Multiphasic Health Testing Centers (MHTC)
Applications:
Complete the information in the forms below for an initial or renewal application. Instructions are included with each form.
Background Screening:
Level 2 Background Screening must be completed for the laboratory director and the chief financial officer prior to approving the initial application and then repeated every five years. Please go to the background screening section of this web site for additional documentation that must be submitted with your application. Fingerprint cards are available by contacting the Laboratory Unit at 850-487-3109. Other fingerprint cards may not be acceptable.
Annual Affidavit of Background Screening Compliance
Each non - waived laboratory is required by section 435.04(05), Florida Statutes(2006) to submit an affidavit of compliance with this section. A recommended form is available at this the link below.
Director’s Qualifications
Director qualifications must be submitted for all physician and non - physician laboratory directors.
The State of Florida requirements for laboratory directors can be found at the
Florida Administrative Code (See Chapter 59A-7 for Clinical Laboratory Rules) website:
http://www.flrules.org/gateway/ChapterHome.asp?Chapter=59A-7
CLIA requirements for directors of moderate complexity testing are at the following link: http://www.phppo.cdc.gov/clia/regs/subpart_m.aspx#493.1405,
CLIA requirements for directors of high complexity testing the requirements are at this link: http://www.phppo.cdc.gov/clia/regs/subpart_m.aspx#493.1443.
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