# How to open a private clinic, a dental practice or a pharmacy in Moldova

The two halves of this field require almost opposite things. Medicine is not licensed: a private clinic and a dental practice work with a sanitary operating authorisation, an entry in the register of private health service providers and accreditation once every five years. A pharmacy, the other way round, opens on a licence from the Medicines and Medical Devices Agency but without a sanitary authorisation — and no closer than 250 metres to the nearest pharmacy. A care home picks its regime by one thing: whether or not it provides medical care.

## In brief

- **CAEM codes:** Divisions 86 and 87, plus 47.73
- **Licence:** Pharmacies only (medicine and dentistry are not licensed activities)
- **Accreditation:** Mandatory, every 5 years (from 1,263.50 lei for a single family doctor)
- **Share capital:** No minimum

## Private clinic: three acts, in the order you obtain them

A private clinic needs no licence — medicine does not appear among Moldova's licensed activities. Three acts stand in its place, in this order: the sanitary operating authorisation from the National Agency for Public Health, entry in the register of private health service providers at the Ministry of Health, and accreditation by the National Council of Evaluation and Accreditation in Health, once every five years.

| Code | Activity | What it means in practice |
| --- | --- | --- |
| 86.21 | General medical practice activities | Consultations and treatment in general medicine, by general practitioners. The class is on the list of activities subject to sanitary operating authorisation. |
| 86.22 | Specialist medical practice activities | Specialist consultations and treatment, including surgery. Invasive procedures a beauty salon may not provide belong here. On the sanitary authorisation list. |
| 86.90 | Other human health activities | The out-of-hospital laboratory, imaging, physiotherapy, medical massage, speech therapy, private ambulance. On the sanitary authorisation list. |
| 86.10 | Hospital activities | The hospital, with inpatients. Of the 89 hospitals in the country, 21 are private. On the sanitary authorisation list. |

- **Authorisation: Sanitary operating authorisation** — National Agency for Public Health, valid for 5 years. Classes 86.10, 86.21, 86.22, 86.23, 86.90, 87.10 and 87.20 — the hospital, the practice, the clinic, dentistry, the laboratory and the nursing home with medical care. Issued free of charge, for each address; you pay only for the assessment of sanitary condition, 875 lei, around 44 euro. Not required of a pharmacy, nor of class 87.30.
- **Notification: Entry in the register of private health service providers** — Ministry of Health. Any private provider of medical services. It is done by notification, with the sanitary operating authorisation attached, and it approves at the same time the list of services you will provide. Without it you cannot deliver care inside the compulsory health insurance system.
- **Authorisation: Accreditation certificate** — National Council of Evaluation and Accreditation in Health, valid for 5 years. All medical service providers, state and private, once every five years. The fee follows the type of care and the number of doctors: 1,263.50 lei for family medicine with one doctor, 6,317.50 lei for dentistry or specialist outpatient care with one doctor. The annual current evaluation is paid separately.

**Who buys it:** You have two payers rather than one, and that changes the whole business plan. The patient pays out of pocket — a household spends an average of 227.7 lei per person a month on health, around 11 euro, and 327 lei in towns. And the National Health Insurance Company contracts with private providers on the same terms as with public ones, so the second revenue stream is a contract, not an invoice.

**What is different about the money:** The cost most often forgotten is not the start-up one but the annual one: on top of the initial evaluation, a private provider also pays for the annual current evaluation, out of its own funds. The accreditation fee follows the number of doctors — 1,263.50 lei for a family medicine practice with a single doctor, around 63 euro, and 3,790.50 lei for one with two or three.

## Dental practice: the same regime, plus radiology

A dental practice falls under exactly the same regime as a clinic: sanitary authorisation, entry in the register, accreditation every five years. One act is added if you have an X-ray unit — the radiological authorisation, issued free of charge by the National Agency for Regulation of Nuclear and Radiological Activities, for seven years. The accreditation fee starts at 6,317.50 lei for a practice with a single dentist.

| Code | Activity | What it means in practice |
| --- | --- | --- |
| 86.23 | Dental practice activities | General and specialist dentistry, orthodontics, dental surgery. On the sanitary authorisation list. Making dentures in a dental laboratory has a different code, 32.50. |

