ADMINISTRATIVE

ORDER NO. 2007 - 0027

August 22, 2007
 ADMINISTRATIVE ORDER
No. 2007 – 0027
REVISED RULES AND REGULATION GOVERNING THE LICENSURE AND
REGULATION OF CLINICAL LABORATORIES IN THE PHILIPPINES
I. RATIONALE
One of the main thrusts of current health sector reforms under FOURmula One (F1)
for health is regulation.

The main objective of regulatory reforms:

• is to ensure access to quality and affordable health products, devices, facilities and
services, especially those commonly used by the poor.
Physicians utilize laboratory work–ups in aid
of diagnosis and management of patients.
Accuracy of laboratory results is important in assuring and improving the quality of
patient care.

Republic Act No. 4688 s. 1966:

“An Act Regulating the Operation and Maintenance of Clinical Laboratories and
Requiring the Registration of the same with the Department of Health, providing
penalty for the violation thereof, and for other purposes”,
• mandated the DOH to look after public welfare
• by effectively enforcing and updating the current regulations to improve
laboratory performance.
Advances in technology necessitate the need to update the
minimum standards and technical requirements for clinical
laboratories.

Current regulatory issuances on this matter may no longer be relevant.

One of these is Administrative Order No. 59 s. 2001, entitled:
“Rules and Regulations governing the Establishment, Operation and Maintenance
of Clinical Laboratories in the Philippines”.

Thus, this Order revises such issuance in order to ensure the quality of services of
clinical laboratories nationwide.
II. OBJECTIVE
• This Order is promulgated to prescribe a revised minimum standard for clinical
laboratories.
• This shall also ensure accuracy and precision of laboratory examinations in order
to safeguard public health and safety.
III. SCOPE AND COVERAGE
This Administrative order:
• shall apply to all individuals, agencies, partnerships or corporations that operate
clinical laboratories in the Philippines
• performing examinations and analysis of samples of tissues, fluids, secretions,
excretions, or other materials from the human body
• that would yield relevant laboratory information:
• which physicians use for the prevention, diagnosis, and treatment of diseases,
• and the management and promotion of personal and public health.
(exemptions to the provisions of AO 2007-0027)
Government clinical laboratories,
• doing microscopy work only for specific DOH programs
such as but not limited to:
• malaria screening,
• acid fast bacilli microscopy,
• test for sexually transmitted infections, and
• cervical cancer screening using Pap smears,
shall be exempted from the provisions of this Order.
IV. DEFINITION OF TERMS

For purposes of this Order, the following terms and acronyms shall have the
following definition:
1. Applicant
•  – a natural or juridical person who intends to operate a clinical laboratory
2. BHFS
• – acronym for the Bureau of Health Facilities and Services
3. CHD
• – acronym for the Center for Health Development
4. Clinical laboratory
• – a facility where tests are done on specimens from the human body:
• to obtain information about the health status of a patient
• for the prevention, diagnosis and treatment of diseases.
These tests include, but are not limited to, the following disciplines:
• clinical chemistry, hematology, immunohematology, microbiology, immunology,
clinical microscopy, histopathology, cytology, toxicology, endocrinology,
molecular biology, and cytogenetics.
Other functions of the clinical laboratory
• are to provide consultative advisory services covering all aspects of laboratory
investigations.
Facilities that are involved in the pre–analytical processes:
• such as the collection, handling or preparation of specimens,
• or act as a mailing or distribution center, such as in a laboratory network or system
are also considered to be a part of a clinical laboratory.

The total testing process includes:

