Information Collection

Clinical Laboratory Improvement Amendments (CLIA) Adverse Action Extract and Supporting Regulations -- 42 CFR 493.1840

IC 8233 under ICR 199706-0938-015 · OMB 0938-0655.

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Information Collection (IC) Details

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IC Title:	Clinical Laboratory Improvement Amendments (CLIA) Adverse Action Extract and Supporting Regulations -- 42 CFR 493.1840	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-462A/B				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,500	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,500	2,500
Annual IC Time Burden (Hours)	5,724	5,724
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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