Dear NDGHA Participant,
Thank you for your interest in the Non-Diagnostic General Health Assessment (NDGHA) registration process. To register to perform screenings in Imperial County, please access the “Registration Form” link.

Please ensure the following requirements are met in order to register your program:

1. Must have a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver
2. Committee must include a California Physician/Surgeon and a Clinical Laboratory Scientist who oversees testing personnel and quality control on its roster
3. The Laboratory Director must be designated on the CLIA certificate

The following are documents that shall be submitted for review prior to obtaining registration:

• Program Registration form
• Copy of current CLIA Certificate of Waiver
• Copy of current Physician’s license for Supervising Physician
• Copy of current Clinical Laboratory Scientist (CLS) license for CLS overseeing testing
• Copy of Medical Waste handling permit(s)
• Copies of all other licensed personnel such as phlebotomists and/or training letters from physicians
• Provide a copy of your Procedure Manual. It should contain QA’s, blood collection and medical waste procedures, client consent forms, results forms, etc.

If you have any questions, please contact Holly Maag at (442) 265-1424. You can also email to hollymaag@co.imperial.ca.us .

Cordially,

Holly Maag, M.H.A., J.D.
Laboratory Director

Forms:

• Health Assessment Registration Form