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Laboratory Practices Questionnaire (LPQ)
Performance Evaluation Program for Rapid HIV Testing
OMB: 0920-0595
IC ID: 191810
OMB.report
HHS/CDC
OMB 0920-0595
ICR 201001-0920-002
IC 191810
( )
Documents and Forms
Document Name
Document Type
Form 4
Laboratory Practices Questionnaire (LPQ)
Form and Instruction
4 Laboratory Practices Questionnaire (LPQ)
0920-0595_att4_LPQ Worksheet.doc
Form and Instruction
Attachment 4b_LPQRT Cover letter-pswrdltr.doc
Attachment 4b_LPQRT Cover letter-pswrdltr
IC Document
Attachment 4c_LPQ Report.pdf
Attachment 4c_LPQ Report
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Laboratory Practices Questionnaire (LPQ)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
4
Laboratory Practices Questionnaire (LPQ)
0920-0595_att4_LPQ Worksheet.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
330
Number of Respondents for Small Entity:
30
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
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
330
0
330
0
0
0
Annual IC Time Burden (Hours)
165
0
165
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 4b_LPQRT Cover letter-pswrdltr
Attachment 4b_LPQRT Cover letter-pswrdltr.doc
12/18/2009
Attachment 4c_LPQ Report
Attachment 4c_LPQ Report.pdf
12/18/2009
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.