Antigen Testing Devices

Question Title

* 1. Facility Name, CLIA Waiver Number, & Capacity

Name

CLIA Waiver Number

Capacity

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* 2. Facility Address & Contact Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Has your facility received the an antigen testing device from CMS?

Yes

No

Question Title

* 4. If yes to Q3, which brand did you receive?

Quidel

BD

Question Title

* 5. If yes to Q3, how many test kits were included with your device?