NVLAP General Application for New Laboratories

N

National Voluntary
Laboratory Accreditation Program

GENERAL APPLICATION FOR NEW LABORATORIES

Instructions for completing the application for accreditation

1. To fill in and save this application form, you must have the latest version of the Adobe Reader
software installed on your computer. This software is freely available from the Adobe Reader
website.*
2. Thoroughly review the accreditation requirements published in NIST Handbook 150, NVLAP
Procedures and General Requirements, and in the handbook of the Laboratory Accreditation
Program(s) (LAP) for which you are applying. These requirements are published on the LAP
webpage for each program. See http://www.nist.gov/nvlap/.
3. Complete this interactive fillable General Application Form by entering the requested information in
each highlighted box or field. To move from one field to the next, press the Tab key.
4. The laboratory's Authorized Representative (AR) must sign page 4 of the General Application to
signify agreement with the NVLAP Conditions for Accreditation.
5. Send this application to NVLAP at [email protected]. It is recommended that you retain a copy for
your records. A one-time Initial Application Fee is also required to be submitted in order to process
this application form. See below for information to remit the required Initial Application Fee. Once
payment is received and the application form is processed, NVLAP will email an acknowledgment
to the AR, along with user account information, a link to the NIWS laboratory portal, and
instructions for completing the remaining application steps through the NIWS.**
6. For more information, go to NVLAP’s website, http://www.nist.gov/nvlap/, and click on “Apply for
Accreditation.” For assistance, contact NVLAP by phone, (301) 975-4016; fax, (301) 926 2884; or
email, [email protected].

* Software is identified in order to assist users of this information service. In no case does such identification
imply recommendation or endorsement by the National Institute of Standards and Technology.
** If the remaining application steps are not completed within six months of receipt of this form, the application
may be canceled.

NVLAP GENERAL APPLICATION (REV. 2024-01-08)

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National Voluntary
Laboratory Accreditation Program

N

GENERAL APPLICATION FOR NEW LABORATORIES
Instructions for completing the application for accreditation (continued)
7. Complete the Accounting data and Billing information along with submission of payment of the
Initial Application Fee to allow for the processing of the application.
Accounting Data
Business Partner Network (BPN) or DUNS Number
NIST BPN: 929956050
Laboratory BPN or DUNS: _______________________
Employer/Taxpayer Identification Number (EIN/TIN)

NIST TIN: 53 0205706

Laboratory EIN or TIN No: _______________________
Billing Information
Lab Billing Information **Bill to Lab/Affiliate is the Lab or Affiliate paying the Invoice
Bill To Lab/Affliate: _______________________________________________________
Bill to Address: __________________________________________________________
Bill to Phone: ____________________________________________________________
Bill to Email: _____________________________________________________________
Payment for the Initial Application Fee can be remitted in one of the following methods:
Regular Postal Mail Only:
NIST
P.O. Box 6200-12
Portland, OR 97228-6200

Courier Deliveries & Postal Services Requiring Signature:
U.S. Bank Government Lockbox
Attn: U.S. Department of Commerce NIST 6200-12
17650 NE Sandy Blvd.
Portland, OR 97230

Credit card or ACH:
Go to: https://pay.gov/paygov/forms/formInstance.html?agencyFormId=31608926

Wire payment:
U.S. Dept of Treasury
33 Liberty Street
New York, NY 10045
202-874-7132

NVLAP GENERAL APPLICATION (REV. 2024-01-08)

Payment details field: CL329930001
ABA#: 021030004
ALC#: 13060001

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DATE :

NVLAP LAB CODE:

NVLAP GENERAL APPLICATION
1. LEGAL NAME AND FULL ADDRESS of the laboratory.

