Phlebotomy License Rules for 2027: California, Louisiana, Nevada and Washington

Passing the NHA CPT gives you a national certification; whether you also need a state credential depends on where you work. NHA says so itself: its Candidate Handbook calls its eligibility rules "separate and distinct from any eligibility to practice requirements set forth under state law," and its help center notes that some states require certification while others require a license (NHA). This guide covers the four states whose rules Passy checked on each state's own pages and regulations on October 28, 2026: California, Louisiana, Nevada and Washington. It isn't a list of every state, and it isn't legal advice.

The four states at a glance for 2027

Details and sources for each state follow.

California: a state certificate is required, and NHA's exam counts

California requires anyone drawing blood as a phlebotomist for diagnostic purposes, outside listed exceptions such as certified medical assistants drawing blood in a physician's office, to hold a state certificate from Laboratory Field Services (LFS). There are three: Limited Phlebotomy Technician (skin puncture only), Certified Phlebotomy Technician I (skin puncture and venipuncture) and Certified Phlebotomy Technician II (adds arterial puncture) (CDPH).

NHA's role is the exam. LFS requires a passing score on a national certification exam from an approved organization, and NHA is on its approved list, with an initial acceptance date of February 4, 2005: only exams passed after that date count. The NHA certification doesn't replace California's training requirement. With no on-the-job experience, CPT I needs 40 hours of classroom training and 40 hours of clinical practice, including at least 50 venipunctures, 10 skin punctures and observation of arterial punctures, in a CDPH-approved program; every program on CDPH's list is in California. The California CPT I guide walks through the application.

What changes around 2027. LFS moved new and renewed phlebotomy certificates to a one-year renewal period starting January 1, 2026, with 3 hours of approved continuing education completed within the previous 12 months. Certificates issued or renewed in 2025 with a 2027 expiration date stay valid until then and move to the annual cycle after their 2027 renewal. LFS suggests renewing at least 30 days before expiration (CDPH). It also says renewing a national certification is optional for this purpose, though an employer may ask for it.

Louisiana: a $40 license, with exemptions written into the law

LSBME's application instructions set out the phlebotomist route: pass a national exam approved by the board, with the passing score report sent directly by the exam agency, and have your professional school send an official transcript. The licensure fee is $40, paid by card and non-refundable. NHA appears on the board's phlebotomist exam list, revised November 1, 2024.

Two Louisiana details matter before you apply:

• Exemptions. The Louisiana Clinical Laboratory Personnel Law, as posted by LSBME, says the licensing part doesn't apply to someone performing phlebotomy who is employed by, or working under the direction and supervision of, a physician licensed by the board, or who is employed by a clinic operated by a licensed health care provider, a hospital, a nursing home or another licensed health care facility, or by a CLIA-licensed or certified testing site that provides at least five calendar days of phlebotomist training and two calendar weeks of on-the-job training (R.S. 37:1313(D); the section was last amended in 2023). Whether your job falls under an exemption is a question for LSBME or your employer.
• Renewal and CE. LSBME licenses renew every year through its online portal, and renewal opens no more than 56 days before expiration (LSBME). Its July 20, 2026 table lists 12 hours of continuing education a year for clinical laboratory personnel, renewing in December, tracked in CE Broker. New licensees skip the annual hours at their first renewal but must first complete a laws and rules course. The table's list of approved CE providers names organizations such as ASCP, AMT and ASCLS; NHA isn't among them.

Nevada: laboratory assistant certification, with new fees since July 2026

Nevada certifies laboratory assistants, who may perform waived tests and "collect and process specimens" (NAC 652.450). Under NAC 652.4855, an applicant needs a high school diploma or GED plus one of three things: at least 6 months of approved training, a phlebotomy certification from an approved organization (the regulation names NHA alongside AMT, ASCP, the American Certification Agency, NCCT and the National Phlebotomy Association), or at least 3 years of work at 30 hours a week in a qualifying laboratory during the past 5 years. The Bureau of Health Care Quality and Compliance, which licenses laboratory personnel, also lists NHA among the phlebotomy exams it accepts for laboratory assistants (HCQC).

