Phlebotomy Requirements by State

Because phlebotomy licensure is not nationally mandated or regulated, each state has its own laws and requirements for phlebotomists’ certifications. When considering a move across state lines, phlebotomists must be aware of whether the state they are moving to has license or certification reciprocation.

How to Study for a Phlebotomy Test

Phlebotomy is a specialty that is in high demand. Phlebotomists work in a variety of medical settings such as hospitals, labs and health practices. Their primary job is drawing blood samples for testing, an extremely important task for assessing patient health. The phlebotomist not only draws blood but is also responsible for making certain that specimens are properly labeled to avoid inconvenient and costly errors. To be sure that a phlebotomist knows his or her stuff, every student must go through extensive training that involves both classwork and hands-on practice. Finally, students must pass a certification exam. In order to make it through this final step, students need to carefully prepare for the test.

Understanding the NCCT National Phlebotomy Certification Examination

The National Center for Competency Training offers its phlebotomy test in many locations. Students have three hours to complete 125 test questions that cover several categories concerning blood-drawing practices. Most of these questions are in a multiple-choice format. However, there are a few exceptions.

Hotspot questions: Students are given a chart or figure with several clickable areas. They will answer a series of questions to prove that they understand the image.

Drag and drop questions: In this format, students must put a group of statements in the right order. These questions focus on procedural knowledge.

Multi-select questions: This type of question is similar to the multiple-choice format. However, students are asked to select more than one correct answer from a series of statements.

The Six Content Categories You Need to Know

The National Phlebotomy Certification Examination covers six content areas that range from legal knowledge to practical aspects of the career. Students must have a decent knowledge of the following areas.

Quality and Professional Issues: Phlebotomy requires direct work with patients. As such, there are several legal aspects of the practice the students need to know. Students will need basic information about HIPAA rules, the Patient’s Bill of Rights and privacy laws around specimen collection. In addition, students will need an understanding of dealing with patients with special needs.

Safety and Infection Control: Working with blood and other samples may mean working with infectious materials. Students must prove that they know how to protect themselves and their fellow staff members against infection. They will also need to prove their knowledge of workplace safety practices.

Order of Draw and Equipment: This section includes questions about the basic materials of phlebotomy. Students will show that they can interpret medical orders and identify common equipment. Learn more about the all-important Order of Draw at the provided link.

Patient ID and Site Preparation: It is critical that a phlebotomist knows the procedures that make certain the right patient gets the right tests. They must also show a knowledge of the proper preparation for a safe blood draw.

Collections: Questions in the category focus on the practical side of phlebotomy. Students will show they know the theory behind an effective blood draw. They will also be asked to display a knowledge of proper sample labeling.

Correcting Issues: This section focuses on cases where a blood draw is complicated by a physical condition, collapsed vein or adverse reaction to the draw. These questions also revolve around the proper procedure when a phlebotomist realizes a mistake has been made in the identification or labeling process.

Phlebotomy Study Tips

Studying for the phlebotomy exam is similar to studying for any major exam. If you have been an attentive student, you have all the knowledge you need to pass the test. Your challenge is to retrieve that knowledge under the pressure of the exam day. There are several strategies you can use to get ready.

Think Procedurally: One of the major concerns of this test is that students understand the many procedures around phlebotomy. You can practice step-by-step procedures by creating flowcharts or checklists for study purposes.

Group Study: Gathering fellow students to study as a group gives you the opportunity to quiz each other. It can also be helpful to talk through procedures with another student. Explaining information is a great way to learn it.

Practice Tests: A week before the test, you might want to find some practice questions or tests to see where you stand. This will allow you to brush up on your weak spots.

How to be Ready on Test Day

On the day of the test, you want to be well-rested and calm. Give yourself plenty of time to get to the testing site. Make sure you get a solid amount of sleep the night before. Eating a healthy breakfast will also help you have the energy to get through a three-hour testing time.

PhlebotomyU: Professional Career Preparation

A solid education will lead to a good score on the phlebotomy test. At PhlebotomyU, we have more than 30 years of experience in helping people enter a career in this important medical field. We work with medical sites throughout Southern California, offering the best training possible. Not only do we offer the phlebotomy exam on-site, but we also prepare you to succeed. Do you think a career in phlebotomy is right for you? Contact us today. 

