Medical Cannabis Laboratory Approval Program Application

This application is designed for use by laboratories seeking approval by the Commissioner of Health for the use of procedures to test the product types and analytes for compliance with the Medical Cannabis Registry Program under Minnesota Statutes, section 152.22 through 152.37, and Minnesota Rules Chapter 4770.

Instructions

1. Complete the required information requested below.

2. Check the specific testing areas for which your laboratory seeks approval (see Testing Areas).

3. Complete the appropriate sections of the application for those specific testing areas.

4. Compile other required documentation into one PDF and upload where noted on the application.

Legal Name of Laboratory

* must provide value

Legal Status of Laboratory

* must provide value

Laboratory Street Address (physical location)

* must provide value

City

* must provide value

State

* must provide value

ZIP Code

* must provide value

Primary Contact Name

* must provide value

Primary Contact Email

* must provide value

Testing Areas (choose all that apply, then complete appropriate sections that follow)

* must provide value

Cannabinoid Profile

Metals Profile

Pesticide Residues and Plant Growth Regulators

Residual Solvents

Microbiological Contaminants

Mycotoxins

Analyte	Method/Technology	Report Limit
Cannabidiol (CBD)
Delta-9 Tetrahydrocannabinol (Δ9-THC)
Cannabinol (CBN)
Cannabichromene (CBC)
Delta-9 Tetrahydrocannabinolic Acid (Δ9-THCA)
Other:
Other:

Analyte	Method/Technology	Report Limit
Arsenic
Cadmium
Lead
Mercury
Other:
Other:

Analyte	Method/Technology	Report Limit
Pesticide Screen*
Pesticide Quantitation**
Other:
Other:
Analytes to be determined *All pesticide hits must be quantitated

Analyte	Method/Technology	Report Limit
Methanol
Ethanol
Pentane
Other:
Other:

Analyte	Method/Technology	Report Limit
Total Viable Aerobic Bacteria
Total Yeast and Mold
Total Coliforms
Bile Tolerant Gram-Negative Bacteria
E. Coli
Salmonella spp.
Other:
Other:

Analyte	Method/Technology	Report Limit
Alfatoxins B1
Alfatoxins B2
Alfatoxins O1
Alfatoxins O2
Alfatoxins A
Other:
Other:

Required additional documentation list

Signed and notarized attestation form stating operational and financial independence
from all Minnesota medical cannabis manufacturers.
Quality assurance manual (see link NEED TO ADD for requirements).
Standard operating procedure (see link NEED TO ADD for requirements).
Sample handling, receipt and acceptance procedures and policies (or
reference if located in SOP or QM).
Demonstration of laboratory capability and acceptable performance through
existing certificates/approvals, documented demonstrations of analytical
capabilities and documented and acceptable proficiency testing samples from
an approved provider.
Method validation procedures for testing methods.
The name and educational qualifications of at least one technical manager
responsible for achieving and maintaining the quality and analytical standards
of practice.

Upload ONE PDF of all required documentation here.

* must provide value

Upload file

Date Time

M-D-Y H:M

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Medical Cannabis Laboratory Approval Program Application

Cannabinoid Profile

Metals Profile

Pesticide Residues and Plant Growth Regulators

Residual Solvents

Microbiological Contaminants*

Mycotoxins**

Required additional documentation list

You have selected an option that triggers this survey to end right now.