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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR LICENSURE UNDER CLINICAL LABORATORIES ACT 1967

ICR 198009-0920-005 · OMB 0920-0028 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
165670 APPLICATION FOR LICENSURE UNDER CLINICAL LABORATORIES ACT 1967 Form Migrated
ICR Details
0920-0028 198009-0920-005
Historical Active 197808-0920-002
HHS/CDC
APPLICATION FOR LICENSURE UNDER CLINICAL LABORATORIES ACT 1967
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/23/1980
Approved with change 09/23/1980
Retrieve Notice of Action (NOA) 09/23/1980
  Inventory as of this Action Requested Previously Approved
12/31/1980 12/31/1980 09/30/1980
3,550 0 3,550
592 0 592
0 0 0
THE CLINICAL LABORATORIES IMPROVEMENT ACT OF 1967 REQUIRED THAT CLINICAL LABORATORIES SOLICITING OR ACCEPTING SPECIMENS IN INTERSTATE COMMERCE MUST HOLD A VALID LICENSE OR LETTER OF EXEMPTION FROM LICENSURE. PROGRAM RESPONSIBILITY FOR IMPLEMENTING CLIA WAS DELEGATED TO THE DIRECTOR, CDC. RESPONSIBILITY HAS SINCE BEEN TRANSFERRED TO THE HEALTH CARE FINANCING ADMINISTRATION.
None
None
No
1
IC Title Form No. Form Name
APPLICATION FOR LICENSURE UNDER CLINICAL LABORATORIES ACT 1967 CDC 3.602-1, CDC 3.602-2, CDC 3.602-3, CDC 3.602-4, CDC 3.602-6, CDC 3.601, CDC 3.639, CDC 3.676
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,550 3,550 0 0 0 0
Annual Time Burden (Hours) 592 592 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/23/1980