Certification Criteria


CUC Required Criteria

1. Validation of Business Entity*:

  • Copy of business license for this facility, certificate of occupancy or equivalent

2. Radiological Equipment*:

  • Copy of current of one of the following x-ray documents:

--Inspection certificate

--State registration


3. Radiological Equipment Attestation:

  • Attest to possessing radiological equipment that can perform:

--Chest x-ray


--Long bone films



4. Laboratory Licensure*:

  • Copy of current laboratory licensure

5. EKG Requirement Attestation:

  •  Attest to the ability to obtain and read an EKG on site

6. Organizational Chart*:

  • Organizational chart including names of all current facility staff and providers with credentials (“MD”, “DO”, “NP”, etc.)

7. Facility Floor Plan*:

  • Copy of facility floor plan with clear labels marking EACH of the following items: exam rooms, treatment rooms (if separate), patient restrooms, x-ray, laboratory, portable defibrillator, oxygen and drug cart

8. Drug Cart Medications*:

  • List of all medications and equipment contained in drug cart – should include adult as well as pediatric or the ability to convert to pediatric dose

9. Marketing Materials*:

  • Copy of recent advertisement, flyer or similar marketing piece for this facility (billboard photos accepted)

10. Medical Director (or equivalent) Job Description*:

  • A written job description for Medical Director (or equivalent)

11. Medical Director Unrestricted Licensure*:

  • Copy of active, unrestricted license for center’s Medical Director

12. Photo Submissions: Facility Structure & External Signage*:

  • Exterior photo clearly showing entire facility structure and external signage

-Photo of main entry door or sign indicating days and hours of operation to the public

--If photo does not include advertisement that walk-ins are accepted during all hours, provide separate proof of advertisement circumstances criteria

--If facility does not meet above criteria, provide address of nearest owned center that meets special circumstances criteria (center must be certified or have an application in process)

13. Facility Equipment*:

  • Photos of portable defibrillator, oxygen equipment and drug cart and facility’s radiological equipment on site (Fixed or Portable)


RURAL CENTERS ONLY - Attach verification of rural address through use of this link.

*In Certification Bank only one document can be submitted per checklist item. Please combine multiple documents into one and attach if applicable. Accepted file types: .doc, .docx, .pdf, .jpeg, .png, .xls, .xlsx




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