- **Authorisation: Sanitary operating authorisation** — National Agency for Public Health, valid for 5 years. Classes 86.10, 86.21, 86.22, 86.23, 86.90, 87.10 and 87.20 — the hospital, the practice, the clinic, dentistry, the laboratory and the nursing home with medical care. Issued free of charge, for each address; you pay only for the assessment of sanitary condition, 875 lei, around 44 euro. Not required of a pharmacy, nor of class 87.30.
- **Notification: Entry in the register of private health service providers** — Ministry of Health. Any private provider of medical services. It is done by notification, with the sanitary operating authorisation attached, and it approves at the same time the list of services you will provide. Without it you cannot deliver care inside the compulsory health insurance system.
- **Authorisation: Accreditation certificate** — National Council of Evaluation and Accreditation in Health, valid for 5 years. All medical service providers, state and private, once every five years. The fee follows the type of care and the number of doctors: 1,263.50 lei for family medicine with one doctor, 6,317.50 lei for dentistry or specialist outpatient care with one doctor. The annual current evaluation is paid separately.
- **Authorisation: Radiological authorisation** — National Agency for Regulation of Nuclear and Radiological Activities, valid for 7 years. Operating roentgen installations in medical diagnosis — the dental X-ray belongs here. Issued free of charge. The holder may use only staff who hold a valid practising permit, and appoints a radiation protection officer by order.

**Who buys it:** A dental patient decides differently from a clinic patient: they choose once, by the practitioner, and stay for years if the treatment went well. They pay out of pocket at every visit, with no intermediary and no payment terms — which gives a dental practice the cleanest cash flow in the whole field, even though it carries the most expensive accreditation per doctor.

**What is different about the money:** This is the one asymmetry worth calculating before you sign: a dental practice with a single dentist pays 6,317.50 lei for accreditation — around 316 euro — while a family medicine practice with a single doctor pays 1,263.50 lei. Five times as much, for the same headcount. The rest of the budget is the dental unit, sterilisation and the X-ray, which brings a file of its own.

## Pharmacy: a licence from the Medicines Agency and the 250-metre rule

The pharmacy is the only licensed branch in this field. The licence is issued by the Medicines and Medical Devices Agency for five years, and the premises are checked inside the licensing procedure itself — which is why a pharmacy files no application for a sanitary operating authorisation. What it files instead are two notifications: a trade one with the town hall and a public-health one.

| Code | Activity | What it means in practice |
| --- | --- | --- |
| 47.73 | Dispensing chemist in specialised stores | The open-access pharmacy and its branches. The class is not on the sanitary authorisation list but on the notification one — and it is at the same time a trade activity, so it is also notified to the town hall. |
| 46.46 | Wholesale of pharmaceutical goods | The pharmaceutical warehouse. Also on the notification list rather than the authorisation one. Like a pharmacy, it may be headed only by a pharmacist. |

- **Licence: Licence for pharmaceutical activity** — Medicines and Medical Devices Agency, valid for 5 years. The pharmacy, its branches and the pharmaceutical warehouse. The application carries the deed for the premises, the pharmacy diplomas and the hiring orders of the managers; the agency makes a control visit and issues its report within ten working days at most. The fee is 3,250 lei, halved for companies registered no more than a year earlier.
- **Notification: Trade notification and public-health notification** — The town hall of the locality and the National Agency for Public Health. Class 47.73 is a trade activity, so it is notified to the town hall of the locality where you will work, like any shop. The same class is also on the list of services with an impact on public health subject to notification — the light form of sanitary authorisation, not the authorisation itself.

**Who buys it:** This is the only branch in the field with daily sales and a small basket rather than appointments and a large ticket. The network grew from 1,524 to 1,799 pharmacies and branches in three years, but all of that growth is outside the capital: in Chișinău the number stayed essentially flat. Where room is left, the state also runs a separate licensing regime for rural localities.

**What is different about the money:** The licence costs 3,250 lei — around 160 euro — or 1,625 lei for a company registered no more than a year before the application is filed, which makes the company-then-licence order matter in cash terms. The pharmacy is the only branch in this field that charges VAT, at 8% on medicines, and the only one that recovers the VAT it pays on rent, fittings and equipment.

## Care with and without accommodation: medical care decides the regime

A care home picks its regime by a single criterion: whether or not it provides medical care. A home with medical care is class 87.10 and appears on the list of activities subject to sanitary operating authorisation; a home with minimal medical assistance or none is 87.30 and does not. Both are social services, and social service providers are accredited every five years as a matter of obligation.

| Code | Activity | What it means in practice |
| --- | --- | --- |
| 87.10 | Residential nursing care activities | The nursing home with medical care, the convalescent home, the hospital-home. On the sanitary authorisation list — as is 87.20, residential mental health and substance abuse facilities. |
| 87.30 | Residential care activities for the elderly and disabled | Assisted living, continuing-care retirement communities, homes with minimal medical assistance or none. The class does not appear on the list of activities subject to sanitary operating authorisation. |

