Clinical Laboratory Improvement Amendments (clia) Flexible Survey Protocol Form

CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) FLEXIBLE SURVEY PROTOCOL FORM

OMB: 0938-0650

IC ID: 114113

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CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) FLEXIBLE SURVEY PROTOCOL FORM
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-667 No No


    

1,000 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1 0 1 0 0 0
Annual IC Time Burden (Hours) 1 0 1 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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