• pre–analytical, analytical and post–analytical procedures.
5. Critical values
• – panic values
• originally described by Lundberg as “life – threatening”
• unless something is done promptly and for which some corrective action could be
undertaken.
6. DOH
• – acronym for the Department of Health
7. EQAP
• – acronym for External Quality Assessment Program.
It is a program where participating laboratories are given unknown samples for
analysis.
These samples are to be treated as ordinary human specimens for the usual processing
and examination.
The quality of performance of the laboratory shall be assessed through the closeness of
its results to be pre–determined value or to the reference value
(these pre–determined value or reference value)
are generated by the participating laboratories
• through peer group analysis.
8. Inspection tool
• – the checklist used by the regulatory officers during inspection visit(s)
• to evaluate compliance of a clinical laboratory to the minimum standards and
technical requirements.
9. Institution
• – a corporate body or establishment
• organized for an educational, medical, charitable or similar purpose.
10. License
• – the document issued by the DOH to an individual, agency, partnership or
corporation that operates a clinical laboratory
• upon compliance with the requirements set forth in this Order.
11. Licensee
• – the individual, agency, partnership or corporation to whom the license is issued
• and upon who rests compliance with this Order.
12. LTO
• – acronym for License to Operate. It also refers to the license.
13. Mobile Clinical Laboratory
• – a laboratory testing unit
• that moves from testing site to another testing site,
• or has a temporary testing location.
• It shall have a base laboratory.
14. Monitoring Examinations
• – tests done in series on patients
• as a guide for treatment or follow–up of their condition.
15. NRL
• – acronym for the National Reference Laboratory.
• It is a laboratory in a government hospital
• which has been designated by the DOH
• to provide special functions and services for specific disease areas.
Functions of the NRL:
These functions include:
• provision of referral services such as confirmatory testing,
• surveillance,
• resolution of conflicting results between or among laboratories;
• training;
• research,
• implementation of EQAS;
• evaluation of diagnostic kits and reagents.
An NRL may or may not be part of a general clinical laboratory.
16. POL
• – acronym for Physician’s Office Laboratory.
• It is an individual doctor’s office/clinic wherein laboratory examinations are
performed.
17. POCT
• – acronym for Point of Care Testing.
• It is a diagnostic testing at or near the site of patient care rather than in the clinical
laboratory.
• It includes bedside testing, outpatient and home care.
18. Routine Tests
• – the basic, commonly requested tests in the laboratory,
• the results of which are not required to be released immediately upon completion.
• It shall follow the usual procedures and system in the laboratory.
19. Satellite Testing Site
• – any testing site that performs laboratory examinations
• under the administrative control of a licensed laboratory,
• but performed outside the physical confines of that laboratory.
20. STAT Tests
• – tests done on urgent cases,
• the results of which shall be released immediately,
• within one (1) hour after the procedure.

STAT is an abbreviation “sta’tim” which means immediately.

V. CLASSIFICATION OF CLINICAL
LABORATORIES
Classification by:
A. Ownership
B. Function
C. Institutional Character
D. Service Capability
A. Classification by Ownership
1. Government
– operated and maintained, partially or wholly,
• by the national government,
• a local government unit (provincial, city or municipal),
• any other political unit or any department, division, board or agency thereof

2. Private
– owned, established and operated
• by any individual, corporation, association or organization
B. Classification by Function
1. Clinical Pathology
– includes:
• Clinical Chemistry, Hematology, Immunohematology, Microbiology, Immunology,
Clinical Microscopy, Endocrinology, Molecular Biology, Cytogenetics, Toxicology
and Therapeutic Drug Monitoring and other similar disciplines

• 2. Anatomic Pathology
– includes:
• Surgical Pathology, Immunohistopathology, Cytology, Autopsy, Forensic
Pathology and Molecular Pathology
C. Classification by Institutional
Character
1. Institution Based
– a laboratory that operates within the premises and as part of an institution,
such as but not limited to:
• hospital, medical clinic, school, medical facility for overseas and seafarers, birthing
home, psychiatric facility, drug rehabilitation center

2. Freestanding
– a laboratory that does not form part of any other institution
D. Classification by Service Capability
1. General Clinical Laboratory
2. Special Clinical Laboratory
1. General Clinical Laboratory
(a) Primary Category – provides the following minimum service capabilities:

(1) Routine Hematology [Complete Blood Count – includes Hemoglobin Mass

Concentration, Erythrocyte Volume Fraction (Hematocrit), Leucocyte Number
Concentration (White Blood Cell or WBC count) and Leucocyte Number Fraction
(Differential count)
(2) Qualitative Platelet Determination
(3) Routine Urinalysis
(4) Routine Fecalysis
(5) Blood typing – for hospital based
(b) Secondary Category
• – provides the minimum service capabilities of a primary category laboratory plus the
following:

(1) Routine Clinical Chemistry – includes Blood Glucose Substance Concentration,

Blood Urea Nitrogen concentration, Blood Uric Acid Substance Concentration,
Blood Creatinine Concentration, Blood Total Cholesterol Concentration
(2) Quantitative Platelet Determination
(3) Cross matching – for hospital based
(4) Gram Staining – for hospital based
(5) KOH – for hospital based
(c) Tertiary Category
• – provides the minimum service capabilities of a secondary category laboratory
plus the following:

