Information Collection

Reference Labs

IC 211394 under ICR 201402-0920-018 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Data Collection Instrument Reference Labs	Form
Data Collection Instrument RefLab- C- IC web.docx	Form
RefLab- D- IC Word.rtf Word Data Collection Instrument	IC Document
RefLab- A- Satisfaction Report.docx Satisfaction Report	IC Document
RefLab- B- Lab List.docx CDC IDLs List	IC Document
RefLab- E- