Laboratory Requisition: What CLIA Requires on the Form

A laboratory requisition is the written or electronic test request a laboratory receives for a patient specimen. Under the US federal CLIA rule at 42 CFR 493.1241, the laboratory must hold a request from an authorized person and must ensure its requisition form asks for eight categories of information. This guide is general regulatory information for laboratory and clinic staff, not medical or legal advice.

Short answer

A laboratory requisition (often called a lab requisition form) is the document that tells a laboratory who is asking for which test on which patient’s specimen. For nonwaived testing, 42 CFR 493.1241(a) requires “a written or electronic request for patient testing from an authorized person,” and 493.1241(c) lists what the requisition must solicit: the requester, the patient, the test, the specimen source, collection date and time, and any extra information a specific test needs.

Definition and scope

The regulation uses the terms “test request” and “test requisition.” The request is the authorization to test; the requisition is the form or record that carries the details. The patient’s chart or medical record may serve as the requisition or authorization, but it must be available to the laboratory at the time of testing and to CMS or a CMS agent on request (493.1241(d)).

The rule sits in Subpart K of 42 CFR Part 493, the quality system for nonwaived testing. Each laboratory designs its own form, which is why forms from different laboratories look different while covering the same regulated elements.

Not the same as a purchase requisition

In procurement, a “requisition” is an internal request to buy goods. That is a different document with a different purpose; see purchase requisition vs purchase order. This guide covers only the laboratory test request.

What the regulation says a requisition must solicit

Under 493.1241(c), “the laboratory must ensure the test requisition solicits the following information.” The word is “solicits”: the form must ask for these items. Some apply only “when appropriate.”

Element (493.1241(c))	What the text asks for	Always or conditional
(1) Requester	Name and address or other suitable identifiers of the authorized person requesting the test; if appropriate, the individual responsible for using the results, or the name and address of the submitting laboratory; a contact for imminently life-threatening, panic or alert values, as applicable	Requester always; other parts “as applicable”
(2) Patient identity	Patient’s name or unique patient identifier	Always
(3) Patient details	Sex and age or date of birth	Always
(4) Test	The test or tests to be performed	Always
(5) Specimen source	The source of the specimen	“When appropriate”
(6) Collection date and time	The date and, if appropriate, time of collection	Date always; time “if appropriate”
(7) Pap smear history	Last menstrual period and whether there was a previous abnormal report, treatment or biopsy	Pap smears only
(8) Test-specific information	Any additional information relevant and necessary for a specific test to ensure accurate and timely testing and reporting, including interpretation if applicable	Depends on the test

How the request reaches the laboratory

Written, electronic or oral

The default is a written or electronic request. The laboratory may accept an oral request if it solicits a written or electronic authorization within 30 days of the oral request and maintains either the authorization or documentation of its efforts to obtain it (493.1241(b)).

Transcription

If the laboratory transcribes or enters requisition or authorization information into a record system or laboratory information system, it must ensure the information is entered accurately (493.1241(e)). For preventing mismatches between specimen and paperwork, see specimen labeling error prevention.

What is the difference between a referral and a requisition?

The CLIA test-request rule concerns the requisition: the request the laboratory receives and the information it must solicit. The text of 493.1241 does not define or address referrals or payer authorization, so a referral should be treated as a separate matter from the requisition the laboratory needs in order to test.

Who fills the requisition form?

The regulation requires that the request come from an “authorized person.” Section 493.2 defines that term as “an individual authorized under State law to order tests or receive test results, or both.” Who may order tests therefore depends on state law, not on the form. The rule does not say which staff member physically completes the fields; because the requisition must identify the authorized person requesting the test (element 1), the ordering authority is what the rule ties to the document.

How to complete a requisition form?

Complete the laboratory’s own form, since the laboratory decides how it solicits the elements above. The table gives the content the regulation expects, so a form left blank on one of those elements is best raised with the laboratory before the specimen is sent. A short checklist for staff who prepare or receive requisitions:

• Is the authorized person identified with a name and address or other suitable identifiers (element 1)?
• Does the patient identifier on the form match the specimen label (elements 2 and 3)?
• Is the test named (element 4), and the specimen source given where it matters (element 5)?
• Are the collection date and, where relevant, time recorded (element 6)?
• Does the test need extra information, and is it present (element 8)?
• If the request was oral, has written or electronic authorization been requested, with the date documented (493.1241(b))?

Where it matters for labs, clinics and supply decisions

Requisitions travel with specimens and collection supplies. Laboratories that standardise kits across sites also standardise the paperwork; see specimen collection kit standardization and the genetic testing lab supply checklist. For the receiving side in trials, see clinical trial central laboratory. The wider equipment topic is covered in the lab equipment hub.

Common misunderstandings

• “Every field is mandatory on every form.” The rule says the form must solicit the items; specimen source, collection time and Pap history are conditional.
• “A requisition is a purchase order.” A laboratory requisition requests a test; a purchase requisition requests goods.
• “The request must be on paper.” The text allows written or electronic requests, and the medical record may serve as the requisition.
• “Oral orders are never allowed.” They are allowed if written or electronic authorization is solicited within 30 days and the laboratory keeps the authorization or documentation of its efforts.

FAQ

What is the difference between a referral and a requisition?

A requisition is the test request the laboratory must hold under 42 CFR 493.1241. That section does not address referrals.

Who fills the requisition form?

The request must come from an authorized person, defined in 42 CFR 493.2 by reference to state law. The regulation does not specify who completes the fields.

How to complete a requisition form?

Use the laboratory’s own form and supply the elements it solicits, which under 493.1241(c) cover the requester, patient, test, specimen source, collection date and time, and test-specific information.

Sources

• 42 CFR 493.1241, Standard: Test request, eCFR, https://www.ecfr.gov/current/title-42/section-493.1241; also published by Cornell LII, https://www.law.cornell.edu/cfr/text/42/493.1241. Checked 2026-11-01.
• 42 CFR 493.2, Definitions (“authorized person”), https://www.law.cornell.edu/cfr/text/42/493.2. Checked 2026-11-01.