Incredible info everyone. So basically, the gold standard verification process is:

1. Check COA has all required elements (the checklist above)
2. Verify the lab exists and is accredited
3. Call the lab to confirm the report number
4. Request raw chromatogram data
5. If still uncertain, send to independent third-party testing (Janoshik, etc.)

That about right?

That's exactly right. And honestly, step 5 is the ultimate verification. A COA is just a piece of paper. Third-party testing is actual science. If you're spending hundreds of dollars on a compounded medication that you're injecting into your body, spending $100-150 on independent testing is a reasonable investment.

The fact that we even have to have this conversation says a lot about the current state of the market. 😔

Wow this thread is making me paranoid. I just started compounded sema from an online telehealth company and never even thought to ask for a COA. Is it weird to ask for one after the fact?

Not weird at all. Look at your vial for the lot/batch number and call the pharmacy (not the telehealth company — the actual compounding pharmacy listed on the label). Ask for the COA for that batch number. If it's a legit operation, they'll email it to you within a day or two. Standard stuff.