Maryland State Compliance Application - Usage Steps
Once you have gathered the necessary information and documentation, you can begin filling out the Maryland State Compliance Application form. This process involves providing specific details about your laboratory, its directors, and the tests you will perform. Be sure to review your application for completeness before submission, as any missing information could delay the licensing process.
- Obtain the form: Download the Maryland State Compliance Application form from the Maryland Department of Health and Mental Hygiene website.
- Fill in laboratory information: Provide the name of your laboratory, the type of laboratory, contact person details, and mailing address.
- Complete director information: Enter the name, degree, work hours, certification details, and state medical license number for the laboratory director.
- Provide supervisor information: Fill out the name, degree, work hours, and certification details for the laboratory supervisor or manager.
- Schedule A - General Permit: Indicate the types of tests your laboratory will perform, selecting from the provided categories.
- Schedule B - Excepted Tests: List any excepted tests your laboratory will conduct, ensuring compliance with Maryland regulations.
- List testing instrumentation: Clearly specify the testing instruments and test kits your laboratory will use, along with the relevant test disciplines.
- Proficiency testing: Indicate whether you are enrolled in proficiency testing and provide the name of the company and discipline if applicable.
- Ownership information: Select the type of entity and provide the necessary ownership details, including the mandatory federal tax identification number.
- Complete the attestation: Sign and date the application, certifying that the information provided is accurate and complete.
After completing the application, review the checklist on the last page to ensure all required documentation is included. This will help avoid any delays in processing your application. Once submitted, allow 6-8 weeks for processing and invoicing.