Abstract: Techniques for managing secure communication certificates for medical devices in a clinical environment are provided. A short-lived, limited-use token may be uniquely assigned to a medical device. The medical device can self-provision a secret key and corresponding public key based on a unique identifier in the token. The medical device generates a certificate signing request (“CSR”) that includes the public key, and sends the CSR and the token to a verification system that serves as an intermediary between medical devices and a certificate authority. The intermediary may only send the CSR to the certificate authority (“CA”) for a certificate if the intermediary is able to validate the token.