CLIA (Clinical Laboratory Improvement Amendments)
Clinical Laboratory Improvement Amendments
Federal regulations applicable to all U.S. facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Acronym for
- Clinical Laboratory Improvement Amendments
- Primary sources
- 1
- Workspace handoff
- compliance binder →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS CLIA requires labs to be certified at one of four levels: CoW (waived), CoC (compliance), CoA (accreditation), or CoR (registration). Most physician practices hold a CoW.
How it shows up in your practice
Match CLIA-waived test list to in-office tests. Billing for a non-waived test under a CoW is a compliance issue.
Sources
- CMS — CLIA Certificationhttps://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
Track CLIA certification in the Compliance Binder
Open compliance binder →Related terms
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
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This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.