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Thinking about starting or advancing your healthcare career in California? You’re in the right place.

Whether you’re planning a move to sunny California or are just exploring your options as a technician or technologist within the state, knowing exactly what certifications and licenses you’ll need is essential to getting started. That’s where this guide comes in: We’ve broken down the most common healthcare technician and technologist roles across key specialties, from radiology and imaging to laboratory, pharmacy, and more.

For each role, we’ve included:

• The specific certifications or licenses required by the state of California
• Any national certifications you’ll need to qualify for those state credentials
• Clarifications around commonly confusing requirements
• You’ll also find helpful links to official state licensing boards and national certification boards throughout the guide. These links will take you to up-to-date education and credential requirements, applications, and exam details so you can take the next step with confidence.

Please note: While we’ve done our best to outline current requirements based on the most up-to-date sources from California licensing boards and nationally recognized certifying bodies, always double-check the exact requirements with the official licensing agency for your profession. The requirements may vary depending on your past work experience and education, as well as the specific role’s duties, care setting, and scope of practice.

Let’s walk through the credentialing requirements for your dream role and help you plan your path to success in California.

Select your role to get started:

Radiology & Imaging

Thinking about a career in radiology and imaging in California? Great choice! It’s a high-impact field that blends technology with patient care. However, to work in one of these roles, you’ll first want to understand which certifications and licenses are required for the role, as well as the differences between national certifications and state-specific credentials required in California.

The California Diagnostic Radiologic Technology Certification (CRT) is issued by the California Department of Public Health’s Radiologic Health Branch (CDPH-RHB) and is required for many of the roles involving radiation or radiologic imaging. You can read more about the certification and how to qualify for it here.

The most frequently required national certifications for these roles are from the American Registry of Radiologic Technologists (ARRT). You can read more about each of the credentials offered by ARRT and how to qualify for them here. When reviewing the credentials listed in this guide, it’s important to keep in mind that ARRT has two pathways to qualify for their certifications:

Primary Eligibility Pathway

ARRT certifications for the following specialties can be earned without having to first attain a supporting ARRT credential.

• Radiography
• MRI
• Nuclear Medicine
• Radiation Therapy
• Sonography
• Vascular Sonography

ARRT has provided a detailed handbook on how to earn a certification through their Primary Eligibility Pathway here.

Postprimary Eligibility Pathway

To earn an ARRT certification for the following specialties, you will first need to attain a supporting ARRT credential through the Primary Eligibility Pathway described above.

ARRT may also consider supporting credentials earned through another approved organization (see more information here).

• Mammography
• CT
• Bone Densitometry
• Cardiac Interventional Radiography
• Vascular Interventional Radiography
• Breast Sonography

ARRT has provided a detailed handbook on how to earn a certification through their Postprimary Eligibility Pathway here.

Most ARRT certifications earned through the Postprimary Eligibility Pathway are for more advanced and specialized radiologic technologist roles.

Rest assured: For entry-level radiologic technologist roles (and for the majority of the radiology & diagnostic roles described in this guide), you will be able to earn the ARRT certification required by California through the Primary Eligibility Pathway, without having to first earn a supporting credential.

Now, let’s break down the most common radiology & imaging roles in California and what credentials you’ll need to get started.

Radiologic Technologist (X-Ray Tech)

This is the core imaging role, and it’s where most radiology technicians and technologists start. You’ll need both the national ARRT (R) certification and California’s state CRT certification in order to work as a radiologic technologist.

Limited Permit X-Ray Technician

Limited Permit X-Ray Technicians can practice with just a California X-Ray Technician Limited Permit. This will allow you to work under supervision and perform certain basic X-ray exams, often in clinics or urgent care settings, without having to attain the national ARRT (R) certification. However, it does not qualify you for full-scope radiologic work.

CT Technologist

CT Technologists must have the national ARRT (R) certification in order to obtain the state CRT certification required by California to legally operate CT equipment.

Because cardiac catheterization technicians and technologists use fluoroscopy to assist with cardiac procedures, you’ll need the national ARRT (R) certification, California’s CRT certification, and California’s Radiologic Technologist Fluoroscopy Permit to work in the cath lab.