A certificate is valid for 2 years (NAC 652.476), and a laboratory assistant needs 1 unit of continuing education, defined as 10 hours, in the 2 years before renewal (NAC 652.455 and 652.148).

The renewal rule has a hard edge: NAC 652.476 says that failing to apply for renewal within 30 days after the certificate expires ends the holder's authority to work in a laboratory at a technical level.

What changed in 2026. The bureau's personnel FAQs say fees changed on July 1, 2026, under LCB File No. R072-26: an assistant now pays $64 for an initial certificate or reinstatement and $48 for a biennial renewal. The state's notice of hearing gives R072-26's main topics as a 7% increase in NAC 652 licensing fees and in NAC 449 penalties; it lists no change to qualifications or continuing education. The copy of NAC 652 Passy could read, an archived capture of the Legislature's page revised April 13, 2026, still shows the older $60 and $45, so go by the bureau's schedule. Nevada applications are filed online through the state's licensing system.

The state credential sits on top of the exam you pass, not instead of it, and planned NHA CPT practice targets the national exam each of these four states lists.

Washington: medical assistant-phlebotomist, and a rule review under way

Washington credentials medical assistant-phlebotomists (MA-P) through the Department of Health. WAC 246-827-0400 gives three ways to meet the training requirement: a phlebotomy program at an accredited postsecondary school or college, a current national phlebotomy certification from a listed organization (NHA is one of six), or a phlebotomy training program approved and supervised by a health care practitioner (WAC 246-827-0400).

The application rule reads differently. WAC 246-827-0410 asks new applicants for proof of the postsecondary program or of a practitioner-attested training program, and the DOH credentialing page lists the same two options for new applicants. DOH does list current national certification, NHA's included, as a way back for a credential expired three years or more. If you plan to apply with your NHA certification as your training proof, ask DOH first.

Fees under WAC 246-827-990, effective August 1, 2025: $145 for the initial credential, $145 to renew, and a $75 late renewal penalty. Credentials renew every two years on your birthday.

What may change. On April 13, 2026, DOH filed a preproposal statement of inquiry (WSR 26-09-062), and on September 1, 2026 it filed proposed rules (WSR 26-18-070), with a hearing on October 6 and an intended adoption date of October 13, 2026. For MA-P applicants, the proposal would replace "proof" of high school education in WAC 246-827-0410 with "an attestation" of it. It leaves the training-proof wording unchanged, so the mismatch with WAC 246-827-0400 on national certification remains. As of October 28, 2026, Washington's register listed no adopted rule for this section, so no effective date is known yet.

What changes in 2027, state by state

• California: certificates issued or renewed in 2025 reach their 2027 renewal and switch to the annual cycle with 3 hours of CE a year.
• Louisiana: no change found; licenses renew annually as before.
• Nevada: the July 1, 2026 fee schedule ($64 and $48 for assistants) applies to 2027 applications and renewals.
• Washington: the rules proposed in September 2026 would let MA-P applicants attest to finishing high school instead of sending proof; adoption and an effective date were still pending on the check date.

Apart from Washington's pending proposal, no rule change for 2027 was found on the pages Passy checked on October 28, 2026: the four agencies' own pages, CDPH's list of proposed regulations, Nevada's regulation workshop page and Washington's register filings for chapter 246-827 WAC and its MA-P sections. Rules can change after that date, so check the agency before you apply.

Checking a state that isn't on this list

For any other state, start with the state health department or the board that licenses clinical laboratory personnel, and ask an employer in your area which credential its job postings require. Don't assume that no state page means no state rule. An NHA certification may still be what employers ask for where the state doesn't credential phlebotomists, and you can compare planned NHA Phlebotomy access periods against your application timeline once you know which steps come first.

Your next step on state phlebotomy rules

If you'll work in California, read the California CPT I guide before you choose a training program, because LFS accepts only California programs on its approved list. For the NHA side of renewal, see the 2027 renewal guide. Whatever your state, the exam is the same, and planned NHA CPT prep is the same for candidates in every state; the 20 free practice questions are a good first check.