EDI 5010 Documentation 837 Professional - Loop 2300 CLIA Number

2300 Clinical Laboratory Improvement Amendment (CLIA) Number

        

Required on Medicare and Medicaid claims for any laboratory performing tests covered by the CLIA Act

Loop	Seg ID	Segment Name	Format	Length	Ref#	Req	Value
2300	REF	CLIA Number	ID	3		R	REF
		Element Separator	AN	1			*
	REF01	Reference Identification Qualifier	ID	2/3	128	R	X4 = Clinical Laboratory Improvement Amendment Number
		Element Separator	AN	1			*
	REF02	Reference Identification	AN	1/30	127	R	Print the CLIA Number
		Segment Terminator					~

 

        

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