Oral Pathology Lab
The UCLA Oral Pathology Diagnostic Laboratory provides expert diagnostic services within the scope of Oral and Maxillofacial Pathology. All services are provided by pathologists who are diplomates of the American Board of Oral and Maxillofacial Pathology (ABOMP).
Our priority is to provide the best service for our clinicians. Please feel free to ask any questions. While our guidelines may seem extensive, they ensure better patient care. Thank you for choosing our services.
Hours & Contact Information
Monday to Friday 8 a.m. to 5 p.m. Closed on the weekends and holidays.
UCLA Oral Pathology Diagnostic Laboratory
Room 53-058 CHS
Los Angeles, CA 90095-1668
On-Site Oral Pathologist: Dr. Yi-Ling Lin
Cost of Care: See billing policy in Form 1: Acknowledgement Form
Billing Service Contact Information:
For Billing Information Contact: CareCloud
1633 Erringer Rd | Simi Valley, CA 93065
(805) 578-8300, Ext.14230 | Fax: (805) 578-8950
Required Forms for Specimen Submission and Medicare Compliance:
For Specimen Submission (Forms 1, 2, 3)
1. Acknowledgement Forms (includes billing policy): Required for specimen submission.
2. Biopsy Kit Request Form: For ordering additional biopsy kits. Doctors can also request kits by calling our office or submitting this form with a specimen.
3. Tissue Examination Request Form: Required for specimen submission.
For Medicare Compliance (Forms 4, 5, 6)
4. 8550 Medicare Form: Required for registration with CMS.
5. Opt-Out Affidavit: Must also include a Medicare Private Contract for each Medicare patient. Doctors must check “Yes” for Order and Refer.
6. Medicare Private Contract: Required for Opt-Out doctors and Medicare patients and retain in their office files.
Request to Release Slides/Blocks (Form 7)
7. Authorization for Release and Disclosure (UCLA OP): Required if a patient requests slides/blocks be sent to an external facility for further analysis.