How to Become a Phlebotomy Instructor

Many phlebotomists choose to enter the educational field after spending a few years working with patients. Let’s take a look at how to become a phlebotomy instructor.

What’s the Most Commonly Used Phlebotomy Equipment? From Scrubs to Needles

phlebotomy equipment

For the trained phlebotomist, using the appropriate phlebotomy equipment is an essential part of a successful venipuncture. A seasoned phlebotomist can assemble materials in such a way their hands glide efficiently from one part of the procedure to the next with speed and precision. Not only does this level of preparation help to ensure a correct blood withdrawal procedure, but it also helps inspire confidence in nervous patients. Let’s go over the most commonly used phlebotomy equipment.

The Most Commonly Used Equipment in Phlebotomy:


A phlebotomist is similar to other healthcare workers in that they are often required to dress in scrubs at the workplace. Depending on the employer, a phlebotomist and other laboratory personnel may be required to wear a certain color of scrubs for easier identification purposes. For practical reasons, phlebotomists rely on the various pockets in scrubs and lab coats to keep a supply of materials like extra alcohol wipes, gloves, and tourniquets.

Non-sterile Gloves

Before each procedure, the phlebotomist will don a pair of latex gloves. Like all healthcare professionals, phlebotomists wear gloves to protect themselves and the patient. While the first step in any procedure is a thorough hand-washing, gloves help prevent the passage of pathogens from the phlebotomist’s hands to the patient. Gloves are necessary to help prevent the transfer of blood pathogens from the patient to the phlebotomist. Gloves should fit neither too loosely or too tight. Snug-fitting gloves ensure ease handling phlebotomy materials. Gloves should be discarded immediately after the procedure.

Alcohol pad

Before the insertion of the needle, the site should be cleansed with an alcohol wipe. Once the site is chosen the phlebotomist will open the alcohol wipe and apply it to the site to prevent potential contamination. The phlebotomist and the patient must not touch the site after it is cleaned or the phlebotomist will have to repeat the procedure before the needle is inserted.


A tourniquet compresses the veins and restricts the flow of blood back to the heart. This allows the phlebotomist to see the veins more clearly to make a successful venipuncture. After the phlebotomist selects the vein, the tourniquet is tied three to four inches above the intended site. The tourniquet should be removed at the end of the procedure.


Needle selection depends on the procedure and personal choice. Some experienced phlebotomists prefer the butterfly needle for every procedure, while others use the butterfly needle for smaller veins or pediatric procedures. Also known as winged infusion sets, butterfly needles are characterized by a pair of plastic wings that the phlebotomist can grip to more easily guide the needle into the vein. A tube extends from the needle down to a tube holder where the phlebotomist connects the collection tube. Straight needles vary in size and are often connected to a plastic tube holder. After insertion in the vein, the needle will be held still by the phlebotomist while the collection tubes are switched in and out in the tube holder.

Blood Collection Tubes

Collection tubes come in a rainbow of colors. Each stopper color denotes a particular function and test. Colored stoppers are essential for the correct order of the draw. A phlebotomist will select the tube depending on the type of test that is ordered for the patient. Additives in the tubes are essential for the type of test for which the blood is collected. For example, lavender tubes contain an additive that helps the blood coagulate and is used for specimen collection specific for hematology procedures. Collection tubes are manufactured so that they are evacuated tubes and then seal. When the phlebotomist inserts a needle in the tube the vacuum pulls the blood from the vein into the tube. At times, a tube will malfunction requiring the phlebotomist to reach for another one to complete the blood collection. For this reason, the phlebotomist should keep extra tubes within reach so that the procedure can continue.


Blood collection tube labels are necessary for the correct transfer of patient samples to the lab for testing and diagnosis. Like other phlebotomy equipment, labels should be secured before the start of the venipuncture. Labels should include the patient’s name, date, and other identifying information. The process for labeling blood collection tubes depends upon the laboratory. Labels may be computer-generated and printed or blank for hand-written labeling. Either way, the phlebotomist will double-check the patient’s identity to make sure the blood sample reaches the lab under the right name.

