San Bernardino header
File #: 11915   
Type: Consent Status: Passed
File created: 3/31/2025 Department: Public Health
On agenda: 4/8/2025 Final action: 4/8/2025
Subject: Clinical Laboratory Improvement Amendments Application for Certification and Attestation for Clinic Licensing
Attachments: 1. ADD-ATT-DPH-4-8-25-Laboratory Testing Declaration, 2. ADD-ATT-DPH-4-8-25-Notice of Laboratory Information Change, 3. ADD-ATT-DPH-4-8-25-Owner's Attestation, 4. ADD-ATT-DPH-4-8-25-Additional Testing Sites, 5. ADD-ATT-DPH-4-8-25-CLIA Application for Certification, 6. ADD-ATT-DPH-4-8-25-Director's Attestation, 7. Item #44 Executed BAI
REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION

April 8, 2025

FROM
JOSHUA DUGAS, Director, Department of Public Health

SUBJECT
Title
Clinical Laboratory Improvement Amendments Application for Certification and Attestation for Clinic Licensing
End

RECOMMENDATION(S)
Recommendation
1. Approve the following California Department of Public Health Laboratory Services templates, as required for new applications or renewal of existing applications for the Clinical and Public Health Laboratory License to the California Department of Public Health:
a. Clinical Laboratory Improvement Amendments Application for Certification
b. Laboratory Testing Declaration
c. Additional Testing Sites
d. Notice of Laboratory Information Change
e. Owner's Attestation
f. Director's Attestation
2. Authorize the Health Officer as the Laboratory Director of the Department of Public Health, and the Director of the Department of Public Health as the Laboratory Owner and Authorized Representative, to execute and submit the California Department of Public Health Laboratory Services templates, as identified in Recommendation No. 1, for the Clinical and Public Health Laboratory License to the California Department of Public Health, on behalf of the County, subject to review by County Counsel.
(Presenter: Joshua Dugas, Director, 387-9146)
Body

COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.

FINANCIAL IMPACT
This item will not result in the use of Discretionary General Funding (Net County Cost). Application and renewal application fees of approximately $1000 are paid from the Department of Public Health (DPH) to the California Department of Public Health (CDPH) and are funded through Medi-Cal, private insurance, and private pay patient funds. Adequate appropriati...

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