Independent Diagnostic Testing Facility and Supporting Regulations Contained in 42 CFR 410.33

ICR 200105-0938-009

OMB: 0938-0721

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0721 200105-0938-009
Historical Active 199803-0938-003
HHS/CMS
Independent Diagnostic Testing Facility and Supporting Regulations Contained in 42 CFR 410.33
Extension without change of a currently approved collection   No
Regular
Approved without change 08/07/2001
Retrieve Notice of Action (NOA) 05/31/2001
  Inventory as of this Action Requested Previously Approved
08/31/2004 08/31/2004 08/31/2001
500 0 500
42 0 42
0 0 0

The information collection requirements asociated with an Independent Diagnostic Testing Facilities involve documentation of proficiency of medical personnel and of resources.

None
None


No

1
IC Title Form No. Form Name
Independent Diagnostic Testing Facility and Supporting Regulations Contained in 42 CFR 410.33 HCFA-R-214

  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 500 500 0 0 0 0
Annual Time Burden (Hours) 42 42 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.
05/31/2001


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