1. Validation of Business Entity*:
2. X-Ray License*:
3. X-Ray Attestation & Photo*:
4. Laboratory License*:
5. EKG Requirement Attestation:
6. Center Organizational Chart*:
7. Facility Floor Plan*:
8. Emergency Equipment/Supplies/Medications*:
9. Marketing Materials*:
10. Medical Director (or equivalent) Job Description Attestation:
11. Medical Director Unrestricted Licensure*:
12. Photo Submissions: Facility Structure & External Signage*: