STATE SURVEY AGENCIES (CLIA CONTACT LIST)



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STATE SURVEY AGENCIES (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 DIVISION OF HEALTH FACILITY SERVICES Arkansas Department of Health 5800 W. 10th Street, Suite 400 Little Rock, AR 72204 (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 410 Capitol Avenue, MS#12HSR PO Box 340308 Hartford, CT 06134-0308 (860) 509-7400 FAX: (860) 509-7535 Contact: John J. Murphy DELAWARE STATE PUBLIC HEALTH LABORATORIES 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 *****FOR LABS IN GUAM, AMERICAN SAMOA OR SAIPAN CONTACT THE HAWAII State Agency.***** 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@idhw.state.id.us 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: WGARRETT@idph.state.il.us 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.us 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 DIVISION OF COMMUNITY HEALTH SERVICES 275 E. Main Street 5EA Frankfort, KY 40621 502-564-2800 Contact: Jenny Mitchel E-mail: jenny.mitchell@ky.gov

DEPARTMENT OF HEALTH & HOSPITALS Health Standards Section 500 Laurel Street, Suite 100 Baton Rouge, LA 70802 (225) 342-9324 CONTACT: Staci Glueck CLIA PROGRAM Division of Licensing & Regulation Services 442 Civic Center Drive, Station #11 Augusta, ME 04333-0011 (207) 287-9339 FAX: (207) 287-9304 Contact: Margaret Naas MARYLAND DEPARTMENT OF HEALTH & MENTAL HYGIENNE 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: 651-215-8704 Fax: 651-215-8709 Contacts: Linda Traster E-mail: Linda.Traster@state.mn.us

LICENSURE AND CERTIFICATION Mississippi Department of Public Health PO Box 1700 Jackson, MS 39215-1700 (601) 576-7300 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@state.mt.us 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 Bascomb

CLINICAL LABORATORY IMPROVEMENT SERVICE State Of New Jersey Departm1ent Of Health & Senior Services PO Box 361 Trenton, NJ 08625-036 (609) 292-0016 FAX: (609) 292-9285 Contact: Alicia Waln DEPARTMENT OF HEALTH Division of Health Improvement Health Facility Licensing and Certification Bureau CLIA Program 625 Silver SW, Suite 410 Albuquerque, NM 87102 (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 PO Box 509 Albany, NY 12201-0509 (518) 485-5352 Contacts: Colleen M. Flood/Edward A. Maziarz For All Other Laboratory Facility Types in New York: CLINICAL LABORATORY EVALUATION PROGRAM Empire State Plaza PO 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) 733-1610 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@state.nd.us

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: Lucy.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 PO 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. 2222 Contact: Julie Colon

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) 545-4291 FAX (803) 545-4563 Contact: Paula Lundy E-mail: lundypv@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 Cordell Hull Bldg, 1st FL 425 5TH Avenue North Nashville, TN 37247-0508 (615) 741-7023 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

*****LABORATORIES LOCATED IN THE VIRGIN ISLANDS SHOULD CONTACT THE NEW YORK REGIONAL OFFICE***** VIRGINIA DEPARTMENT OF HEALTH Center for Quality Health Care Services 3600 W Broad Street, Suite 216 Richmond, VA 23230 (804) 367-2107 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