(1) Special Chemistry

(2) Special Hematology, including coagulation procedures
(3) Immunology
(4) Microbiology – culture and sensitivity
• Aerobic and anaerobic (for hospital and non–hospital based)
A clinical laboratory, licensed under any
of the above category:
Shall be permitted to offer laboratory services other than the respective
stipulated minimum services,
provided that, they comply with the requirements with respect to:
• staff, equipment, reagents and supplies for such additional services,
provided further, that such additional services are listed under its LTO.
(d) Limited Service Capability
(for institution–based only)
• – provides the laboratory tests required for a particular service in institutions such
as but not limited to:
• dialysis centers and social hygiene clinics.
2. Special Clinical Laboratory
• A laboratory that offers highly specialized laboratory services that are usually not
provided by a general clinical laboratory.
VI. GUIDELINES
A. GENERAL GUIDELINES
B. SPECIIFC GUIDELINES
A. GENERAL GUIDELINES
1. The LTO shall be issued only to:
• clinical laboratories that comply
• with the standards and technical requirements formulated by the BHFS.

2. Clinical laboratories that are operated and maintained exclusively for research
and teaching purposes:
• shall be exempted from the licensing requirement of this Order
• but shall be required to register with the BHFS.
3. Special clinical laboratories that are not subject to the provisions of other
administrative orders:
such as but not limited to:
• Assisted Reproduction Technology Laboratories, Molecular and Cellular
Technology, Molecular Biology, Molecular Pathology, Forensic Pathology,
Anatomic Pathology laboratories operating independent of a clinical laboratory
Are required to register with the BHFS without being licensed under the provisions
of this Order.
Such procedure shall subsist until the appropriate regulation for such purpose is
subsequently promulgated.

A pathologist or a licensed physician who is trained in the management,

principles and methodology of the specialized services that are being provided
shall head this type of laboratory.
4. The NRL designated by the DOH:
• shall be covered by the license of the clinical laboratory of the hospital where they
are respectively assigned.
The NRL that is physically independent from the clinical laboratory of the hospital
where they are respectively assigned:
• shall be allowed to register only with the BHFS,

Provided that, they are duly accredited or certified by an international accrediting or

certifying body, such as but not limited to:
• the Center for Disease Control of the U.S.A.
• and the World Health Organization
• and/or local accrediting or certifying body recognized by the DOH.
5. A POL is required to secure a clinical laboratory license when it undertakes any or
all of the following activities:

(a) Issue official laboratory results;

(b) Perform more than monitoring examinations; and
(c) Cater not only to the Physician’s own patients

Examinations performed in a POL shall only be permitted when they are used
for monitoring patients.
6. A POCT, conducted in a hospital,
- is required to be under the management and supervision of the licensed clinical
laboratory of the respective hospital.
B. SPECIFIC GUIDELINES
1. Standards

• Every clinical laboratory shall be organized to provide quality, effective and

efficient laboratory services.
(a) Human Resource
(1) Every clinical laboratory shall be headed and managed by a Pathologist certified
either as:
• a Clinical Pathologist, an Anatomic Pathologist or both
• by the Philippine Board of Pathology.

(2) The head of the laboratory shall have administrative and technical supervision
of the activities in the laboratory.

(3) The head of the laboratory shall supervise the staff in accordance to the
standards set by the Philippine Society of Pathologists.
(a) Human Resource (continued)
(4) There shall be an adequate number of medical technologists and other health
professionals with documented training and experience to conduct the laboratory
procedures.
• The number of staff shall depend on the workload and the services being provided.

(5) There shall be staff development and continuing education program at all levels
of organization to upgrade the knowledge, attitude and skills of staff.
(b) Equipment
• (1) There shall be available and operational equipment to provide the laboratory
examinations that the laboratory is licensed for.

• (2) There shall be a calibration, preventive maintenance and repair program for
the equipment.

• (3) There shall be a contingency plan in case of equipment breakdown.

(c) Glassware, Reagents and Supplies
• (1) There shall be available reagents, glassware and supplies for the laboratory
examinations to be provided.

• (2) There shall be an inventory control of the reagents, glassware and supplies.

