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State of CT FDA Emergency Use of Authorization EUA Attestation Form

The below form must be completed and submitted along with the documentation to DPH.FLISlab@ct.gov for all Clinical Laboratory Improvement Amendment (CLIA) certificate of waiver laboratories in Connecticut that utilize any manufacturer assay granted EUA from the FDA to perform COVID-19 testing on clinical specimens during a public health emergency.

 

FDA EUA Approved for COW Labs - Word Document

FDA EUA Approved for COW Lab - Fillable PDF