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CLIA Program Contact Info
29 Oct 2006
New Lockbox Address for CLIA Fee Payments
Effective August 29, 2006, laboratories must now send CLIA fee payments to the following address:
CLIA Laboratory Program
P.O. Box 70948
Charlotte, NC 28272-0948
State Agencies for CLIA Contact List
ALABAMA DEPARTMENT OF PUBLIC HEALTH Division Of Health Care Facilities CLIA Program P.O. Box 303017 Montgomery, AL 36130-3017 (334) 206-5120 Contact: Brenda Furlow E-mail: bfurlow@adph.state.al.us
DEPARTMENT OF PUBLIC HEALTH 619 East Ship Creek Avenue, Suite 232 Anchorage, AK 99501 (907) 334-2491 FAX: (907) 561-3011 Contact: Diana Parks E-mail: diana_parks@health.state.ak.us
ARIZONA DEPARTMENT OF HEALTH SERVICES STATE LABORATORY Office of Laboratory Services 250 N. 17TH Avenue Phoenix, AZ 85007-3231 (602) 364-0738 FAX: (602) 364-0759 Contact: Joan Apt, Program Manager
E-mail: aptj@azdhs.gov
HEALTH FACILITY SERVICES Slot H9 Arkansas Department of Health and Human Services P.O. Box 1437
Little Rock, AR 72203-1437 (501) 661-2201 Contact: Laura Moody
CALIFORNIA DEPARTMENT OF HEALTH SERVICES Laboratory Field Services Division of Laboratory Science 320 West 4th Street, Suite 890 Los Angeles, CA 90013 (213) 620-6160 FAX: (213) 620-6565 Contact: Donna McCallum, Examiner III
COLORADO DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT Laboratory Services Division 8100 Lowry Blvd. Denver, CO 80230-6928 (303) 692-3291 FAX: (303) 344-9965 Contact: Diane Luck
CLIA LABORATORY PROGRAM Department Of Public Health P.O. Box 340308 410 Capitol Avenue, MS#12HSR Hartford, CT 06134-0308 (860) 509-7400 FAX: (860) 509-7535 Contact: John J. Murphy
DELAWARE STATE PUBLIC HEALTH LABORATORIES P.O. Box 1047
30 Sunnyside Road Smyrna, DE 19977 (302) 223-1392 Contact: Donna Phillips-DiMaria
DC DEPARTMENT OF HEALTH Health Care Regulation and Licensing Administration 825 N. Capitol Street NE, 2nd Floor Washington, DC 20002 (202) 442-4706 Contact: Semret Tesfaye
STATE OF FLORIDA Agency For Health Care Administration Laboratory Licensing Unit 2727 Mahan Drive, Mail Stop 32 Tallahassee, FL 32308 (850) 487-3109 FAX: (850) 410-1511 Contact: Pat James E-mail: jamesp@fdhc.state.fl.us
GEORGIA DEPARTMENT OF HUMAN RESOURCES Office of Regulatory Services Diagnostic Service Unit 2 Peachtree Street, N.W. 33-250 Atlanta, GA 30303-3142 (404) 657-5447 Contact: Jeannie Arnold E-mail: jearnold@dhr.state.ga.us
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FOR LABS IN GUAM, AMERICAN SAMOA OR SAIPAN CONTACT THE
HAWAII State Agency.
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HAWAII DEPARTMENT OF HEALTH CLIA Program 601 Kamokila Boulevard, Room 395 Kapolei, HI 96707 (808) 692-7420 FAX: (808) 692-7447 Contact: Susan O. Naka
LABORATORY IMPROVEMENT SECTION Bureau of Laboratories 2220 Old Penitentiary Road Boise, ID 83712-8299 (208) 334-2235 x245 FAX: (208) 334-2382 Contact: David Eisentrager E-mail: eisentra@dhw.idaho.gov
ILLINOIS DEPARTMENT OF PUBLIC HEALTH Division Of Health Care Facilities & Programs 525 W. Jefferson Street Fourth Floor Springfield, IL 62761 Phone: 217-782-6747
FAX: 217-782-0382 Contact: William Garrett
E-mail: william.garrett@illinois.gov
INDIANA STATE DEPARTMENT OF HEALTH Division of Acute Care Services 2 North Meridian Street, Room 4A Indianapolis, IN 46204 (317) 233-7502 FAX: (317) 233-7157 Contact: Wanda Proffitt E-mail: wproffit@isdh.in.gov
University of Iowa Hygienic Laboratory Iowa CLIA Laboratory Program 102 Oakdale Campus, H101 OH Iowa City, IA 52242 (319) 335-4500 Contact: Nancy Grove
KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT Laboratory Certification Building 740 Forbes Field Topeka, KS 66620-0001 (785) 296-3811 Contact: Ruby Brower
