2aa5afcb_anges_to_your_CLIA_Certificate__WHAT_FORM_DO_I_USE_
[I NEED TO:] Reactivate a terminated CLIA certificate (terminated greater than six months) [ANYTHING ELSE?] Any necessary laboratory director qualifying documentation; personnel qualifications can be found on this website under the Application and Information tab [WHAT FORM DO I USE?] 
CMS-116, marked as a reactivation, with CLIA number included
Illinois CLIA - Making Changes to your CLIA Certificate
WHAT FORM DO I USE?