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Laboratory Medicine Best Practices Project Data Submission Form
Laboratory Medicine Best Practices Project
OMB: 0920-0848
IC ID: 192353
OMB.report
HHS/CDC
OMB 0920-0848
ICR 201204-0920-003
IC 192353
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0848 can be found here:
2013-04-17 - No material or nonsubstantive change to a currently approved collection
2013-02-15 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment C LMBP Data Collection -Submission Form.doc
Instruction
Attachment 2 LMBP Data Instructions.docx
Instruction
1 LMBP Quality Improvement (QI) Data Submission Form
Attachment 1 Revised Data Submission Form.doc
Form
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:
Modified
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
Instruction
Attachment 2 LMBP Data Instructions.docx
Yes
No
Paper Only
Form
1
LMBP Quality Improvement (QI) Data Submission Form
Attachment 1 Revised Data Submission Form.doc
No
No
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:
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 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
150
0
0
0
0
150
Annual IC Time Burden (Hours)
100
0
0
0
0
100
Annual IC Cost Burden (Dollars)
0
0
0
0
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.