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This final rule updates histocompatibility and personnel regulations under CLIA to address obsolete regulations and updates regulations to incorporate changes in technology. This rule also makes a change to regulations related to the imposition of alternative sanction for Certificate of Waiver (CoW) laboratories in order to more closely align the regulations with the CLIA statute.  Additionally, this rule updates fees for determination of program compliance and additional fees for laboratories established under CLIA regulations as well as the collection of other fees we are authorized to collect, such as fees for revised certificates, post survey follow-up visits, complaint investigations, and activities related to imposition of sanctions.