Information Collection

Laboratory Medicine Best Practices Project Data Submission Form

IC 192353 under ICR 201003-0920-013 · OMB 0920-0848.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0848 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment C LMBP Data Collection -Submission Form.doc	Instruction
Attachment D_Draft LMBP Evidence Summary Table Format .doc Attachment D_Draft LMBP Evidence Summary Table Format	IC Document

IC Title:

Laboratory Medicine Best Practices Project Data Submission Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment C LMBP Data Collection -Submission Form.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 20

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment D_Draft LMBP Evidence Summary Table Format	Attachment D_Draft LMBP Evidence Summary Table Format .doc	11/20/2009

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