3 Certification Applications

• LIC 9214 - Application for Administrator Certification What is LIC 9214? LIC 9214 is the form an applicant must submit to the Department in order to be certified as an administrator. This form must be accompanied by the appropriate fee and documentation, as specified on the form. What is LIC 9214 u
• T1004 Applying for the Certification of a Provisional PSPA T1004 Applying for the Certification of a Provisional PSPA ✓ Easily fill out and sign forms ✓ Download blank or editable online
• CLIA CMS-116 Form What is CMS-116? CMS-116 is the form that has to be filed by every laboratory that provides tests on humans. It should be accompanied by other documents that match CLIA standards. The first time this form is filed, the laboratory received a Certificate of