Information Collection

Application For Licensure Under Clinical Laboratories Act 1967

IC 165670 under ICR 198009-0920-005 · OMB 0920-0028.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

IC Title:

APPLICATION FOR LICENSURE UNDER CLINICAL LABORATORIES ACT 1967

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CDC 3.601	No	No
Form	CDC 3.602-3	No	No
Form	CDC 3.602-2	No	No
Form	CDC 3.602-4	No	No
Form	CDC 3.639	No	No
Form	CDC 3.676	No	No
Form	CDC 3.602-1	No	No
Form	CDC 3.602-6	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,550

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,550	3,550
Annual IC Time Burden (Hours)	592	592
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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