What Actually Happens During a CLIA Survey? (A Former Surveyor Tells All)
- Amy Thiele
- Jul 8
- 3 min read
Some of the anxiety around CLIA surveys comes from one thing: not knowing what's actually going to happen.
I get it. For most of the people reading this, a survey is a once-every-couple-years event, if that. There's no reason you'd know the rhythm of it the way I do, after 7 years of doing this for the Arkansas Department of Health and 12 years of experiencing it from the lab side.
So let's fix that. Here's what an actual CLIA survey looks like, start to finish, from someone who used to walk in with the clipboard.
Before the Surveyor Even Arrives
CLIA surveys are typically announced one to two weeks prior to the visit. The surveyor will send all the forms that need to be completed by you which will include a list of testing personnel and a list of all testing. The length of the survey will depend on the size of the lab, the number of techs, and the type of testing performed.
Remember: This is just another set of eyes ensuring you are providing the best patient care.
The Entrance Conference
When I arrived at a lab, my first stop was to check in with the lab manager, lead techs, and lab director. I explained the process and was always happy to answer any questions they might have. I would review the forms I had sent to ensure they were properly completed and to note any changes since the last inspection. I would then tour the lab.
Record Review
This is the bulk of the survey — and it's exactly what it sounds like. I'd walk through the lab, observe testing in progress, and then sit down to review records.
I would start the record review with the 3 Ps: Procedure Manual, Personnel Records, and Proficiency Testing.
What helps here: Having these basic documents organized and easy to locate. It sounds small, but a lab that can produce its personnel files and proficiency testing records in two minutes versus twenty minutes tells me something about how organized the rest of the day is going to be.
I would then move on to review quality control, maintenance, temperature logs, and quality assurance records.
Personnel Interviews
I'd usually talk with a few testing personnel directly — not to trip anyone up, but to get a sense of whether training and competency assessments had actually translated into real understanding and to ensure the procedures reflected current practice.
A tip from the other side of the table: Be sure your testing personnel know that if they don't know an answer off the top of their head, it's perfectly fine to tell the surveyor what they'd do to find out — refer to the procedure manual, check the operator's manual, or call a supervisor. This is an acceptable answer. No one is expected to memorize a 60-page procedure manual or 300-page operator’s manual.
The “Snoop”
I would usually conclude the survey with an in-depth inspection of the lab. I’d open all the drawers and cabinets, checking for expired reagents or supplies and ensuring everything was stored properly.
The Exit Conference
At the end of the survey, I'd sit down with the lab manager, lead techs, and the lab director and walk through everything I found — citations, if any, and the general tone of how things went. This is also your chance to ask questions and get clarification on anything that was identified.
Don't skip this conversation or rush through it. This is the moment to fully understand what's being cited and why, while the surveyor is still right there to explain their reasoning.
What Happens After
If deficiencies were identified, you'll receive a formal statement of deficiencies and will need to submit a plan of correction within the required timeframe. This isn't the dramatic ending it sounds like — it's a standard part of the process, and most labs go through it at some point. It is just a matter of record keeping.
Key Takeaways
Surveys are routine, not punitive
Organization matters from the very first request for documents
Surveyors are evaluating whether your records and your practice tell the same story
Staff should answer questions honestly but are allowed to refer to other sources
The exit conference is your best opportunity to ask questions — use it
Want to walk into your next survey feeling prepared instead of anxious?
Grab my free Top 10 CLIA Deficiencies Checklist — it's built from exactly what I saw most often as a surveyor. [Download it here →]
That Lab Chic is an educational resource and does not constitute legal or regulatory advice.
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