Print
	CLIA Waiver	Practice Standards	Reporting	Reimbursement

All other facilities that offer laboratory testing, holding a permit issued by the NYSDOH Clinical Laboratory Evaluation Program (CLEP) in the category of Toxicology -Blood Lead.

1 Confirm that you are permitted to conduct blood-lead testing

Laboratories that are not private physician practices or limited laboratories must have a permit issued by the NYSDOH Clinical Laboratory Evaluation Program (CLEP) in the category of Toxicology - Blood Lead.

• Add lead to your testing menu - complete form DOH-3519(f)

  Complete for the addition and/or deletion of new analytes. This form contains three blocks that you may use to add or delete analytes under categories you already hold on your laboratory permit. (If you are adding or deleting an entire category of testing, or if you are deleting all the analytes under a permit category, only form DOH-3519g is required.) Complete a separate block for each analyte; you may make additional copies of this form as needed. Please indicate additions and deletions on separate forms. If you are adding an analyte, indicate the permit category under which the analyte falls. If you are not certain which category covers the analytes you wish to add please indicate "not known" and we will inform you how the analyte is currently categorized.

  Please note: signatures must be original; signature stamps will not be accepted

  Send form to: New York State Department of Health
  Clinical Laboratory Evaluation Program
  Wadsworth Center
  P.O. Box 509
  Albany, New York 12201-0509
  Phone: (518) 485-5378
  Fax: (518) 485-5414

• Download instructions for notification of changes
• Download form DOH-3519(f) - application to add or delete analyte

To purchase a LeadCare II system, call (800) 305.0197