Gauze or Bandages

At the end of the venipuncture procedure, the phlebotomist will remove the needle from the blood draw site and check for bleeding. A piece of gauze or a cotton ball will be placed over the injection site and a slight bit of pressure applied to prevent excessive bleeding and to encourage clotting. Afterward, the phlebotomist will affix a bandage or a piece of gauze secured by tape. The bandage should remain in place for the length of time specified by the phlebotomist.

Learn More About a Career in Phlebotomy

Are you interested in pursuing a rewarding career in a demanding field? Contact us and learn more about how phlebotomy training at PhlebotomyU will put you on the path to success.

Phlebotomy License Renewal Steps

The CPT I License is the main requirement for becoming a practicing phlebotomist. Once certified, the CA phlebotomy certificate renewal must be done every two years using the CDPH license renewal process. The initial certified phlebotomy technician (CPT I) course can range from five weeks to 9 weeks and includes analytical subjects such as anatomy, order of draw, hospital techniques, and post puncture care. You may click here for a complete list of courses and cost information. In addition to the phlebotomy training, the cost also covers class materials, lab supplies, and the National Exam and the clinical internship. Drug screenings and background checks are also paid for. Financial aid is also available with several payment options being offered.

CPT I License Renewal Process

The CPT I phlebotomy license must be renewed every two years. This ensures that the professionals in the field are taking the initiative to stay informed of any and all updates pertaining to phlebotomy. Before a license can be renewed, certain requirements must be met. Those applying for renewal must already have either a limited phlebotomist technician certificate or a certified phlebotomist technician certificate. Keep in mind that meeting deadlines for certification renewal is crucial. This is discussed in detail under Late Renewals.

Approximately seventy-five days before the expiration of the CPT I license, notices are mailed out to certified phlebotomists for license renewal. Sixty days prior to expiration the license can be renewed. However, it must be renewed thirty days before expiration to avoid suspension.

Phlebotomy License Renewal Requirements

  1. Continuing Education with CPT Classes – Before applying for license renewal and two years before license expiration, six contact hours of ongoing education must be completed. This must be done at a CDPH credit approved school or agency. Copies of certificates or unofficial transcripts must accompany the application proving that the contact hours have been completed.
  2. Current Phlebotomist’s Information – It is the responsibility of each applicant to make sure that all their information is updated with any changes in name and/or address. This information should be reviewed prior to applying for renewal. A license or certificate number will also be needed. Go to the Laboratory Personnel License Search in case of a lost or forgotten license or certificate number.
  3. Completing the Online Application All applications must be completed online by going to the CDPH Certificates, Licenses, Permits and Registration Portal. First-time applicants will be required to set up an account with a user ID and a password. Once this has been completed, they can begin filling out the application to renew their phlebotomy license/certificate. Remember, proof of completion of six contact hours must accompany the application.
  4. Application and Renewal Fees – Whether the applicant is a limited phlebotomy technician or a certified phlebotomy technician, an introductory fee along with a renewal fee must be paid at the time of completion. The California phlebotomy license renewal fee is $100.00.

Approval and Receiving the Renewed License

Once the certification process has been completed and approved, applicants can print out their approval notice to serve as temporary proof of their certification. They can check the status of their application on a regular basis because the CDPH website updates every few days. Since hard copies of licenses are no longer mailed, applicants will need to print them out once their renewal has been approved. A PDF reader is required for printing and an applicant can print out as many copies as needed.

What Happens to Late CPT I Renewals

Getting the phlebotomy license renewed after it expires does not require the payment of a late charge for the Limited Phlebotomy Technicians or the Certified Phlebotomy Technicians. However, phlebotomists are not permitted to work while their license is expired and it may take longer to have your license reactivated. It is extremely important to get the CPT 1 renewal application done on time along with having the required contact hours of ongoing education.

Recap – The CPT License Renewal

Being a phlebotomist can be an exciting and rewarding career. You can start out with the basic beginning requirements or, if you have previous venipuncture experience, you can take the abbreviated course. There are also additional courses for those who want to advance their careers in phlebotomy. For more information on signing up for phlebotomy classes or help with renewing your license, be sure to contact PhlebotomyU. You can call, send an email and fill out a form to request course information. Don’t put it off. Your future in phlebotomy is waiting for you! 