Mammography Technologists must have the California Mammographic Radiologic Technology certification. In order to obtain this certification, you must first have ARRT (R) and the state CRT certification, as well as either a national ARRT (M) certification or have passed the state’s Mammographic Radiologic Technology Certification exam.*

*The California Mammographic Radiologic Technology Certification Exam is administered by ARRT (on behalf of the California Department of Public Health) to those who do not already have the ARRT (M) certification. It’s important to note that passing this California exam qualifies you to perform mammography only within the state. In contrast, earning the full ARRT (M) credential grants you a nationally recognized certification, allowing you to practice in other states that accept ARRT credentials.

Nuclear Medicine Technologist

Nuclear medicine is a highly specialized field that uses radioactive drugs to produce imaging or treat disease. Technologists in this area need a specialized national certification, either ARRT (N) or the Certified Nuclear Medicine Technologist Certification (CNMT) from the Nuclear Medicine Technology Certification Board (NMTCB). Additionally, nuclear medicine technologists in California will need the state Certified Nuclear Medicine Technologist certification (NMT).

Radiation Therapy Technologists work with cancer patients delivering targeted radiation treatment. To work in this role, you’ll need to attain the national ARRT (T) certification and California’s Therapeutic Radiologic Technology Certification (CRT-T).

Already ARRT (T) certified? You’re just one step away! Now it’s time to apply for California’s CRT-T.

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: ARRT Radiation Therapy (T) (Primary Eligibility Pathway)

State Credential: California Therapeutic Radiologic Technology Certification (CRT-T)

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Phlebotomy & Laboratory

Phlebotomy and laboratory technicians and technologists play a vital role in disease diagnoses by collecting and analyzing blood, tissues, and other specimens. California has state licensing requirements for each of the roles below, usually through the Department of Public Health (CDPH). National certifications are also typically required or strongly preferred, and are often necessary for state licensure. Let’s see what credentials you’ll need to get started in your preferred role.

Medical Laboratory Technician

To work as a Medical Laboratory Technician in California, you must have a national Medical Laboratory Technician (MLT) certification from either the Association of Bioanalysts (AAB) or the American Society of Clinical Pathology (ASCP), and you must obtain the California Medical Laboratory Technician License.

Already MLT certified by the AAB or ASCP? You’re just one step away! Now it’s time to apply for California’s Medical Laboratory Technician License (MLT).

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: Medical Laboratory Technician (MLT) certification from the American Association of Bioanalysts (AAB) OR
National Credential: Medical Laboratory Technician (MLT) certification from the American Society of Clinical Pathology (ASCP)

State Credential: California Medical Laboratory Technician License (MLT)

Phlebotomist

If you’re a Phlebotomist in California, you need to be state certified, in addition to holding a national phlebotomy credential. California recognizes three levels of phlebotomist licensing based on training and scope of work. According to the CDPH, these three levels include:

1. LPT: Can only perform blood collection via skin puncture
2. CPT I: Can perform blood collection via venipuncture & skin puncture
3. CPT II: Can perform blood collection via arterial puncture, venipuncture, and skin puncture

Good news: If you’re already nationally certified as a Phlebotomist by one of the certifying bodies listed below, then you’re already qualified to apply for your state credentials.

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: You’ll need a Phlebotomist certification from at least one of the following certifying bodies:
• American Certification Agency (ACA)
• American Medical Certification Association (AMCA)
• American Medical Technologists (AMT)
• American Society of Clinical Pathology (ASCP)
• National Center for Competency Testing (NCCT)
• National Healthcareer Association (NHA)

State Credential: You’ll need one of the following state certifications, depending on your scope of practice:
• California Limited Phlebotomy Technician (LPT)
• California Certified Phlebotomy Technician I (CPT I)
• California Certified Phlebotomy Technician II (CPT II)

Cytotechnologist

Cytotechnologists work under the supervision of pathologists to examine cells for abnormalities, often in Pap smears and biopsies. In California, this is a licensed role that requires both the state Cytotechnologist license and the national CT certification from the ASCP.

Already CT certified by the ASCP? You’re just one step away! Now you just need to apply for California’s Cytotechnologist License.