• (3) The reagents, glassware and supplies shall be stored under the required
conditions.
(d) Administrative Policies and
Procedures
The clinical laboratory shall have written policies and procedures
• for the provision of laboratory services
• and for the operation and maintenance of the laboratory.
(e) Technical Procedures
There shall be documented technical procedures for services provided in each
Section of the laboratory:
• which will ensure the quality of laboratory results.
(f) Quality Assurance Program
• (1) There shall be an Internal Quality Assurance Program which shall include:

i. An Internal Quality Control Program for technical procedure

ii. An Internal Quality Assurance Program for inputs, processes and outputs
iii. A Continuous Quality Improvement Program covering all aspects of laboratory
performance.

• (2) The clinical laboratory shall participate in an EQAP administered by

designated NRL or in other local and international EQAP approved by the DOH.
(g) Communication and Records
• (1) There shall be procedures for the receipt and performance of routine and STAT
requests for laboratory examinations.

• (2) There shall be procedures for the reporting of results of routine and STAT
laboratory examinations, including critical values that would impact on patient
care.
(g) Communication and Records
(continued)
• (3) All laboratory reports on various examinations of specimens shall bear the
name of:
• facsimile signature of the Pathologist who shall be accountable for the reliability
of the results.
• The reports shall also bear the name and signature of the registered medical
technologist(s) who have performed the examinations.

Electronic signatures shall be permitted in accordance to the provisions of the E–

Commerce Law.
(g) Communication and Records
(continued)
• (4) There shall be procedures for the reporting of workload, quality control,
inventory control, work schedule and assignments.

• (5) There shall be procedures for the reporting and analysis of incidents, adverse
events and in handling complaints.

• (6) The retention of laboratory records shall be in accordance to the standards

promulgated by the DOH or by competent authorities for such purposes.
(h) Physical Facilities/Work Environment
• (1) The clinical laboratory shall conform to all applicable local and national
regulations for the construction, renovation, maintenance and repair of clinical
laboratories.

• (2) The laboratory shall conform to the required space for the conduct of its
activities.

• (3) There shall be well–ventilated, lighted, clean, safe and functional areas based
on the services provided.
(h) Physical Facilities/Work Environment
(continued)
• (4) There shall be a program of proper maintenance and monitoring of physical
plant and facilities

• (5) There shall be procedures for the proper disposal of waste and hazardous
substances.

• (6) There shall be policy guidelines on laboratory biosafety and biosecurity.

(i) Referral of Examinations outside of
the Clinical Laboratory
When laboratory examinations are referred to and provided by an outside
laboratory:
the head of the referring clinical laboratory:
• shall obtain assurance of the quality of services
• provided through a Memorandum of Agreement or its equivalent
with a licensed clinical laboratory performing the laboratory services needed.
2. LTO (License to Operate)
• (a) The LTO is issued in the name of the licensee and is non – transferable,
whether voluntarily and involuntarily, through sale, assignment or any other
means.
• The license is not valid for any premise/location other than that which is stipulated
therein.

• (b) The LTO is issued to a clinical laboratory, unless sooner suspended or revoked,
• is valid for one year
• and expires on the date set forth by the CHD,
• as stipulated on the face of the license.
 2. LTO (License to Operate)
(continued)
• (c) The LTO issued to a non–hospital based clinical laboratory
shall specifically stipulate the following:
• name of the clinical laboratory,
• name(s) of the owner or operator,
• head of the laboratory,
• service capability,
• period of validity,
• license number, and
• location wherein the laboratory procedures are to be performed.
(d) The LTO issued to a non–hospital based clinical laboratory must be displayed at all time at a
prominent place within the laboratory premises.
2. LTO (License to Operate)
(continued)
• (e) Hospital based clinical laboratories:
• shall be licensed as part of the hospital through the One–Stop–Shop Licensure for
Hospitals
• and are therefore not required to obtain a separate license.

• (f) The capability to perform HIV testing and/or drinking water analysis shall be
specifically indicated in the LTO, as issued by the CHD.
2. LTO (License to Operate)
(continued)
• (g) The clinical laboratory and its satellite services within the same compound
shall have one (1) LTO.

• (h) A satellite laboratory outside the premises where the central laboratory is
situated shall be required to secure a separate LTO.
2. LTO (License to Operate)
(continued)
• (i) Mobile clinical laboratories
• shall be licensed as part of the main clinical laboratory and
• shall be permitted to collect specimens only.
It shall be allowed to operate only within one hundred (100) km radius from its
main laboratory.