Collecting Blood from Newborns

Neonatal phlebotomy can be understandably intimidating. There are certain things to consider when performing a phlebotomy procedure on a young infant. Learn about the neonatal heel prick, also known as dermal puncture, here.

California Phlebotomy License Renewal Requirements

While many fear blood or the act of getting their blood drawn, the role of the phlebotomist is extremely important in the health and treatment of individuals. Here are 8 phlebotomy facts that demonstrate its importance in medical practice over the past two thousand years.

8 Surprising Phlebotomy Facts

8 Facts About Phlebotomy

A phlebotomist is someone who uses venipuncture to draw blood from an individual. While many fear blood or the act of getting their blood drawn, the role of the phlebotomist is extremely important in the health and treatment of individuals. Drawn blood can indicate the presence or absence of blood cells to indicate a serious illness or unhealthy levels of cholesterol or blood sugars. It can also indicate genetic markers that signal a predisposition for a disease, or the possibility of disease in future children. Here are 8 phlebotomy facts that demonstrate its importance in medical practice over the past two thousand years.

Bloodletting Was Common in Ancient Egypt, Greece, and Rome

Phlebotomy’s earliest ancestor was the process of bloodletting. While it was used for very different purposes than the modern procedures, the idea behind the process was similar. Instead of removing blood for diagnostic purposes, physicians believed that releasing blood from the body was a way to treat common and serious ailments, essentially letting the poisonous illness drain from the body. Additionally, there was a belief that physicians needed to balance the four humors of the body: yellow bile, black bile, phlegm, and blood. Bloodletting was believed to be a therapeutic way to accomplish this equilibrium.

George Washington Died From Lack of Blood

Our very first president could have lived a longer life if only he had a modern phlebotomist to help him out. Washington reportedly lost between 5 and 7 pints of blood in 2/3 of a day as a result of excessive bloodletting. He received the treatment in response to a very bad sore throat but ultimately lost his life due to a significant shortage of blood in his body. More modern facts about phlebotomy have informed technicians on the proper procedures for drawing blood in order to avoid situations where patients lose too much blood.

Blood Used to be Drawn From Larger Veins

Prior to the modern understanding of safe venipuncture, blood used to be let by severing arteries and veins in the neck or forearm. This practice was done using any sharp metal or wooden implement and was used to treat common ailments during medieval times, such as smallpox, gout and the plague. This led to an excess of blood being released from the body in some instances, and the lack of sterilization could lead to serious or lethal infection.

Barbers Were Also Phlebotomists

While the idea of drawing blood in the lab might feel nerve-wracking, consider the idea that barbershops used to practice phlebotomy in addition to cutting hair. As mentioned above, bloodletting was common in ancient and medieval times, and medical care used to be administered by monks and assisted by barbers at their shop. Patients could get a haircut and have a vein cut to drain blood all in the same visit. This is why a barber’s pole is red, white and blue. The pole resembles the shape of the stick patients held to make their vein prominent while the red color symbolized the blood and the white represented the bandages.

Leeches Were Commonly Used to Draw Blood in the 19th Century

As if cutting people open to release their blood doesn’t sound bad enough, physicians in France and England used to use leeches to suck the blood of patients in the 1830s and 1840s. Back in ancient times, and again in the middle ages, the leeches were used to heal headaches and other ailments. While leeches are currently still used to help with removing blood in swollen areas or following procedures with an increased risk for blood clots, there are much safer means to draw blood for diagnostic purposes.

Veterinarians Also Practice Phlebotomy

People are not the only ones who require blood to be drawn on occasion. Animals can also require blood to be drawn to check for disease or to perform routine checkups. Pets, such as dogs and cats, may require regular bloodwork in order to ensure that they do not have any life-threatening illnesses such as Lyme disease or heartworms. When animals are ill, it might also be necessary to collect blood to check for disease.

There are Four Blood Types

There are only four major blood types that run through everybody’s veins: A, B, AB and O. Additionally, these blood types are labeled positive or negative depending on whether the Rh antigen is found in the blood. Blood typing is important for blood transfusions, as patients need to receive blood of the same type as what runs through their veins. Those with type O blood are considered “universal donors” because their blood can be used for any blood type because it does not contain antigens.

