A
Documents Submitted
1. Notarized application for Accreditation of Drug Testing
2. Letter of endorsement to the HFSRB Director (if filed at DOH-Regional office)
3. List of Personnel
4. Photocopies of the following:
PRC ID/ Board certificate
PSP Certificate, if applicable
Certificate of Training/Record of Work Experience
Proof of employment of head of laboratory, analyst, and authorized specimen
collector
5. List of equipment / instrument
6. Duly accomplished Assessment Tool
7. Documentation of Chain of Custody
8.Quality control program
9. Certificate of Proficiency
10. Procedure manual
11.Contract of Lease
12. Health Facility Geographic Form ( Location Map)
13. Photographs of the exterior and interior of the laboratory
14. Floor layout with appropriate scale reflecting properly labeled areas to include
spatial relationshio with adjacent areas if present
15. Board Resolution
16. Photocopy of DOH Certificate of Accreditation
Received by:
Date:
B
FOR INITIAL
0