Kim Hawkins
Compliance Analyst Office of Inspector General P. O. Box 12250
2250 Leestown Road
Lexington, KY 40511 (859) 246-2301 Contact: Kim Hawkins E-mail: kim.hawkins@ky.gov
DEPARTMENT OF HEALTH & HOSPITALS Health Standards Section 500 Laurel Street, Suite 100 Baton Rouge, LA 70821 (225) 342-9324 Contact: Staci Glueck
CLIA PROGRAM Division of Licensing & Regulatory Services 41 Anthony Avenue, Station #11 Augusta, ME 04333-0011 (207) 287-9339 FAX: (207) 287-9304 Contact: Margaret Naas
MARYLAND DEPARTMENT OF HEALTH & MENTAL HYGIENE Office Of Health Care Quality - Labs Bland Bryant Building Spring Grove Hospital Center 55 Wade Avenue Catonsville, MD 21228 (410) 402-8025 Contact: Kathleen Steed
Division of Health Care Quality
Clinical Laboratory Program
99 Chauncy Street – 3rd floor
Boston, MA 02111
(617) 753-8438 FAX: (617) 753-8096
Contact: Roberta Teixeira
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Laboratory Improvement Section P.O. Box 30664 611 W. Ottawa Street, First Floor Lansing, MI 48909 Phone: (517) 241-0821 FAX: (517) 241-3354 Contact: Pamela Diebolt E-mail: pjdiebo@michigan.gov
MINNESOTA DEPARTMENT OF HEALTH Licensing & Certification Section 85 East Seventh Place, Suite 300 Box 64900 St. Paul, MN 55164-0900 Phone: (651) 201-4120
Fax: (651) 201-4110 Contacts: Roxanne Beyer
E-mail: roxanne.beyer@state.mn.us
LICENSURE AND CERTIFICATION Mississippi Department of Public Health P.O. Box 1700 Jackson, MS 39215-1700 (601) 364-1115 Contact: Theresa Irwin E-mail: theresa.irwin@msdh.state.ms.us
MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES CLIA Section PO Box 570 Jefferson City, MO 65102 (573) 751-6318 Contact: William Nugent
CLIA PROGRAM Division of Quality Assurance Department of Public Health & Human Services 2401 Colonial Drive, 2nd Floor PO Box 202953 Helena, MT 59620-2953 (406) 444-1451 FAX: (406) 444-3456 Contact: Ed Adams E-mail: eadams@mt.gov
NEBRASKA STATE HEALTH & HUMAN SERVICES Regulations and Licensure Credentialing Division PO Box 94986 Lincoln, NE 68509-4986 (402) 471-4363 Contact: Joann Erickson
NEVADA STATE HEALTH DIVISION Bureau of Lic. And Certification 1550 E. College Parkway, #158 Carson City, NV 89706 (775) 687-4475 FAX: (775) 687-6588 Contact: Vickie Estes, MT(ASCP)
HEALTH FACILITIES ADMINISTRATION Department of Health & Human Services 129 Pleasant Street Concord, NH 03301 (603) 271-4832 FAX: (603) 271-4968 Contact: Rodney Bascom
CLINICAL LABORATORY IMPROVEMENT SERVICE State of New Jersey Department Of Health & Senior Services P.O. Box 361 Trenton, NJ 08625-0361 (609) 292-0016 FAX: (609) 292-9285 Contact: Alicia Waln
Division of Health Improvement Health Facility Licensing & Certification Bureau CLIA Program 2040 S. Pacheo Street, 2nd Floor, Room 413 Santa Fe, NM 87505 (505) 841-4524 FAX: (505) 841-5834 Contact: Julie Aragon
For Physician Office Laboratories in New York:
STATE OF NEW YORK DEPARTMENT OF HEALTH Physician Office Laboratory Evaluation Program Empire State Plaza
P.O. Box 509 Albany, NY 12201-0509 (518) 485-5352 Contacts: Thomas Heckert
For All Other Laboratory Facility Types in New York: CLINICAL LABORATORY EVALUATION PROGRAM Empire State Plaza P.O. BOX 509 Albany, NY 12201-0509 (518) 485-5378 Contact: Deirdre Astin
NORTH CAROLINA DEPARTMENT OF HEALTH and HUMAN SERVICES Division Of Facility Services/CLIA Certification 2713 Mail Service Center Raleigh, NC 27699-2713 (919) 855-4620 FAX: (919) 733-0176
Contact: Azzie Conley E-mail: azzie.conley@NCmail.net
HEALTH RESOURCES SECTION North Dakota Department Of Health State Capital 600 East Boulevard Avenue/Dept 301 Bismarck, ND 58505-0200 (701) 328-2352 FAX: (701) 328-1890
