Skip to form

Maryland Medical Cannabis Commission (MMCC)

applications.mmcc@maryland.gov

849 International Drive, 4th Floor, Linthicum, MD, 21090, US

Independent Laboratory Registration

Please make $100 registration or renewal fee payable to the following address:
 
The Maryland Medical Cannabis Commission
Attention-Ugo Osoh
849 International Drive, Suite 450
Linthicum, Maryland 21090

Please Provide Your Business Name(s)

This is an application for:

Is the lab 17025 ISO/IEC accredited?

Please upload a copy of the certificate of accreditation, the scope of accreditation, and all supporting documentation.

Provisional Registration

Please submit a copy of the contract with the accreditation body applying to become accredited accompanied by a copy of the proposed scope of the accreditation.

Please submit evidence that the independent testing laboratory has been accredited by the accreditation body in another jurisdiction.

Has the lab applied for ISO accreditation?

Please upload proof of application and all supporting documentation. (e.g., confirmation email from accreditation body.)

Business Contact Information

Physical Address

IS YOUR PHYSICAL ADDRESS THE SAME AS YOUR MAILING ADDRESS?

Mailing Address

Authorized Point-Of-Contact(s)

Primary Point-of-Contact


Additional Point-of-Contact (if applicable)

Incorporation/Formation Information

What type of business structure do you have?

Date of Incorporation/Formation

Date Picker

Incorporator/Founder

Maryland SDAT Compliance

Is this Business registered in Maryland?

Status of Good Standing

Please provide your status of Good Standing (from the Maryland Department of Assessments and Taxation - MD SDAT).

Business History

Has the Business or any of its partners, members, managers, officers, stockholders, or directors:

Has a cannabis license or registration ever been issued to the Business or any of its partners, members, managers, officers, stockholders, or directors?

Does the Business have legal control of the physical address listed above by virtue of:

Please upload a diagram of the physical location of the business to be registered. The diagram must label and indicate the dimensions of: limited access areas, walls, partitions, entrances, and exits. The diagram must also identify the location of any security equipment and indicate how each designated area will be utilized. (The diagram should be no larger than 8 1/2" X 11" but does not have to be to scale.)

Please upload all notes, security instruments, written agreements, and/or details of verbal agreements by which any person, firm, partnership, corporation, limited liability company, or trust will share in the profit or gross proceeds of this business.

Are there any agreement that are conditionally or contingently related to this business by way of volume, profit, sales, advice, or consultation?

Please upload any agreement that is conditionally or contingently related to this business by way of volume, profit, sales, advice, or consultation.

Ownership Structure

Other than those listed above, is there any other person, supplier, lender, landlord, etc. who will directly or indirectly receive compensation or rents based upon a percentage or share of gross proceeds or income of the registrant’s business?

Has the business, a parent company, or any other intermediary business entity ever applied for a cannabis license or registration in any state or country? (regardless of whether or not the license or registration was ever issued)

Has the business, a parent company, or any other intermediary business entity ever owned a cannabis license or registration in any state or country?

Was the business, a parent company, or any other intermediary business entity who owned a cannabis license or registration, ever subject to any of the following actions?

Criminal History

Has the business, a subsidiary, or a principal employee, director, principals, officer, owner, investor, trustee, agent, or partner (of 5% or greater) ever been subject to any of the following actions in any criminal proceeding in this state or any other jurisdiction?

Financial History

Is the applicant, the applicant’s parent company or any other intermediary business entity delinquent in the payment of any judgments, taxes, interest, or penalties due in any jurisdiction?

Have any of the following federal/state/foreign trust or security law or regulation violations ever been filed or entered against the business, parent company, or intermediary business entity?

UPLOAD REQUIRED: Please provide any documents to prove settlement of these issues. (Include any items currently under formal dispute or legal appeal.)

In the past five (5) years, has the business, parent company, or intermediary business entity been a party to a lawsuit in this or any other state/federal/foreign jurisdiction?

UPLOAD REQUIRED: Please provide any documents to prove settlement of these issues. (Include any items currently under formal dispute or legal appeal.)

In the past two (2) years, has the business, parent company, or intermediary business entity filed a business tax return?

In the past two (2) years, has the business, parent company, or intermediary business entity completed audited or unaudited financial statements?

UPLOAD REQUIRED: Please provide all financial statements completed in the past two (2) years.

UPLOAD REQUIRED: Please upload a list of the business' operating and investment accounts. (For each account, please include the name of the institution, the address, phone, and account number.)

UPLOAD REQUIRED: Please upload a list detailing each outstanding loan and financial obligation obtained for use in this business. (For each, please include the name of the creditor, the address, phone, loan number, terms, date acquired, due date, and payment history.)

Business Plan

Please provide a detailed plan for how the business will operate long-term. Business plan should include the following: 

  1. A description of the facility (desired square footage, number of employees to be hired, etc.);
  2. The scope of proposed activities;
  3. The budget and resource narratives;
  4. A timeline for initiating operations; and
  5. A description of the plan to ensure appropriate employee working conditions, benefits and training.

UPLOAD REQUIRED: Detailed Business Plan

Please provide any other supplemental documentation that demonstrates this business's ability to quickly and successfully enter the market.

Security Plan

The Security Plan must demonstrate that the business can assure that medical cannabis is secure at all times during transport through a detailed description of the business' standard security protocol, security protocol in the case of an emergency, how the business will employ technology and other resources to enhance security the security of its medical cannabis transportation operations, and any other relevant information.

Appendix A: Independent Testing Laboratory

Please provide a completed copy of Appendix A: Independent Testing Laboratory (Available for download on our website.) as well as a curriculum vitae (CV) for each employees listed in this application.

Acknowledgment and Disclosure

Check "Yes" and use the blank box to acknowledge that the lab is independent from all growers, processors, and dispensaries registered with the State of Maryland.

Signature of Authorized Representative

Choose how to sign