CMS-116 (CLIA Application for Certification):
Complete the CMS-116 Application for Certification, in its entirety, for any of the following: · Initial Laboratory Certification · Change in Certification Type · Change in Provider Name · Change in Address, Telephone Number, etc. · Change in Laboratory DirectorFor laboratories located in the State of Wyoming, mail the completed and signed CMS-116 Application for Certification to the address listed below.
Wyoming CLIA Office:Healthcare Licensing and SurveysCLIA Certification6101 Yellowstone Rd.Ste. 186CCheyenne WY 82002Telephone: (307) 777-7123Fax: (307) 777-7127
Not a Wyoming laboratory?
Refer to the Federal CLIA page for contact information in your state.
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