Contact: Bridget Weidner E-mail: bweidner@nd.gov
OHIO DEPARTMENT OF HEALTH Laboratory Certification Program P.O. Box 118 246 N. High Street, 2nd Floor Columbus, OH 43216-0118 (614) 644-1845 FAX: (614) 728-9169 Contact: Lucille Raabe E-mail: Lucille.Raabe@odh.ohio.gov
OKLAHOMA STATE DEPARTMENT OF HEALTH Protective Health Services Medical Facilities 1000 NE 10TH Street Oklahoma City, OK 73117-1299 (405) 271-6576 Contact: Dean Bay Internet: www.medicalfacilities@health.state.ok.us
OREGON STATE PUBLIC HEALTH LABORATORY Laboratory Compliance and Quality Assurance P.O. Box 275 Portland, OR 97207 (503) 229-5853 FAX: (503) 229-5682 Contact: Rita Scheu E-mail: rita.a.scheu@state.or.us
PENNSYLVANIA DEPARTMENT OF HEALTH Bureau of Laboratories 110 Pickering Way
Lionville, PA 19353 (610) 280-3464 Contact: Clerical Support Section
Internet: www.health.state.pa.us/labs
COMMONWEALTH OF PUERTO RICO
Puerto Rico Health Department Office of Certification & Licensure
Former-Ruiz Soler Hospital
Road No. 2 Bayamon, PR 00619 (787) 782-0120 Ext. 2214 Contact: Ricardo Santiago
DIVISION OF FACILITIES REGULATION Department of Health 3 Capitol Hill Providence, RI 02908 (401) 222-4526 FAX: (401) 222-3999 Contact: Nancy Hines
SOUTH CAROLINA DEPARTMENT OF HEALTH & ENVIRONMENTAL CONTROL Bureau of Health Licensure & Certification 2600 Bull Street Columbia, SC 29201 (803) 545-4329 FAX (803) 545-4563 Contact: Mary White E-mail: whitem1@dhec.sc.gov
SOUTH DAKOTA DEPARTMENT OF HEALTH Health Care Facilities Licensure 615 E 4TH Street Pierre, SD 57501-1700 (605) 773-3694 FAX: (605) 773-6667 Contact: Connie Richards E-mail: Connie.Richards@state.sd.us
TENNESSEE HEALTH CARE FACILITIES 227 French Landing, Suite 501
Heritage Place Metro Center Nashville, TN 37243
(615) 741-7034 Contact: Irmgard Brown E-mail: Irmgard.A.Brown@state.tn.us
HEALTH FACILITY COMPLIANCE DIVISION Patient Quality Care Unit
Texas Department of State Health Services 1100 West 49th Street Austin, TX 78756-3199 (512) 834-6792 Internet: www.dshs.state.tx.us
UTAH DEPARTMENT OF HEALTH Bureau of Laboratory Improvement 46 North Medical Drive Salt Lake City, UT 84113-1105 (801) 584-8471 FAX: (801) 584-8501 Contact: Rebecca Christiansen E-mail: rchristiansen@utah.gov
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LABORATORIES LOCATED IN THE VIRGIN ISLANDS SHOULD CONTACT THE NEW YORK REGIONAL OFFICE.
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VIRGINIA DEPARTMENT OF HEALTH Office of Licensure and Certification 3600 W Broad Street, Suite 216 Richmond, VA 23230 (804) 367-2107
FAX: (804) 367-2524 Contact: Sarah Pendergrass
CLIA LABORATORY PROGRAM Vermont Department of Health 108 Cherry Street Burlington VT 05402 (802) 652-4145 FAX: (802) 865-7701 Contact: Carol Drawbaugh
OFFICE OF LABORATORY QUALITY ASSURANCE Department of Health 1610 NE 150TH Street Shoreline, WA 98155-9701 (206) 418-5418 FAX: (206) 418-5505 Contact: Susan Walker E-mail: susan.walker@doh.wa.gov
WEST VIRGINIA DEPARTMENT OF HEALTH Office of Laboratory Services 167 11TH Avenue
South Charleston, WV 25303-1137 (304) 558-3530, Extension 2103 FAX: (304) 558-2006 Contact: Jerry Gross E-mail: jerrygross@wvdhhr.org
WISCONSIN DEPARTMENT OF HEALTH & FAMILY SERVICES Clinical Laboratory Unit/BQA /DDES 2917 International Lane, Suite 300 Madison, WI 53704 Phone: 608-243-2023
FAX: 608-243-2045 Contact: Sharon Abraham E-mail: abrahsa@dhfs.state.wi.us
Office of Healthcare Licensing and Surveys
8th Floor - 2020 Carey Avenue
Cheyenne WY 82002
Contact: Russ Forney
Phone: 307-777-7123
FAX: 307-777-7127
E-mail: rforne@state.wy.us
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