- **Authorisation: Sanitary operating authorisation** — National Agency for Public Health, valid for 5 years. Classes 86.10, 86.21, 86.22, 86.23, 86.90, 87.10 and 87.20 — the hospital, the practice, the clinic, dentistry, the laboratory and the nursing home with medical care. Issued free of charge, for each address; you pay only for the assessment of sanitary condition, 875 lei, around 44 euro. Not required of a pharmacy, nor of class 87.30.
- **Authorisation: Accreditation certificate for a social service provider** — State Social Inspectorate, valid for 5 years. All social service providers, as a matter of obligation, once every five years, whatever the form of ownership — for-profit companies are named in the law among private providers. The condition to prepare from the start: the founding act must provide for activities in the field of social services.

**Who buys it:** The family pays, monthly, for a service that lasts years rather than sessions — the most predictable revenue in the whole field. The decision is made once and with difficulty, after a visit and a recommendation, and a place taken stays taken. Demand comes from the same direction as everywhere in Europe: an ageing population and families who work and cannot provide care at home.

**What is different about the money:** The budget is the building and the people, in proportions no other branch has: round-the-clock care means shifts, so three times the staff you see on any given day. And if you add medical care you move to 87.10 and onto the sanitary authorisation list — a decision taken when the service is designed, not after it opens.

## How the sector got here

- **1 January 2023 — Law no. 372/2022.** Accreditation of social service providers moves to the State Social Inspectorate, an administrative authority under the Ministry of Labour and Social Protection. Anyone opening a care home has filed there ever since, not with the former accreditation council.
- **15 August 2024 — Law no. 227/2024.** The article setting out who is accredited in health is rewritten: state and private medical service providers are subject to evaluation and accreditation once every five years. The rule has been framed around the provider ever since, not around the type of institution.
- **9 October 2024 — Government Decision no. 702/2024.** The Government approves the methodology by which health evaluation and accreditation fees are calculated. From it comes the formula the tariffs rest on: a minimum fee multiplied by a complexity coefficient.
- **24 October 2025 — Ministry of Health Order no. 893/2025.** The current accreditation tariffs enter into force. The minimum fee is 12,635 lei, and the coefficient follows the number of doctors or beds: 1,263.50 lei for family medicine with a single doctor and 6,317.50 lei for dentistry or specialist outpatient care with a single doctor.
- **30 December 2025 — Law no. 227/2025.** The list of activities subject to sanitary operating authorisation is rewritten by CAEM class. Health now appears by code: 86.10, 86.21, 86.22, 86.23, 86.90, 87.10 and 87.20 are on the list. Trade in pharmaceutical products stays on the notification list, and class 87.30 is on neither.
- **21 March 2026 — Law no. 10/2009, version in force.** The law now states outright that sanitary operating authorisations are issued free of charge and that only the sanitary expertise is paid for, at tariffs approved by the Government. For a clinic or a practice, the act itself no longer has a cost.

## What the private healthcare market is worth

The best measure of demand here is not the state budget but the patient's wallet. In 2025 a household spent an average of 227.7 lei per person a month on health — around 11 euro, 4.5% of all consumption, and 327 lei in towns. For comparison, education services came to 52.6 lei. Health is the category people reach into their own pockets for four times more readily than for schooling.

Supply followed demand. At the end of 2025 there were 645 private medical institutions providing primary and specialist care, against 589 a year earlier and 568 in 2022. Public institutions of the same kind fell over the same period from 436 to 428. Of the 89 hospitals in the country, 21 are private.

The pharmacy network grew more visibly still: 1,799 pharmacies and branches in 2025, against 1,524 in 2022. What is interesting is where it grew. Chișinău had 524 in 2022 and 528 in 2025 — essentially unmoved. The entire increase of 275 units happened outside the capital.

And the people followed. Health and social care units in forms of ownership other than public employed 12,511 people at 31 December 2025, against 10,598 in 2023.

## Why now is a good time to open a clinic or a pharmacy

Because since 30 December 2025 the rules have been written by CAEM code. You know before you sign a lease that 86.21, 86.22, 86.23 and 86.90 are on the sanitary authorisation list and that 47.73 is not. Until then the same list was framed by category of institution and left room for interpretation at every inspection.

Because the most important act costs nothing. The sanitary operating authorisation is issued free of charge — the law has said so outright since 21 March 2026 — and only the sanitary expertise is paid for. The radiological authorisation is likewise free and runs for seven years.

