Changes CLIA Form CMS-116 required unless accredited. Written notification on company letterhead immediately. Other Changes Written notification required for tax ID, volume, name, telephone/fax, multiple site, change in accrediting organization, closure or termination of services, personnel-technical supervisor. Other changes must be reported 60-120 days prior to change. Any change that requires a change to the state license must be received timely along with a check for $25 or receive a $500 late fine.