Background: CKD diagnosis is under recognized in T2D. We determined the interval between biochemical and clinically documented CKD diagnosis in a retrospective cohort of adults seen in the clinics of a large academic center between 1/1/11-7/31/20. Methods: Biochemical CKD diagnosis was defined as 2 estimated glomerular filtration rate (eGFRcr) <60 ml/min/1.73 m2 (CKD-EPI) and/or 2 out of 3 albumin-to-creatinine ratios (ACR, spot urine) >30 mg/g, ≥3 months apart. KDIGO GFR and ACR categories were used. Clinical CKD diagnosis was defined by presence of any CKD code in the electronic health record. Results: 139,369 unique patients with T2D (60±15 yrs; 47% female; 83% white) were seen during the study period. 62,201 (44.6%) and 53,352 (38.3%) had at least one GFR or ACR, respectively, and 53,141 (38.1%) had both lab measurements. 15,770 (25.3%) had CKD by eGFR criteria. The median interval between biochemical and clinical diagnosis was 1.9 yrs (range 0.003-17.9), longer among patients on CKD stage G3a (2.1 yrs, [0-18.0]) than on G3b (1.5 [0-16.2] yrs; P<0.001) or G4 (1.2 [0-16.0] yrs; P<0.001). 13,647 (15.6%) had CKD by ACR criteria. Out of the 24,368 patients who had albuminuria on a given sample, 7,866 (32.3%) reverted to normoalbuminuria and 2,152 (8.8%) died before repeating ACR. Median interval between biochemical (ACR criteria) and clinical CKD diagnosis was 1.3 [0-15.5] yrs for stage A2 and 1.1 [0-9.3] yrs for A3; P<0.00001. Among patients who had both eGFR and ACR measurements, the median interval between biochemical (either by GFR or ACR) and clinical diagnosis was 1.7 [0.002-18.0] yrs. Conclusions: Our study indicates low screening rates and delayed CKD diagnosis documentation in T2D. This was particularly marked at earlier disease stages, although significant documentation delay was also common among patients with more severe CKD. These findings suggest lack of physician awareness, which may lead to suboptimal care. Screening and documentation of CKD is of paramount importance to improve CKD care in T2D. Disclosure T. Harindhanavudhi: Stock/Shareholder; Self; Dexcom, Inc. R. L. Freese: None. L. Caramori: Consultant; Self; AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Novartis Pharmaceuticals Corporation, Speaker’s Bureau; Self; Bayer AG.