1. An application for a license must be on a form prescribed by the Division and must contain the following information:
(a) The name and location of the laboratory;
(b) The name and proof of identity of the laboratory director;
(c) The name of the owner or owners of the laboratory or, if a corporation, the names of the officers, directors and beneficial owners of 10 percent or more of its shares;
(d) A description of the program and services provided by the laboratory; and
(e) Such other information as the Division may deem necessary or expedient to carry out its powers and duties under this chapter.
2. The Board shall adopt regulations to carry out the provisions of subsection 1, including, without limitation, regulations setting forth the acceptable forms of proof of identity that a laboratory director must include in an application pursuant to paragraph (b) of subsection 1.