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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.