access the Tool and choose “CLIA Laboratory Lookup” from the left menu bar (2nd option from the top).  When you click the entry for the laboratory, a box containing the laboratory information and a link to the certificate will pop up in a new window.