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The number of applications per quarter varies, but generally exceeds 100, resulting in over 200 reviews per quarter. During this time, the applications are divided into two groups. ** The ICANL randomly selects a percentage of the applications received each quarter and require only that select group to undergo a site visit. These laboratories are contacted in advance by the ICANL site visitor to schedule a date for the site visit. The applicant laboratories not selected for the site visit will undergo an audit, and instead be required to submit relative policies and documentation. Details regarding the information for this audit will be requested in a separate mailing from the ICANL. Labs will have 45 days to submit the documentation, which is then reviewed by the ICANL and contributes to the accreditation decision.

Once the in-house reviews are complete and applications are assigned to application reviewers and site visitors, the completed applications are boxed and shipped to reviewers who are located throughout the United States and Canada. Over the next four to six weeks, the applications undergo a detailed review of clinical components, including the case studies, for adherence to The Standards, and the laboratory is visited by an ICANL representative.

Upon completion of each application's review, the comments and recommendations are returned to the ICANL office, and the ICANL Technical Manager enters the information from both reviewers and the site visitor into the database. The data is then compiled and reviewed by the IAC CEO and ICANL Technical Manager in preparation for discussion and a final review by the ICANL Board Of Directors.

After the Board Of Directors meets and makes the accreditation decisions, the Technical Manager notifies the laboratory in writing of the Board decisions and any additional information required to grant accreditation. These notification letters are given priority and are sent in the timeliest manner possible. Two copies of the correspondence are sent; an original to the Medical Director, and a copy to the Technical Director. When accreditation is granted, the certificates accompany the letter to the Medical Director and are sent UPS Ground to allow the ability to track delivery of the documents.

As illustrated above, there are a number of avenues through which an accreditation application must travel in order to complete the cycle. The Board Of Director's meetings are held within the same months each quarter, but the dates vary based on the availability of these volunteers. It should be reassuring to laboratories that the process of reviewing applications and determining accreditation decisions is thorough and lengthy -- a fitting complement to the time and effort put into their initial preparation by those seeking accreditation.

**Based on a new policy recently enacted by the ICANL Board of Directors. Beginning with the July 2, 2007 application deadline, the ICANL will randomly select a percentage of the applications received each quarter and require only that select group to undergo a site visit.The applicant laboratories not selected for the site visit will instead be required to submit relative policies and documentation.