• (j) The LTO may be revoked, suspended or modified in full or in part for any
material false statement by the applicant, or as shown by the record of inspection
or for violation of, or failure to comply with any of the terms and conditions and
provisions of these rules and regulations.
VII. PROCEDURAL GUIDELINES
A. Registration for Special Clinical Laboratories, National Reference
Laboratories, Research and Teaching Laboratories
B. Procedures for Application for Initial/Renewal of LTO
C. Renewal of LTO
D. Inspection
E. Monitoring
A. Registration for Special Clinical Laboratories, National
Reference Laboratories, Research and Teaching Laboratories

1. Applicants can acquire the prescribed Application Form for Registration from:
• the BHFS,
• CHD that has jurisdiction over the existing or proposed clinical laboratory
• or at the DOH website (www.doh.gov.ph).
A. Registration for Special Clinical Laboratories, National
Reference Laboratories, Research and Teaching Laboratories
(continued)

2. The accomplished form together with the necessary attachments:

• is to be submitted to the BHFS
• or through the CHD that has jurisdiction over the existing or proposed clinical
laboratory.

The applicant shall be required to pay a non–refundable application fee for

Certificate of Registration:
• upon submission of the accomplished form and documentary requirements.
A. Registration for Special Clinical Laboratories, National
Reference Laboratories, Research and Teaching Laboratories
(continued)

• 3. The BHFS shall evaluate and accept applications based on:

• due execution of forms and completeness of attachments.
B. Procedures for Application for
Initial/Renewal of LTO
1. Applicants can acquire the prescribed application form for LTO from:
• the BHFS,
• CHD that has jurisdiction over the existing or proposed clinical laboratory,
• or at the DOH website (www.doh.gov.ph).
B. Procedures for Application for
Initial/Renewal of LTO (continued)
2. The accomplished form together with the necessary attachments:
• is to be submitted to the CHD that has jurisdiction over the existing or proposed
clinical laboratory.

The applicant shall be required to pay a non–refundable application fee for LTO
upon submission of the accomplished form.
B. Procedures for Application for
Initial/Renewal of LTO (continued)
3. The CHD that has jurisdiction over the existing or proposed clinical laboratory:
• shall conduct inspections in accordance with licensing requirements,
• as provided for under this Order and the One–Stop–Shop Licensure System for
Hospitals.
C. Renewal of LTO
• 1. Renewal of hospital based clinical laboratories shall be in accordance with the
licensing process under the One–Stop–Shop Licensure System for Hospitals.

• 2. Non–hospital based clinical laboratories shall file applications for renewal of LTO
beginning on:
• the first day of October until the last day of November of the current year.
A discount on the renewal fee shall be granted if a complete application filed during
this period.
C. Renewal of LTO (continued)
• 3. Renewal of license for compliant clinical laboratories:
• shall be processed not later than five (5) working days after the expiration date of
its license.

• 4. The LTO of a clinical laboratory shall be automatically cancelled without notice

when it fails to:
• submit a duly accomplished application form and
• to pay the proper fee
on or before the expiration date stated in its license.
D. Inspection
• 1. The CHD shall conduct an announced licensure inspection at any reasonable
time.

• 2. The licensee shall ensure the accessibility of the premises and facilities where
the laboratory examinations are being performed for the inspection of the CHD
Director or his authorized representative(s) at any reasonable time.
D. Inspection (continued)
• 3. The licensee shall ensure the availability of all pertinent records for
checking/review of the CHD Director or his authorized representative(s).

• 4. An inspection tool, which prescribed the standards, criteria and technical

requirements for the issuance of LTO, shall be utilized.
E. Monitoring
• 1. All clinical laboratories shall be monitored regularly.

• 2. The BHFS or the CHD Director or his authorized representative(s):

• shall monitor clinical laboratories
• through monitoring visits to the laboratory at any reasonable time.

• 3. All clinical laboratories shall ensure that all laboratory records, premises and
facilities are made available to the BHFS or the CHD Director or his authorized
representative(s) in order to determine compliance with the provisions of this Order.
E. Monitoring (continued)
• 4. A Notice of Violation for non–compliant clinical laboratories shall be issued
immediately after monitoring the clinical laboratory.