Blood Can Also be Drawn for “Good” Reasons

The last but certainly not least of the facts about phlebotomy is the idea that getting your blood drawn doesn’t have to be a “bad” thing. Although we tend to associate phlebotomy with illness, the process of drawing blood can be useful for other things as well. Research assistants may draw blood as part of their studies to help understand and make sense of human health. Analyzing the blood of participants to determine genetic markers for illnesses, the body’s responses to treatment, or the way blood cells behave when the patient already has a known diagnosis can help further our knowledge of how to recognize and treat serious illnesses.

As these phlebotomy facts show, the work that phlebotomists do saves the lives of patients every day. Whether taking a sample to determine the presence of an illness or drawing donated blood to help those in need of transfusions, the work of someone skilled in venipuncture is incredibly important to the health and safety of the individuals they work with. If you think you would like to learn how to do this all-important job, contact us today!

Legal Issues in Phlebotomy

Phlebotomists are an integral part of a modern medical team. As such, their jobs encompass much more than the simple mechanics of blood withdrawal. An important part of a phlebotomist’s education involves learning about the ethical and legal questions associated with the field of phlebotomy. This article will provide you with a brief overview of some of the major legal issues faced by phlebotomists every day.

Informed Consent

Every medical professional must make sure that his or her patients understand and consent to every procedure. In most instances, the patient has the right to an explanation of what medical procedure is being performed and why. If the patient is a minor, her parents or guardians must provide consent on her behalf. Phlebotomists must also bear in mind that the patient has the right to refuse consent. Even if a doctor has ordered a blood draw or injection, the patient has the right to refuse any venipuncture.


You may be surprised to see assault on a list of legal issues in phlebotomy. Unfortunately, they are lurking closer to the surface than you might think. If a phlebotomist threatens someone with a needle, they have committed assault. Simply put, assault is defined as making someone fear that you will use force to harm them. This can be a sensitive issue for phlebotomists because many people have a fear of needles and the pain associated with venipuncture. A well-trained phlebotomist will know how to deal with patients in a safe and legal manner.


Assault simply involves causing someone to fear that bodily harm will come to them. For the crime of battery to take place, actual physical contact must occur. In phlebotomy, this can be an issue if a phlebotomist forces an injection on a patient against their will. If a phlebotomist intentionally holds a patient down or uses more force than necessary, he has committed battery. This can not only end a career, it can lead to ruinous lawsuits and criminal charges.

Another issue that falls into the category of assault and battery is use of a dirty needle. Even if no excessive force is used, a dirty needle can cause life-altering harm to a patient. A phlebotomist is legally responsible for ensuring the sterility of all equipment in his or her care.


A patient has the right to know that their personal information will not be spread by the medical professionals who are in charge of their care. Blood withdrawals are often associated with testing for sensitive diseases, and phlebotomists will be privy to confidential information about many patients. They have a legal obligation to maintain their patients’ privacy. The law describing a patient’s right to medical privacy is commonly referred to as HIPAA. Under HIPAA, a patient has a right to confidentiality regarding any identifying information, including their diagnosis, treatment, and even birthday.


Even if a phlebotomist has not committed one of the crimes listed above, they can still be held liable for negligence. Negligence involves four elements: duty, breach, cause, and harm. This essentially means that for a patient to sue a medical practitioner, they must show that the practitioner failed in executing their duty to the patient, which was the direct cause of harm. This may sound simple, but it has been the subject of countless long courtroom battles. Following basic phlebotomy principles is one of the best ways for a phlebotomist to help prevent charges of negligence.


Malpractice is a term for the type of civil lawsuits that patients generally bring against medical practitioners who have failed to follow the standard of care. If a phlebotomist is facing a malpractice suit, they are not in danger of going to jail, but they may face other severe consequences. Depending on their jurisdiction and the severity of the harm caused, a jury may award the injured party a significant financial reward.

Medical practitioners take out malpractice insurance so that they can safely afford to pay for the damages awarded in malpractice suits. Phlebotomists can choose to purchase their own malpractice insurance or they may be covered by their supervising physician. However, ultimate cost of a malpractice lawsuit may be the loss of a profitable career rather than the payment of damages. Malpractice insurance premiums often rise after a lawsuit, leading many professionals unable to continue in their chosen career paths.

Interested in learning more?

