special state certification in the united states is required only in four states: california, washington, nevada, and louisiana. a phlebotomist can become nationally certified through many different organizations. however, california currently only accepts national certificates from six agencies. these include: american certification agency (aca), american medical technologists (amt), american society for clinical pathology (ascp), national center for competency testing/multi-skilled medical certification institute (ncct/mmci), national credentialing agency (nca), national healthcareer association (nha), national phlebotomy certification examination (npce). these and other agencies also certify phlebotomists outside the state of california. to qualify to sit for an examination, candidates must complete a full phlebotomy course and provide documentation of clinical or laboratory experience.