Centers for Medicare & Medicaid Services has completed the transition to a fully paperless system for the Clinical Laboratory Improvement Amendments (CLIA) program. CLIA certificates and fee coupons will no longer be mailed, and all certification and survey fees must now be paid online rather than by paper check. Laboratories must also ensure they have a valid email address on file to receive electronic certificates, billing notices, and other CMS communications to avoid potential certification or payment issues. The update does not apply to CLIA-exempt states or state licensure programs, and CMS has provided additional FAQs and resources to help laboratories navigate the transition.