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F312 – Scope of Accreditation Selection List: ISO 15189 Medical Testing Laboratories To apply for A2LA accreditation under the medical field of testing, it is suggested that each applicant identify the test type/test technology and associated test method(s) for which accreditation is sought on table-A below. In addition, please identify the types of samples tested in your laboratory on table-B below. This will help ensure that an assessor’s technical expertise is correctly matched to the testing that your laboratory performs and enables A2LA staff to generate the desired draft Scope of Accreditation. Refer to the example proposed Scope of Accreditation (0000.01) on the next page when entering the required information in tables A and B. Submission via electronic means is preferred. Table-A Specialty Microbiology: Sub Specialty Technology/Methodology Bacteriology Bacterial culture, complete ID Bacterial culture Genital cultures Stool cultures Urine cultures Wound cultures Chemistry Routine Chemistry Colorimeter and/or spectrophotometer Enzyme immunoassay (EMIT) Enzyme-linked immunosorbent assay (ELISA) Immunoassay Urinalysis Microscopy, Urine Sediment Urine Dipstick, Manual Endocrinology Chemiluminiscent Method Table-B Types of products, materials, and/or structures that the laboratory tests: e.g. Whole blood, serum, plasma, urine, CSF, gastric contents, stool, other body fluids, L:\Forms\F312 – Scope of Accreditation Selection List: ISO 15189 Medical Testing Laboratories (10/18/2007) Page 1 of 2 PROPOSED SCOPE OF ACCREDITATION SCOPE OF ACCREDITATION TO ISO 15189:2007 SCOPE EXAMPLE LABORATORY 12345 Main Street Frederick, MD 21704 John Doe Phone: 555 555 5555 Identify the sample types upon which you perform testing. MEDICAL Valid To: May 31, 2007 Certificate Number: 0000.01 In recognition of the successful completion of the A2LA evaluation process, accreditation is granted to this laboratory to perform the following types of testing on human samples, including: Whole blood, serum, plasma, urine, CSF, gastric contents, stool, other body fluids Specialty Microbiology: Sub Specialty *Technology/Methodology Bacteriology Bacterial culture, complete ID Bacterial culture Genital cultures Stool cultures Urine cultures Wound cultures List the test Specialty and Subspecialty(s) that the laboratory is seeking accreditation for. Chemistry Routine Chemistry Colorimeter and/or spectrophotometer Enzyme immunoassay (EMIT) Enzyme-linked immunosorbent assay (ELISA) Immunoassay List the technologies or methodologies to be included on the Scope of Accreditation Urinalysis Microscopy, Urine Sediment Urine Dipstick, Manual Endocrinology Chemiluminiscent Method * Please note that to be considered for accreditation, a copy of each selected test method and the requisite equipment must be available at the laboratory. L:\Forms\F312 – Scope of Accreditation Selection List: ISO 15189 Medical Testing Laboratories (10/18/2007) Page 2 of 2