• 5. The CHD concerned shall submit a quarterly summary of the violations to the
BHFS stating:
• the name of the clinical laboratory,
• location,
• its corresponding violation
• and the course of action taken.
E. Monitoring (continued)
• 6. The Provincial, City and Municipal Health Officers:
• are enjoined to report to the BHFS /CHD the existence of unlicensed clinical
laboratories or any private party
performing laboratory examinations without proper license
and/or violations to these rules and regulations.
VIII. SCHEDULE OF FEES
A. A non–refundable fee shall be charged for the initial application /renewal of
license to operate a clinical laboratory, either government or private.

B. All fees/checks shall be paid to the order of DOH in person or through postal
money order.

C. All fees, surcharges and discounts shall follow the current DOH prescribed
schedule of fees.
IX. VIOLATIONS
• Violation of Republic Act 4688 or these rules and regulations and/or commission of
the following acts by personnel operating the clinical laboratory under this
authority shall be penalized:
• A. Refusal of any clinical laboratory to participate in an EQAP conducted by the
designated NRL or other external proficiency program approved by the DOH;

• B. Issuance of a report, orally or in writing, in whole or portions thereof, which is

not in accordance with the documented procedure approved by the head of the
laboratory;

• C. Permitting unauthorized persons to perform technical procedures;

• D. Demonstrating incompetence or making consistent errors in the performance

of clinical laboratory examinations and procedures;

• E. Deviation from the standard test procedures including use of expired reagents;
• F. Reporting/release of erroneous results;

• G. Lending or using the name of the licensed clinical laboratory or the head of the
laboratory or medical technologist to an unlicensed clinical laboratory;

• H. Unauthorized use of the name and signature of the Pathologist and medical
technologists to secure LTO;

• I. Reporting a test result for a clinical specimen even if the test was not actually
performed;

• J. Transferring of results of tests done in an outside clinical laboratory to the result

form of the referring laboratory;
• K. Performing and reporting tests in a specialty or subspecialty in which the
laboratory is not licensed;

• L. Giving and receiving any commission, bonus, kickback or rebate or engaging in

an split–fee arrangement in any form whatsoever with any facility, physician,
organization, agency or person, either directly or indirectly, for patients referred to
an clinical laboratory licensed by the DOH.
X. INVESTIGATION OF COMPLAINTS
• A.
• The BHFS Director
• or the CHD Director
• or his authorized representative(s)
- shall investigate the complaint
- and verify if the laboratory concerned or any of its personnel
is accountable for an alleged violation.
X. INVESTIGATION OF COMPLAINTS
(continued)
• B.
• The CHD Director
• or his authorized representative(s),
• after investigation:
• shall suspend, cancel or revoke for a determined period of time
• the LTO of licensees who are found violating the provision of R.A. 4688 or this
Order, without prejudice to taking the case to judicial authority for criminal action.
The CHD shall seek the assistance of any law enforcement agency to execute the
closure of any erring clinical laboratory, when necessary.
XI. PENALTY
Any person who operates a clinical laboratory without the proper license from the
DOH shall upon conviction:
• be subject to imprisonment for not less than one (1) month
• or a fine of not less than PhP 1,000.00 and not more than Php 5,000.00
• or both at the discretion of the court.
Provided, however:
that if the offender is a firm or corporation
• the managing head and/or owner(s) thereof shall be liable to the penalty imposed
herein.
XII. APPEAL
The decision of the BHFS/CHD:
• may be appealed to the Office of the Health Secretary
• within ten (10) days after receipt of the notice of the decision.
Thereupon, the BHFS shall promptly certify and file a copy of the decision,
-including all documents and transcripts of hearings on which the decision is based,
- with the Office of the Health Secretary for review.

The decision of the Office of the Health Secretary is final and executory.
XIII. REPEALING CLAUSE
• Provisions from previous issuances that are inconsistent or contrary to the
provisions of this Order are hereby rescinded and modified accordingly.
XIV. SEPARABILITY CLAUSE
In the event that any provision or part of this Order be declared unauthorized or
rendered invalid by any court of law or competent authority:
• those provisions not affected by such declaration shall remain valid and effective.
XV. EFFECTIVITY
• This Order shall take effect fifteen (15) days after its approval and publication in
the Official Gazette or newspaper of general circulation

FRANCISCO T. DUQUE III, M.D., MSc

Secretary of Health