PAPERWORK ASSOCIATED WITH THE DEPARTMENTAL CLINICAL LABORATORY SURVEY

ICR 198211-0938-006

OMB: 0938-0032

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0032 198211-0938-006
Historical Inactive 198203-0938-010
HHS/CMS
PAPERWORK ASSOCIATED WITH THE DEPARTMENTAL CLINICAL LABORATORY SURVEY
Revision of a currently approved collection   No
Regular
Disapproved and continue 01/20/1983
Retrieve Notice of Action (NOA) 11/12/1982
AS INDICATED IN CHRISTOPHER DEMUTHS JANUARY 4, 1983, LETTER TO DALE SOPPER, ANY FORM PRESCRIBED FOR USE BY HHS AS PART OF AN INFORMATION COLLECTION MUST SHOW A CURRENT OMB NUMBER. SINCE HHS REQUIRES STATE INSPECTION AGENCIES OR OTHER PERSONS TO USE THE HCFA 1557, IT MAY ONLY BE USED IF IT REFLECTS A CURRENT OMB NUMBER . THIS CLEARANCE REQUEST IS THEREFORE NOT APPROVED SINCE IT IS INCONSISTENT WITH THE TERMS OF THE PAPERWORK REDUCTION ACT IN THAT HHS IS PROPOSING TO REVISE THE HCF 1557 BY REMOVING THE OMB NUMBER. HOWEVER, THE CURRENT COLLECTION ENTITLED DEPARTMENTAL CLINICAL LABORATORY SURVEY REPORT INCLUSIVE OF T HCFA 1557 REFLECTING THE OMB NUMBER MAY CONTINUE IN USE THROUGH APRIL 1983.
  Inventory as of this Action Requested Previously Approved
11/30/1982 04/30/1983 11/30/1982
3,000 0 3,000
35,000 0 35,000
0 0 0

THESE CLINICAL LABORATORY SURVEYS ARE PERFORMED TO DETERMINE IF PROVIDERS AND SUPPLIERS INITIALLY MEET AND/OR CONTINUE TO MEET PROGRAM REQUIREMENTS FOR PARTICIPATION IN MEDICARE AND CLIA OF 1967 PROGRAMS.

None
None


No

1
IC Title Form No. Form Name
PAPERWORK ASSOCIATED WITH THE DEPARTMENTAL CLINICAL LABORATORY SURVEY HCFA-R9

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.
11/12/1982


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