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Application & Instructions for Initial Licensure - Clinical Laboratory Personnel

Log in to LaMED DashBoard to begin a new online initial application, complete a previously started (and saved) online initial application or to check the status of your completed online initial application.

The items listed below MUST be completed and mailed to the LSBME as part of the initial application process.

Note: notarized documents must be signed in the presence of a notary.

Oath or Affirmation
This form must be notarized. All yes answers must be accompanied by a sworn affidavit. A sworn affidavit is an explanation (in applicant’s own words) that must be typed and notarized. Note: If criminal history is found that was not disclosed, you will be required to submit a new Oath or Affirmation, a notarized affidavit as to why you did not disclose the information and a new processing fee equal to the initial licensure fee. It is important that you answer question 3 accurately and truthfully. Do not take the advice of friends, lawyer, etc.

Third Party Authorization
This form must be notarized. It authorizes LSBME to obtain information concerning the applicant from third parties.

Photograph
 A passport quality photograph must be submitted.  This photo must be a 2"x2" clear, head and shoulders photo taken within the last 6 months.

Background Check
LSBME conducts background checks as part of the application process. Instructions and forms can be found at the link above.

Additional Requirements

Birth Certificate/Valid Visa

  • U.S. citizen - submit a notarized or certified copy of your birth certificate.
  • U.S. citizen not born in the U.S. - submit a notarized copy of your certificate of citizenship, consular report of birth abroad or certificate of naturalization.
  • Non-U.S. citizen - submit a notarized copy of current proof of citizenship.  Acceptable forms of citizenship are an H1B Visa, J1 Visa, O1 Visa, TN Visa, Permanent Resident card or Employment Authorization card.
  • Louisiana law (LA RS: 37.12) requires a valid permit to live and work in the United States to practice medicine.
  • J1 Visas are structured for training and educational purposes only.  The typical sponsor for a Medical Doctor’s J1 Visa is the ECFMG.  A J1 visa is not for employment outside of a formal training program.
  • H1B Visas are intended for those who are performing a specialized service or occupation.  These Visas are usually sponsored by hospitals or a particular employer.
  • The LSBME works with the United States INS to grant interlocking letters to obtain an effective date for the H1B Visa.  The effective date of the Visa will be the effective date of the Louisiana license or permit issued by the LSBME.
  • The applicant’s employer usually needs a valid LSBME license to complete the credentialing process for hospitals, insurance companies, and professional liability insurers.  Therefore, the licensure applicant should work with the United States INS Visa sponsor to set the effective date for the Visa. 

If sending an original document (i.e. Visa or Permanent Resident card), it is recommended that you send in a trackable way i.e. Federal Express. Document will be returned via USPS certified mail, return receipt requested or by Federal Express if you submit a prepaid, self-addressed Fed Ex envelope.

Marriage Certificate/Name Change
Application for licensure in a name other than what appears on the applicant’s birth certificate requires a notarized copy of official documentation of name change (ie marriage certificate).

Notarization as a “true copy”
Request the notary to notarize a copy of your birth certificate and/or marriage certificate as a “true and correct copy of the original”. If the notary will not notarize the document,
you can attest that it is a “true and correct copy of the original”. The notary can then notarize your signature.

Verification of Other Licenses
Verification of all state licenses are required.  Contact the state board(s) directly to obtain verification of your license.  Please note, there may be a processing fee needed.

​Professional School /High School Transcript
Generalists, Phlebotomists, Specialists, Technicians, and Cytotechnologists - an official transcript must be received by LSBME directly from your professional school. Your professional school is the school that qualified you to sit for the national certification examination.
Lab Assistants – an official high school transcript (or documentation of GED from the Louisiana Department of Education) must be received by LSBME directly from your high school.

National Certification Examinations
See Examinations Approved By LSBME

 

Specific Instructions

CLS-Generalist, Specialist, Technician and Cytotechnologist

Fees
Licensure $65.00
Temporary License $65
Trainee License $65.00
Fee must be paid via credit/debit card (Visa, MasterCard or Discover only).
​Temporary license applicants must pay the temporary license fee as well as the licensure fee upon application.
​Fee is non-refundable.

Licensure applicants
Licensure applicants must have successfully completed a national exam approved by the board. A passing score report must be sent directly from the examination agency to LSBME. Contact the agency for instructions and fee.

Temporary license applicants – recent graduates
Temporary licenses may be issued to recent graduates who have registered for a certification exam. Confirmation of date of exam must be submitted before a temporary license will be issued. When registering for the examination, request a score report be sent to LSBME or after examination a score report must be ordered and mailed directly from the agency to LSBME. Contact agency for instructions and fee.

Trainee license applicants
Trainee licenses may be issued to students who work under supervision while in a clinical lab program or to returning practitioners who have not been engaged in clinical laboratory practice for 10 years. A letter from the program, lab or hospital director must be submitted providing prospective training dates.

Laboratory Assistant

Fees
Licensure $40.00
Trainee License $40.00.
Fees must be paid via credit/debit card (Visa, MasterCard or Discover only). Fees are non-refundable.

Licensure applicants
A completed Competency Checklist must be received by LSBME directly from the Medical Director or Laboratory Director for verification of competency.

Note: you do not need to complete this form if you have successfully completed a national exam approved by the board (see Examination Contact List). If nationally certified, a score report must be received by LSBME directly from the examination agency. Contact agency for instructions and fee.

Trainee license applicants
Trainee licenses may be issued to lab employees preparing for competency assessment or to returning practitioners who have not been engaged in clinical laboratory practice for 10 years. A letter from the program, lab or hospital director must be submitted providing prospective training dates. During the training period, a trainee may not report lab results.

Phlebotomist

Fees
Licensure $40.00
Temporary License $40.00
Fees must be paid via credit/debit card (Visa, MasterCard or Discover only). Temporary license applicants must pay the temporary license fee as well as the licensure fee upon application. Fees are non-refundable.

Licensure applicants
Licensure applicants must have successfully completed a national exam approved by the board. A passing score report must be sent directly from the examination agency to LSBME. Contact the agency for instructions and fee.

Temporary license applicants
Temporary licenses may be issued to recent graduates who have registered for a certification exam. Confirmation of date of exam must be submitted before a temporary license will be issued. When registering for the examination, request a score report be sent to LSBME or after examination a score report must be ordered and mailed directly from the agency to LSBME. Contact agency for instructions and fee.

Other Information

Verification of Application/Licensure Status
Visit our website www.lsbme.la.gov and log on to your account to verify the progress/status of your application.

Communication with the Board
Mailing Address - LSBME, 630 Camp Street, New Orleans, LA 70130
Questions - Contact our licensing department at licensing@lsbme.la.gov. To find the analyst directly assigned to your application, click on Contact Us.

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