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CMS-116 Clinical Laboratory Improvement Amendments CLIA Application for Certification
CMS-116 Clinical Laboratory Improvement Amendments CLIA Application for Certification is a blank, fillable PDF (AcroForm) with 299 fillable fields over 10 pages. It is filed under Nursing & Healthcare Support › Medicare (CMS).
Made for people and organisations working in nursing & healthcare support who need the document in a clean, fillable form.
| Format | PDF (AcroForm) |
|---|---|
| Pages | 10 |
| Form fields | 299 fillable fields |
| Jurisdiction | Not specified |
| Field / type | Nursing & Healthcare Support › Medicare (CMS) |
| Version (last updated) | 2026-10-17 |
| Licence | US-gov-PD (checked 2026-10-17) |
| Attribution | Source: U.S. Centers for Medicare & Medicaid Services (public domain in the United States, 17 U.S.C. 105; official form available free at cms.gov). Prepared by FormSphere as a fillable AcroForm; not affiliated with or endorsed by the agency. |
Where this document comes from
| Origin | Official form published by cms.gov |
|---|---|
| Licence | US federal government work (public domain) |
| Rights checked | 2026-10-17 |
| PDF check | 299 fillable fields over 10 pages, blank |
| Status | Cleared for sale |
What you get over the free original
- The publisher's original is free at cms.gov. We link to that source and do not replace it.
- A clean, blank AcroForm: every field empty, working in any PDF reader, with wording, page order and layout unchanged.
- Checked page by page against the source, with its licence and the date we checked it shown here.
Questions about this document
Can I fill in CMS-116 Clinical Laboratory Improvement Amendments CLIA Application for Certification without printing it?
Yes. Open the PDF in any normal PDF reader, type into the fields, tick the boxes and save. You can still print it if you prefer.
Is this document up to date and legally valid?
Please check the document for currency and for the rules that apply to you. It is a blank template, not legal advice or a guarantee of compliance.
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