Clinical Establishments Act states list: where it applies Every state and UT, the law it uses, and what a single-doctor clinic does next.

Short answer: the central Clinical Establishments (Registration and Regulation) Act, 2010 applies in 19 states and union territories. The Ministry of Health's portal names them as Arunachal Pradesh, Assam, Bihar, Haryana, Himachal Pradesh, Jharkhand, Mizoram, Rajasthan, Sikkim, Telangana, Uttar Pradesh, Uttarakhand "and all Union Territories except the NCT of Delhi". Karnataka, Tamil Nadu, Gujarat, Kerala, Goa, Nagaland and West Bengal run their own laws. Maharashtra, Delhi, Madhya Pradesh, Odisha, Andhra Pradesh, Manipur and Punjab have older laws that the 2010 Act listed in its Schedule, and some of those turn on beds rather than on whether you see patients.

Which states and UTs follow the central Act?

The table below follows the portal's home page and its state list, both checked on 26 October 2026. Neither page gives an adoption year or notification number for each state, so we have not added any from other sources. Where a state's own health department publishes a date, we note it.

Two details on that list are worth knowing before you act on it. First, the portal's state-list page shows Dadra and Nagar Haveli and Daman and Diu as separate rows and leaves out Telangana, while the home page names Telangana and the fee page carries a Telangana schedule. We have followed the home page. Second, Haryana adopted the Act but its health department says it applies to clinical establishments "having more than fifty beds (with effect from 4th April, 2018)" and to establishments doing pathological and other investigations from 14 March 2019. On that page, a bedless consulting room in Haryana is outside the Act's current reach. Ask the district health office before you rely on that, because a state can widen the scope by notification.

Which states have their own clinical establishments law?

These states regulate clinics under a law passed by their own legislature. The forms, fees and registering authorities come from that law and its rules, and the central Act's sections do not apply. The "covers a bedless clinic" column quotes each Act's own definition.

For West Bengal we could fetch the Bill as published in the Kolkata Gazette on 1 March 2017, which carries the short title above and repeals the state's 2010 clinical establishments Act, but not the final Act text, so we have not quoted its definition. Gujarat, Tamil Nadu and Karnataka publish fee schedules online; they are in our post on clinic registration fees by state.

Which states have only an older law, or none we could confirm?

When Parliament passed the 2010 Act, its Schedule listed nine state laws that would keep running until those states adopted the central Act. The table shows each one and what we found on 26 October 2026. An older nursing-home law often turns on indoor admission, so a clinic with no beds may sit outside it. That does not mean the state has nothing for you: bio-medical waste authorisation from the State Pollution Control Board applies to every clinic that generates such waste, "irrespective of the quantity" (rule 10 of the Bio-Medical Waste Management Rules, 2016).

Two more names in that Schedule need a word. Nagaland's 1997 Act is the same law shown in the previous table. West Bengal's listed law is a 1950 Act; the state's later law is covered above. The Punjab Clinical Establishments (Registration and Regulation) Act, 2020 received the Governor's assent on 6 October 2020, and its section 1(3) says it "shall come into force on such date as the State Government may, by notification, appoint". We did not find that notification on 26 October 2026.

Does the Act cover a single-doctor OPD clinic?

Yes, wherever the central Act applies in full. Section 2(c) defines a clinical establishment as "a hospital, maternity home, nursing home, dispensary, clinic, sanatorium or an institution by whatever name called" offering diagnosis, treatment or care in any recognised system of medicine, and adds that it "shall include a clinical establishment owned, controlled or managed by" a list ending with "a single doctor". The only exclusion is establishments of the Armed Forces. Nothing in the definition turns on beds, so a ground-floor consulting room with one doctor and one attendant is in scope.

Section 14(5) closes another gap: a clinic already registered under some other law "shall apply for registration" under this Act anyway. The Haryana scope limit above is the exception we found among the adopting states. The definition is not limited to allopathy either; it says "any recognised system of medicine".

What changes for your clinic once the Act applies?

• Section 11: "No person shall run a clinical establishment unless it has been duly registered".
• Section 12: registration depends on the minimum standards, staff and records "as may be prescribed" for your category.
• Section 18: the certificate is "kept affixed in a conspicuous place" where every visitor can see it.
• Section 35: the state government "may charge fees for different categories of clinical establishments". There is no national fee.
• Section 12(1)(iii): "provisions for maintenance of records and reporting as may be prescribed" are a condition of registration. Our post on whether EMR is mandatory covers what that means for records.

Provisional and permanent registration, briefly

The full procedure, with documents, is in our clinic registration guide. The central Act's clock runs like this:

1. Apply to the district registering authority with the prescribed form and fee, in person, by post or online (section 14(1) and (2)).
2. The authority grants provisional registration within ten days of receiving the application (section 15) and "shall not conduct any inquiry" before it (section 16(1)).
3. Provisional registration is valid "to the last day of the twelfth month from the date of issue" and is renewable (section 17). Apply for renewal thirty days before expiry; a late renewal costs an enhanced fee (section 22).
4. Once minimum standards are notified for your category, provisional registration cannot run beyond two years from that notification for a clinic set up before it, or six months for a clinic set up after it (section 23).
5. Permanent registration needs evidence that you meet the standards (sections 24 and 25). The certificate "shall be valid for a period of five years from the date of issue" (section 30(2)), and renewal is due within six months before it expires (section 30(4)).

State Acts set their own periods. Tamil Nadu's Act, for example, says every certificate "is valid for a period of five years" and may be renewed for five years at a time, and its 2018 Rules ask for the renewal application ninety days before expiry.

What are the penalties after the Jan Vishwas amendments?

The Jan Vishwas (Amendment of Provisions) Act, 2026 (No. 8 of 2026) received the President's assent on 7 April 2026. Serial number 67 of its Schedule amends the Clinical Establishments Act, and the Health Ministry brought that entry into force on 22 June 2026 by notification S.O. 3273(E). The change is mostly in wording and process: "fine" becomes "penalty" in sections 40, 43 and 46, the authority adjudicates them under section 41(3), and company liability in section 44 is rewritten. The maximum amounts stay where they were.

Before imposing a penalty the authority holds an inquiry and gives you "a reasonable opportunity of being heard" (section 41(3)). It must weigh "the category, size and type of the clinical establishment and local conditions" (section 41(5)), and you can appeal to the State Council within three months (section 41(6)). State Acts carry their own penalties; Karnataka's original section 19, for instance, provided imprisonment of up to three years for running without registration, so read your state's current text.

How do you find your district registering authority?

1. Under the central Act, section 10 sets up a district registering authority chaired by the District Collector with the District Health Officer as convenor. For provisional registration, section 10(2) lets "the District Health Officer or the Chief Medical Officer (by whatever name called)" act alone, so the CMO's office is the first stop.
2. The Ministry's FAQ says the application goes "to the district registering authority (i.e. District Health Officer / Chief Medical Officer)". Ask at the CMO office whether your state takes applications on a portal.
3. In Tamil Nadu, apply on the state's TNCEA portal, choosing the revenue district first; the portal ties your login to the district's competent authority. In Karnataka, the KPME portal of the health department takes fresh applications and renewals.
4. In Delhi, the DGHS Nursing Home Cell handles registration for establishments with indoor beds.
5. Write down the officer's name, the date and what you were told. If the office says your clinic does not need registration, ask for that in writing.

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