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: Certified Cytologist (CT) from the American Society of Clinical Pathology (ASCP)

State Credential: California Cytotechnologist License

Medical Lab Scientist or Clinical Lab Scientist

This advanced lab technologist role involves conducting complex clinical testing, often in hospital labs. It typically requires a bachelor’s degree in a biological science as well as specialized training. California requires either the state Clinical Laboratory Scientist (Generalist) License or the state Limited Clinical Laboratory Scientist License. The Generalist License allows you to work in all Clinical Laboratory Scientist specialties. However, the Limited License will only allow you to work in the specific specialty you’re currently licensed in.

In addition to the state license, you will need to pass a national certification exam. Refer to the links below to see the full list of national certifications currently accepted in California.

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: You’ll need a Medical Lab Technologist/Medical Lab Scientist certification from at least one of the following certifying bodies to qualify for the California CLS (Generalist) License:
• American Society of Clinical Pathology (ASCP) (If you received your MLS certification before October 2002, you will need to retake the certifying exam.)
• American Society of Clinical Pathology International (ASCPi)
• American Association of Bioanalysts (AAB)
• American Medical Technologists (AMT) (Only versions of the exam from 2014 and after are accepted by the CDPH.)

If you are interested in the California Limited CLS License, please reference this page to see the available specialties and which national credentials are currently accepted for the specialty you’re interested in.

State Credential: You’ll have to have one of the following state licenses, depending on your scope of practice:
• California Clinical Laboratory Scientist (Generalist) License
• California Limited Clinical Laboratory Scientist License

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Therapy & Rehabilitation

These healthcare roles focus on helping patients recover from injury, surgery, or illness. Licensing in California is role-specific and managed by different boards, depending on the discipline. While most roles require completion of accredited programs and passing national exams, the path varies slightly depending on whether you’re working with movement, speech, or respiratory support.

Physical Therapy Assistant

Physical Therapy Assistants work under the supervision of a licensed physical therapist to carry out rehabilitative exercises and care. To be a PTA in California, you will need to pass the National Physical Therapy Examination (NPTE exam) and obtain the California Physical Therapy Assistant License (PTA).

Already passed the NPTE? You’re just one step away! Now you just need to apply for California’s PTA License.

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: Pass the National Physical Therapy Examination (NPTE)

State Credential: California Physical Therapy Assistant License (PTA)

Speech Therapy Technician (Speech-Language Pathology Assistant)

Speech-Language Pathology Assistants support speech-language pathologists in providing speech therapy services, including conducting screenings and preparing therapy materials. California does not require a national exam for SLPAs, but you must complete an approved SLPA associate degree or equivalent training (with clinical hours) before you can apply for state registration as a Speech-Language Pathologist Assistant.

Good news: California does not require an additional national credential or exam for SLPAs. You will only need state credentials.

Select the credential below to explore the education and steps required to qualify and apply.

State Credential: California Speech-Language Pathologist Assistant Registration

Respiratory Therapist

Respiratory Therapists help patients with breathing disorders, ventilator support, and respiratory emergencies, often in ICUs and ERs. To be a Respiratory Therapist in California, you will first need to pass the National Board for Respiratory Care (NBRC) exam and receive the Registered Respiratory Therapist (RRT certification) before you are able to apply for the required state Respiratory Care Practitioner License.

Already have your RRT certification from the NBRC? You’re just one step away! Now you just need to apply for California’s RCP License.

Select a credential below to explore the education and steps required to qualify and apply.

National Credential: Registered Respiratory Therapist (RRT) certification from the National Board for Respiratory Care (NBRC)

State Credential: California Respiratory Care Practitioner License

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Other Roles

Certified Nursing Assistant

Certified Nursing Assistants assist nurses in providing basic patient care such as bathing, dressing, and monitoring vital signs. California requires CNAs to have the state Certified Nursing Assistant certification.*

*Some California employers also require state CNA certification for Patient Care Technician (PCT) roles, although PCTs may also be expected to have additional certifications like EKG or phlebotomy training.