Because you have two revenue channels rather than one. A contract with the National Health Insurance Company is open to private providers on the same terms as to public ones, and the public health budget came to 19,393.1 million lei in 2025 — close to 970 million euro — against 15,944.1 million in 2023. Anyone entering the system enters a sum that is growing.

And because the company that holds all of it together — an SRL — is registered with no minimum share capital, in a few working days. If a pharmacy is the plan, the order matters in cash: the licence fee is halved for companies registered no more than a year before the application is filed.

## What it costs to open

On the medical side the permissive acts are cheap and the evaluation is expensive. The sanitary operating authorisation costs nothing; you pay only 875 lei — around 44 euro — for the assessment of sanitary condition. Entry in the register of providers is done by notification to the Ministry of Health. Accreditation, by contrast, is priced by the type of care and the number of doctors, starting from a minimum fee of 12,635 lei multiplied by a complexity coefficient: 1,263.50 lei for family medicine with a single doctor, 6,317.50 lei for dentistry or specialist outpatient care with a single doctor, 12,635 lei — around 630 euro — for a hospital of up to 25 beds. To these is added the annual current evaluation, which a private provider bears from its own funds.

On the pharmaceutical side there is one figure and it is fixed. The licence for pharmaceutical activity costs 3,250 lei, and 1,625 lei for applicants registered no more than a year before the application — around 160 and 80 euro. The trade notification at the town hall costs 100 lei, around 5 euro. No sanitary authorisation is paid for, because none is required.

Registering the SRL has no minimum share capital and takes a few working days at the Public Services Agency — we file the papers, pick the CAEM codes and hand you a company ready for the authorisation file. The rest of the budget — premises with a health-sector designated use, equipment, sterilisation and, above all, salaries — is where your choices matter.

## What to know before you open

### The sanitary authorisation comes first, accreditation second

The order is not a convention, it is written into the file: the sanitary operating authorisation is attached to the accreditation application. You cannot apply for accreditation until you hold the authorisation, and the authorisation is granted per address, so it depends on the lease.

The health insurance law puts all three conditions in a single sentence: medical care is delivered by providers who are sanitarily authorised, accredited, and entered in the register of providers. Three acts, three authorities — the National Agency for Public Health, the National Council of Evaluation and Accreditation in Health and the Ministry of Health — and one order in which they are obtained.

### A pharmacy has no sanitary authorisation; it has a licence and a notification

This is the part that surprises people most often, because it looks backwards. A pharmacy files no application for a sanitary operating authorisation: the premises are checked by the Medicines Agency, inside the licensing procedure, through a control visit that ends in a report within ten working days at most.

What it files instead are two notifications. A trade one, with the town hall, because retail sale of pharmaceutical products is a trade activity like any other. And a public-health one, because that same class 47.73 is on the list of services subject to notification — the light form of the very regime the authorisation belongs to.

### The clinic is VAT-exempt; the pharmacy charges 8% — and deducts

Medical services are exempt from VAT, with one exception named in the law: cosmetic ones. The exemption comes without the right to deduct, though, so the VAT a clinic pays on rent, equipment and consumables stays a cost.

At a pharmacy it works precisely the other way. Medicines registered in the State Nomenclature of Medicines are sold with VAT at 8%, which makes a pharmacy a VAT payer — and therefore the only branch in this field that recovers the VAT it pays on rent, fittings and equipment. The same difference in regime explains why the two budgets are built differently from the first line.

### The premises must carry a health-sector designated use

The health law requires private providers to work in premises they own or lease that carry a designated use in the field of healthcare. This is not a paperwork formality: it changes the list of buildings you can consider and sometimes the calendar, if the designated use has to be changed first.

Which is why the lease is negotiated before the file, not after — all the more so because the sanitary authorisation runs for five years if you own the building or the lease is longer than five years, and if the lease is shorter, the authorisation ends with it.

### In care, medical care decides the regime

The classifier draws the line very precisely. A nursing home with medical care is 87.10; a home with minimal medical assistance or none is 87.30. The first class is on the list of activities subject to sanitary operating authorisation, the second is not. The same building, the same residents, two regimes — the medical component makes the difference.

On top of that sits social accreditation, which is required in both cases: social service providers are accredited every five years as a matter of obligation, by the State Social Inspectorate. And one of the conditions is prepared long before the file: the company's founding act must provide for activities in the field of social services. It is written at registration, not at accreditation.

## Which legal form to choose: SRL, individual practice or patent

**An SRL — Moldova's limited liability company — is the form a health business opens in**, and the first reason is given by the very law that says who may found a private provider. The text is short and heavy: natural and legal persons have the right to found private providers of medical services and bear responsibility for their financial and material provision, for the organisation of medical care and for its quality. Responsibility for the quality of the medical act is placed by statute on the founder. In a field where the risk is not commercial but human, the line between the company's assets and your own is exactly what the legal form buys.