Laboratory Name

Address (Line 1)

Address (Line 2)

City

State

Foreign City

Foreign Postal Code

ZIP + 4

Country
2. LABORATORY NAME AS YOU WANT IT TO APPEAR ON THE CERTIFICATE AND SCOPE
OF ACCREDITATION

NVLAP GENERAL APPLICATION (REV. 2024-01-08)

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DATE :

NVLAP LAB CODE:

3. LABORATORY ACCREDITATION PROGRAM (LAP) for which the laboratory is applying.
You may select more than one program.
Acoustical Testing Services

Federal Warfare System(s)

Asbestos Fiber Analysis

Ionizing Radiation Dosimetry

Biometrics Testing

ITST: Common Criteria Testing

Calibration Laboratories

ITST: Cryptographic & Security Testing

Carpet and Carpet Cushion

ITST: Healthcare Information Tech. Testing

Construction Materials Testing

Law Enforcement and Correct. Equipment

Efficiency of Electric Motors

Radiation Detection Instruments

Electromagnetic Compatibility &Telecom.

Thermal Insulation Materials

Energy Efficient Lighting Products

Voting System Testing

Fasteners and Metals

4. AUTHORIZED REPRESENTATIVE of the laboratory. The Authorized Representative is
responsible for ensuring that the laboratory complies with the conditions and criteria for
accreditation. This person's name will appear in NVLAP directories and on Scopes of
Accreditation. The Authorized Representative will receive all NVLAP correspondence, receive
proficiency testing materials and reports, and be contacted about on-site assessments.

Name:
Title:
Phone No.:

Fax No.:

E-Mail:

NVLAP GENERAL APPLICATION (REV. 2024-01-08)

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DATE :

NVLAP LAB CODE:

CONDITIONS FOR ACCREDITATION
To become accredited and maintain accreditation, a laboratory shall agree in writing to comply with the following NVLAP
conditions for accreditation:

a) comply at all times with the NVLAP requirements for accreditation as set forth in NIST Handbook 150 and relevant
technical documents, including any changes to those requirements;

b) fulfill the accreditation procedure, especially to receive the assessment team and allow access to information,
documents, and records;

c) when the laboratory conducts activities at clients’ sites, have arrangements to provide access to the assessment team;
d) pay the fees charged to the applicant laboratory as determined by NVLAP, and maintain relevant financial agreements;
e) participate in proficiency testing as required;
f)

follow NVLAP conditions for referencing accreditation status (see Annex A and Annex E);

g) resolve all nonconformities;
h) report to NVLAP within 30 days any significant changes relevant to its accreditation, in any aspect of its status or
operation relating to:

 legal, commercial, organizational, or ownership status,
 organization, top management, or ley personnel, including Authorized Representative and Approved Signatories,
 main policies,
 resources and location, including equipment, facilities, and working environment, where significant,
 scope of accreditation, or
 other matters that may affect the laboratory's ability to comply with the requirements of NIST Handbook 150
and/or relevant technical documents;

i)

return to NVLAP the Certificate of Accreditation and the Scope of Accreditation should it be requested to do so by
NVLAP.
In addition to the confidentiality provisions of NIST Handbook 150 paragraph 1.7, NVLAP (administered by NIST) and
the laboratory seeking accreditation acknowledge and agree that the accreditation assessments and proficiency testing
work done by NIST/NVLAP is done in accordance with the authority granted to NIST by Title 15 United States Code
Section 3710a. The Parties further agree that to the extent permitted by law, NIST will protect information obtained
during application, on-site assessment, proficiency testing, evaluation, and accreditation from disclosure pursuant to
Title 15 USC 3710a(c)(7)(A) and (7)(B) for a period of five (5) years after it is obtained.
For the first five years that laboratory information is held by NVLAP, both confidentiality provisions will be in force —
NIST Handbook 150 and 15USC3710a. Information in NVLAP's possession for more than five years will continue to be
held in confidence under the provision of NIST Handbook 150.
As the applicant laboratory's Authorized Representative, I agree to the above conditions for accreditation. I attest
that all statements made in this application are correct to the best of my knowledge and are made in good faith.

Signature

Date

Printed Name

NVLAP GENERAL APPLICATION (REV. 2024-01-08)

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