Surgical technology is a fast-paced, hands-on field that offers a wide range of career opportunities for healthcare professionals looking to make an impact on patient outcomes. And with demand for surgical technologists and assistants projected to grow 6 percent from 2023 to 2033, there’s never been a better time to map out your career journey.

In this guide, we’ll walk through each stage of a surgical technologist’s career and outlines actionable steps to help you earn a higher salary, expand your impact, and grow your career. 

Remember: every career path is different. Use this guide as a starting point, but don’t be afraid to forge your own path—there are countless opportunities to grow depending on your unique interests and skills.

Kickstart Your Career: Get Certified

Your career begins with education. To practice as a surgical technologist, you’ll need to complete an accredited surgical technology training program, which typically takes 1-2 years to complete. When you finish, you’ll need to pass the National Board of Surgical Technology and Surgical Assisting (NBSTSA) exam to become a Certified Surgical Technician (CST).

Choose the right program for you

You must have a high school diploma or GED to enroll in a surgical technology certification program. There are multiple ways you can earn your education, depending on your timeline, work/life balance, and long-term goals. 

The most common programs include:

Choose an accredited program

Whichever path you choose, selecting an accredited program is the only way to ensure your education will satisfy the eligibility requirements for the CST exam. Programs should be accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or Accrediting Bureau of Health Education Schools (ABHES). You can find a list of accredited programs on the CAAHEP and ABHES websites.

Early Career: Master Core Skills & Maintain Your Credential

Once you’ve passed the CST exam, you’re eligible to start working as a surgical technologist. The first three years of your career are about mastering core skills, building confidence in the OR, and gaining a solid foundation of experience across a range of procedures. 

As you learn, start reflecting on which parts of the job excite you the most. Understanding your strengths, technical interests, and soft skills early on can help guide your long-term career path. 

Your early career is also an ideal time to grow your professional network. Build mentorship relationships with senior techs, attend conferences and workshops, and stay open to learning opportunities. The connections you make now can open the door to new roles, specializations, or opportunities down the line.

Maintain your credentials through continuing education

To maintain your CST credential, you’ll either need to earn a certain amount of continuing education (CE) credits or retake and pass the certification exam every two years. Most surgical techs opt to gain CE credits rather than retake the exam because it helps you grow professionally in addition to maintaining your credential. Visit the NBSTSA’s website to learn more about CST renewal and recertification requirements.

What are CE credits for surgical technologists?

Continuing education credits are earned by completing relevant professional development experiences or activities that help CSTs refresh their knowledge and learn about new advancements in the field. One credit typically equals 60 minutes of activity, and a portion of credits must be live credits, meaning they were earned by attending a live event like a conference or workshop. 

CSTs must earn 30 CE credits every 2 years, while Certified Surgical First Assistants (CSFAs) must earn 38 CE credits every 2 years. All CE credits must be recognized by the Association of Surgical Technologists (AST) and submitted for approval to count toward your total.

Here are a few ways to gain CE credits as a surgical technologist:

Mid-Career: Specialize and Deepen Your Skills

Once you’ve got 3-5 years of experience under your belt, you likely have a clear sense of which parts of the role you enjoy most. If you’re drawn to the technical aspects of the job, this could be the right time to specialize in a surgical area that aligns with your interests. If you’re more interested in a leadership role, now’s a great time to start exploring those opportunities and preparing yourself to take on more responsibility. 

This is an exciting stage in your career where you can begin shaping your long-term career aspirations. Here are a few paths to consider:

Choose a surgical specialty

Specializing in a specific branch of surgery is a great way to deepen your expertise and unlock new career opportunities. Many specializations require (or prefer) additional training or certification, but in turn offer higher salaries and more opportunities for advancement. You’ll generally need to have a few years of general OR experience as a CST to specialize. 

There are many surgical specialties to choose from, including orthopedics, neurosurgery, cardiovascular, robotics, and OB/GYN. See a list of common specialties and which one might be right for you.

While every specialization is different, here are the steps most surgical techs will take to specialize:

Pursue a team lead role

If you enjoy the variety that general surgery offers, but are looking to advance your career in other ways—particularly on the leadership and admin side—you may want to consider pursuing a team lead role on the surgical floor. Whether it’s mentoring more junior techs, managing case flow, or coordinating the surgical team, lead roles typically come with increased pay and greater responsibility. 