The second reason is that an SRL makes possible everything that follows. You can hire doctors, nurses and pharmacists on individual employment contracts. You can sign the contract with the National Health Insurance Company. You can open a second pharmacy branch and file an authorisation application for each address. You can provide in the founding act for social-service activities, if a care home is also in the plan. And there is no entry threshold: an SRL has no minimum share capital and is registered at the Public Services Agency within a few working days.

The individual family doctor's practice is the one real alternative, and we will tell you plainly where it applies. The law defines it as a form of organising the professional activity of family doctors who hold a practice, founded by a single family doctor, acting and appearing in legal relations as a natural person. Two or more family doctors may form a family doctors' centre, which is a legal person. A family doctor may found only one of the two.

The limits, though, are exactly where you might be looking. The form exists only for family medicine. There is no individual practice for dentistry, for a specialist clinic or for a pharmacy — and the individual practice acts as a natural person, so without the separation of assets a company gives you.

The entrepreneur's patent has a single entry in this field — massage, care of the sick and other medical services provided by junior medical staff — at 140 lei a month in Chișinău, Bălți, Bender and Tiraspol, 70 lei in other municipalities and towns and 35 lei in rural localities. The entry is written for auxiliary staff, not for doctors, and the patent carries its two usual limits besides: at most 300,000 lei — around 15,000 euro — in sales revenue over 12 consecutive months, and no employees. On a patent you cannot hold a pharmaceutical licence, cannot be accredited as a medical service provider and cannot enter the register of providers.

The sole trader — the întreprindere individuală — looks like a shortcut, but it is not: the law states outright that an ÎI is not a legal person and that its owner is liable without limit, with their entire personal estate. You pay the same taxes as a company and keep the same records, but you retain the personal risk — the combination with no advantage at all in a field where responsibility for quality falls on the founder in any case.

We register the SRL, pick the CAEM codes for every activity you will have — including the social ones, if care is part of the plan — and prepare in parallel the file for the sanitary authorisation or, for a pharmacy, the licensing file, so that you do not lose the half-year between the lease and the first patient.

## Frequently asked questions

### Do you need a licence for a private clinic in Moldova?

No. The list of licensed activities has 22 entries and none of them covers medicine, dentistry or hospitals — the only entry from this field is pharmaceutical activity. Three acts come instead of a licence: the sanitary operating authorisation, entry in the register of private health service providers, and accreditation once every five years.

### What CAEM code does a private medical practice have?

General medicine is 86.21 and specialist medicine 86.22; the laboratory, imaging and physiotherapy are 86.90, and the hospital with inpatients is 86.10. All four are on the list of activities subject to sanitary operating authorisation, so choosing the code does not change the obligation — only how the activity is described in the company's papers.

### Can a private clinic work with the compulsory health insurance system?

Yes. In the wording of the law, providers inside the compulsory health insurance system are the public and private providers that have signed a contract with the National Health Insurance Company or its territorial agencies. The condition of entry is the same triad: sanitary authorisation, accreditation, and entry in the register of providers.

### What does accreditation cost for a dental practice?

The fee is 6,317.50 lei for a practice with up to one dentist and 12,635 lei for one with one to three — dentistry is priced the same way as specialist outpatient care. On top of the initial evaluation, a private provider also pays for the annual current evaluation, out of its own funds.

### What authorisation does a dental X-ray need?

The radiological authorisation, issued free of charge by the National Agency for Regulation of Nuclear and Radiological Activities for seven years: operating roentgen installations in medical diagnosis is an activity subject to authorisation. The holder may use only staff holding a valid practising permit, and appoints a radiation protection officer by order.

### How far apart do pharmacies have to be?

At least 250 metres by an accessible route from an existing pharmacy or branch, and at least 500 metres from a pharmacy that compounds medicines. In municipalities, towns and district centres a demographic norm is added: one pharmacy per 3,000 to 4,000 inhabitants, evidenced by a certificate from the town hall.

### Can you work in health on an entrepreneur's patent?

For one entry only: massage, care of the sick and other medical services provided by junior medical staff, at 140 lei a month in Chișinău, 70 in other towns and 35 in rural localities — around 7, 3.5 and under 2 euro. The entry is written for auxiliary staff. A clinic, a dental practice or a pharmacy cannot be opened on a patent.

Choosing the CAEM codes, drafting the constitutive documents and filing with the Public Services Agency are part of the registration service.