Participant demographics.

The Clinical Laboratory Improvement Amendments (CLIA) regulations of 1988 required certification of some clinical laboratory professionals but not of others. Analyzing survey data 35 years later, we explore how laboratory professionals today are inadvertently affected by those regulations, specifically their sense of professional identity and their perceptions of justice—and the consequences of those on their turnover intentions. Turnover is a major concern among laboratory professionals. Survey results show that even 35 years after the unintended disenfranchisement caused by CLIA, clinical laboratory professionals whose specialty was included in CLIA have a stronger sense of being an ingroup, expressed as positive professional identity, and had a higher assessment of there being procedural and distributive justice than those excluded in CLIA. Turnover intentions, however, were primarily a matter of negative professional identity and reduced distributive justice.