While opportunities to gain leadership skills vary by facility, here are some of the steps you can take to begin your journey toward a leadership role:

Maintain your credentials

Don’t forget that you’ll still need to earn CE credits and renew your CST certification every two years for as long as you’re a practicing surgical technologist. As you advance your career, use your CE activities as an opportunity to further deepen your expertise and expand your skillset in your chosen specialization.

Senior Level Career: Take on a Leadership Role

After several years of hands-on experience, many surgical techs start to seek advanced roles that offer greater impact, increased responsibility, and higher earning potential. Late-career advancement is an exciting opportunity to put your hard-earned expertise to use in new and meaningful ways.

Common paths at this stage include becoming a Certified Surgical First Assistant (CSFA), pursuing a senior leadership role, or becoming an educator. The right path for you depends on whether you’re more interested in continuing to support surgeons in the operating room, overseeing team operations and department workflows, or training and mentoring new surgical technologists.

Become a Certified Surgical First Assistant

First assistants work side-by-side with surgeons in the operating room, taking on a broader set of responsibilities that extend beyond the setup and support duties of a traditional surgical technologist. This more advanced and hands-on role offers increased earning potential and a strong foundation for techs looking to make a career pivot down the line, such as becoming a Physician Assistant or an RN First Assistant. 

To apply for a CSFA program, you’ll need to have at least 3,000 hours of experience as a CST in an OR. Once you’ve reached that milestone, you can enroll in a program accredited by CAAHEP, which typically takes 12-24 months to complete. 

Once you graduate from a CAAHEP-accredited program, you can take national certification examinations through the National Board of Surgical Technology and Surgical Assisting (NBSTSA) or National Commission for the Certification of Surgical Assistants (NCCSA).

Upon passing the exam, you’ll be certified to practice as a CSFA.

Take on a leadership role

Transitioning into a leadership role can be a rewarding next step for senior surgical technologists who have spent their career building a strong clinical foundation and advancing their leadership skills. Depending on what kind of facility you work in, there are a number of leadership roles you can pursue, from Sterile Processing Supervisor to Surgical Services Supervisor or Sterile Processing Supervisor. These positions sit on the administrative side of running an OR, overseeing essential processes like managing schedules, mentoring staff, and improving workflows. 

If you’re aiming to move up in surgical leadership, it’s recommended you pursue an associate’s or bachelor’s degree in surgical services or healthcare management. Some hospitals offer tuition reimbursement to help surgical techs enroll in these programs, along with support for pursuing certifications and continuing education programs that build leadership skills. Flexible options like online or part-time programs make it possible to earn your degree while continuing to work as a CST. 

When you’re ready to start applying for leadership roles, be sure to tailor your resume to highlight your leadership experience, both official and unofficial—including skills like people management, operations, and communications. Join Incredible Health to find permanent surgical leadership positions at top hospitals and surgery centers.

Become an educator

With years of clinical experience under your belt, you’re in a great position to help new surgical technologists start their careers. Becoming a surgical technology instructor or a clinical preceptor is a rewarding role where you can help shape the next generation of surgical technologists. 

To become an educator, you’ll typically need at least an associate’s degree and several years of clinical experience in the OR. While not always necessary, it’s recommended that you take courses and workshops on skills like curriculum development and classroom management. Some of these courses may even help you earn CE credits to maintain your CST certification, which you’ll need even as an educator. 

From there, you can begin looking for educational roles at community colleges, vocational schools, or hospitals with robust onboarding programs. 

Choosing the right path for you

There’s no one-size-fits-all career path for surgical technologists. Whatever your goals, surgical technology offers countless opportunities for advancement, growth, and a meaningful career creating great patient outcomes. 

Incredible Health connects surgical technologists across all levels of experience and specialties to find permanent roles and the top hospitals and ambulatory surgery centers nationwide. If you’re looking for your next surgical tech role, join Incredible Health today to start writing your next chapter.

Plus: Read our healthcare technician resume guide and surgical tech intervew guide for tips and tricks to land an interview—and then ace it.