Every lab outside New York and Washington needs a CLIA certificate, even for waived tests. Some states add their own license, permit or registration on top, and a few reach labs doing only waived tests. New York and Washington run their own programs in place of CLIA. Each guide covers the state requirement, exemptions, fees and where the CMS-116 goes. Every fact links to its source; anything we could not confirm is marked as not verified rather than guessed.
Starting with the federal certificate? The CLIA Certificate of Waiver, explained.
Verified October 10, 2026. Each state decides its own applications; confirm with it before you rely on a detail.
Compare every state
| State | On top of CLIA | Reaches waived-only labs |
|---|---|---|
| Alabama | State lab license | Not verified |
| Alaska | No state lab license | No |
| Arizona | Not verified | Not verified |
| Arkansas | No state lab license | No |
| California | State license, including waived labs | Yes |
| Colorado | No state lab license | No |
| Connecticut | State lab license | Not verified |
| Delaware | No state lab license | No |
| District of Columbia | State license, including waived labs | Yes |
| Florida | No state lab license | No |
| Georgia | No state lab license | No |
| Hawaii | State license, including waived labs | Yes |
| Idaho | No state lab license | No |
| Illinois | No state lab license | No |
| Indiana | No state lab license | No |
| Iowa | No state lab license | No |
| Kansas | No state lab license | No |
| Kentucky | State license, including waived labs | Yes |
| Louisiana | No state lab license | No |
| Maine | State license, including waived labs | Yes |
| Maryland | State license, including waived labs | Yes |
| Massachusetts | State lab license | No |
| Michigan | No state lab license | No |
| Minnesota | No state lab license | No |
| Mississippi | No state lab license | No |
| Missouri | No state lab license | No |
| Montana | No state lab license | No |
| Nebraska | No state lab license | No |
| Nevada | State license, including waived labs | Yes |
| New Hampshire | State license, including waived labs | Yes |
| New Jersey | State lab license | Not verified |
| New Mexico | Not verified | Not verified |
| New York | CLIA-exempt state program | Yes |
| North Carolina | No state lab license | No |
| North Dakota | No state lab license | No |
| Ohio | Not verified | Not verified |
| Oklahoma | Not verified | Not verified |
| Oregon | No state lab license | No |
| Pennsylvania | State license, including waived labs | Yes |
| Rhode Island | State lab license | No |
| South Carolina | Not verified | Not verified |
| South Dakota | No state lab license | No |
| Tennessee | State lab license | Not verified |
| Texas | No state lab license | No |
| Utah | Not verified | Not verified |
| Vermont | Not verified | Not verified |
| Virginia | No state lab license | No |
| Washington | CLIA-exempt state program | Yes |
| West Virginia | No state lab license | No |
| Wisconsin | Not verified | Not verified |
| Wyoming | Not verified | Not verified |
Want us to prepare it?
A Certificate of Waiver application is $399 per site; a state lab registration is $299 and a full state license or permit $699. You pay CMS and the state directly. See every price.