18 min readUpdated Jan 2026

CLIA Compliance Guide for Clinical Laboratories

The foundation of laboratory quality in the United States. Here's what CLIA requires and how to build compliance into daily operations.

CLIA Certificate Types

Certificate of Waiver

~73% of labs

Scope: Simple tests with low error risk

Requirements: Follow manufacturer instructions, PT where applicable

Certificate of PPM

~5% of labs

Scope: Provider-performed microscopy

Requirements: Moderate complexity requirements, practitioner present

Certificate of Compliance/Accreditation

~22% of labs

Scope: Moderate/high complexity

Requirements: Full CLIA requirements or accreditation (CAP, COLA)

Core CLIA Requirements

Personnel Qualifications

Director, supervisor, consultant, and testing personnel must meet education/experience requirements

Quality Control

Two levels of controls daily, established ranges, documented results, corrective action

Proficiency Testing

CMS-approved PT for regulated analytes, treated like patient specimens

Quality Assessment

Ongoing monitoring of pre-analytical, analytical, and post-analytical factors

Patient Test Management

Positive specimen ID, verification before reporting, critical value notification

Records & Reporting

Requisitions, testing records, QC data, PT results—2+ year retention

LIMS Support for CLIA Compliance

Automated Audit TrailsWho did what, when—automatically captured for every action
QC ManagementPrevent reporting until QC passes, Levey-Jennings charts, Westgard rules
Specimen TrackingBarcode-based identification, complete chain of custody
Personnel CompetencyTrack training, restrict test performance to qualified personnel
Procedure ManagementVersion-controlled SOPs, ensure staff access current procedures
Result VerificationValidation rules, critical value alerting, delta checks

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Frequently Asked Questions