You now know more about the basics of legal issues in phlebotomy. These issues are not incidental to a safe and successful phlebotomy career; rather, they are absolutely integral. In the modern world, it is impossible to be an ethical member of a medical team without awareness of the often complicated legal issues that surround the field.

The issues discussed here are only the tip of the iceberg. If you are interested in pursuing your education and learning more about phlebotomy, contact PhlebotomyU today. We’ll give you guidance as you join this exciting and dynamic profession.

Is Bruising After Blood Donation Normal?

Many people feel anxiety about donating blood. They may be worried about the pain or nervous about the possibility of feeling light-headed or even fainting. Despite this, blood donations are an increasingly common part of modern medicine. Blood donation centers can be found everywhere, and it is likely you will someday be met with an opportunity to donate. If you have already donated blood, you may have been one of many to find an unwelcome surprise on your arms later on in the form of bruises. You’ve probably stopped to ask yourself, “Is bruising after blood donation normal?” Fortunately, though it may not be pleasant, bruising is an entirely normal issue in the field of phlebotomy. While not everyone will experience bruising every time they donate blood, if you are donating blood on a regular basis, it will almost certainly happen to you at some point. In this article, you can find out more about what causes bruising and how it can be prevented.

What causes bruising after blood donation?

The human body is host to about 100,000 miles of blood vessels. Bruising occurs when blood leaks from one of those blood vessels and pools under the skin. People have varying degrees of susceptibility to bruising. Some can suffer significant injuries with limited bruising, but others find themselves covered with bruises from seemingly minor accidents.

During a blood donation, the phlebotomist will insert a needle into a blood vessel to draw blood out of the body. In the course of this process, blood may spill from the blood vessel. It is also possible that another minor vein or capillary will be damaged in the process of donating blood. It is difficult for even the most skilled phlebotomist to avoid hitting all veins and capillaries during this process. 

Even if bruising does not occur during the blood donation process, it is important for donors and phlebotomists alike to practice proper aftercare. After donating, donors should apply pressure to the donation site to prevent blood from leaking out under the skin. They should also avoid lifting heavy objects for the remainder of the day, as this can cause additional bruising.

What can be one to avoid bruising?

Although bruising is common, donors can take action to avoid bruising. If you are planning a blood donation, avoid wearing tight clothes, as this can create unnecessary compression on the veins. A skilled phlebotomist will also be able to offer advice that can help minimize bruising. Throughout the donation process, it is important to follow any instructions your phlebotomist gives you, as this can help ensure a painless donation and decrease your chance of bruising. Fortunately, the science and technology associated with phlebotomy are always improving. Hospitals have even recently begun to introduce a new needle designed to decrease the pain associated with blood draws. Knowing this, you should be able to walk into your blood donation with confidence.

After your donation is complete, you should be careful with the arm that was used for a donation. Although you might not be feeling any pain, your body still has to work to heal itself following blood donation. After you have donated blood, a small clot will begin to form over the puncture in the blood vessel used for donation. This may sound alarming, but it is completely normal. However, agitating or exercising the donation site may dislodge the clot and cause blood to leak out into the arm. For this reason, it is a good idea to avoid choosing a donation site in your dominant arm. If you have the opportunity, you should sit and relax for a few minutes after your donation. The healing process begins immediately after the donation has ended, and it is in your best interest to allow this process to occur unimpeded.

What should I do if bruising occurs?

In most instances, bruising does not require special treatment. You can simply use a cold compress or ice pack on the bruising site to minimize pain. Donors should always consult a doctor before taking any pain medication. It is usually inadvisable to take ibuprofen or aspirin for at least 24 hours after donation, as these medications can interfere with the clotting process.

In some severe cases, it may be necessary to consult a doctor. If you experience severe pain, pain that does not diminish, numbness, swelling, or inflammation, you should seek medical treatment immediately. This is extremely rare, and most people will find that their post blood donation symptoms will be limited to some soreness, bruising, and stiffness around the donation site. You may find the bruising seems to grow in area before it disappears. This is also completely normal and is a sign that the blood is no longer concentrated around the donation site.

Interested in learning more about blood drawing?

If you would like to learn more about blood donation and phlebotomy, PhlebotomyU is here to help! Contact us today to take the first steps towards a fulfilling career as a phlebotomist. We have all the resources you need to make your dream a reality.