[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-277132-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-277132-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","california-phlebotomy-certification-letter-of-experience","California Phlebotomy Certification Letter of Experience","","Letter form for documenting an applicant’s on-the-job phlebotomy experience for California certification. It collects laboratory and applicant contact details, CLIA certificate information, employment dates, and total phlebotomy hours completed in the previous five years. The letter lists required competencies, including specimen collection equipment selection, patient preparation and infection control, venipuncture and skin puncture across varying patient profiles, post-puncture care, blood processing and centrifugation, and proper disposal of sharps. It also records minimum required clinical procedures and director attestation.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/letters/","Letters",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/california-phlebotomy-certification-letter-of-experience/277132/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/california-phlebotomy-certification-letter-of-experience/277132.png","ImageObject",442,249,{"name":42,"@type":43},"Emma Wilson","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-03","2026-09-15",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",28,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information is required in the laboratory section?","Question",{"text":63,"@type":64},"The form requests the laboratory name, address, email, telephone, and CLIA certificate number and certificate type.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which phlebotomy competencies must be demonstrated?",{"text":68,"@type":64},"The letter covers selecting proper blood collection equipment, patient preparation and infection control, venipuncture and skin puncture across patient groups, post puncture care, blood container processing including centrifugation, and disposal of needles, sharps, and medical waste.",{"name":70,"@type":61,"acceptedAnswer":71},"How are required clinical procedures documented and attested?",{"text":72,"@type":64},"A checklist records minimum successful skin punctures, venipunctures, and arterial punctures as applicable. The laboratory director (MD/DO/CLB only) attests by providing name, signature, date, and license number.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},277132,1790150370,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,114,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},17,"Forms",40,"forms",{"id":115,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":116,"slug":117},18,30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":115,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":4},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","LETTER OF PHLEBOTOMY EXPERIENCE FOR CALIFORNIA CERTIFICATION  \nLaboratory Information:  \nName of Laboratory Where Employed:  \nLaboratory Address:  \nLaboratory Email:  \nLaboratory Telephone:  \nLaboratory CLIA Certificate No. \\#:  \nLaboratory CLIA Certificate type: COW PPMP COC COA (Check One)  \nApplicant Information:  \nName of Applicant:  \nApplicant Address:  \nApplicant Telephone:  \nDates of Employment: from to  \nTotal hours of on the job experience in phlebotomy in the last 5 years  \nIf less than 1040 hours: hours If 1040 hours or greater: hours  \nThe above named individual has on-the-job experience in phlebotomy in the last 5 years, in accordance with the California Business and Professions Code section 1220(d)(1) or (d)(2)(A) and Title 17, California Code of Regulations section 1035.1(f)(1-8) , and has demonstrated proficiency in the following areas:  \n1. Selection of blood collection equipment appropriate to test requisitions.  \n2. Preparation of the patient and infection control.  \n3. Venipuncture from patients of varying ages , weights, health and obesity status.  \n4. Skin puncture from patients of varying ages, including pediatric/geriatric, and of varying health/obesity status.  \n5. Post puncture care.  \n6. Processing of blood containers after collection, including centrifugation.  \n7. Proper disposal of needles, sharps, and medical waste.  \nAdditionally, this individual has completed the following procedures on actual clinical patients of varying ages, health, and obesity status:  \n\n| ☐ LPT | ☐ CPT 1 | ☐ CPT 2 |\n| --- | --- | --- |\n| Minimum 25 successful skin punctures | Minimum 50 successful venipunctures\u003Cbr>Minimum 10 successful skin punctures Observation of arterial puncture | Minimum of 20 arterial punctures pursuant to Business and Professions Code 1220(d)(1) or (d)(2)(A)\u003Cbr>Meets requirements as CPT 1 and has a minimum of 1040 hours of onthe-job experience in phlebotomy in the previous five years. |\n\nAs attested by:  \nLaboratory Director Name (Please Print) Laboratory Director Signature Date  \n(MD, DO, CLB Only)  \nLaboratory Director License No.\\#","cbCaidwdtbAtKoSx","https://ap.wps.com/l/cbCaidwdtbAtKoSx","pdf",1980304,"English","# Laboratory Information\n## Applicant Information\n## Phlebotomy Competency Areas\n## Clinical Procedures Checklist\n## Laboratory Director Attestation","[{\"question\":\"What information is required in the laboratory section?\",\"answer\":\"The form requests the laboratory name, address, email, telephone, and CLIA certificate number and certificate type.\"},{\"question\":\"Which phlebotomy competencies must be demonstrated?\",\"answer\":\"The letter covers selecting proper blood collection equipment, patient preparation and infection control, venipuncture and skin puncture across patient groups, post puncture care, blood container processing including centrifugation, and disposal of needles, sharps, and medical waste.\"},{\"question\":\"How are required clinical procedures documented and attested?\",\"answer\":\"A checklist records minimum successful skin punctures, venipunctures, and arterial punctures as applicable. The laboratory director (MD/DO/CLB only) attests by providing name, signature, date, and license number.\"}]","California Phlebotomy Certification Letter of Experience | PDF",1789498028]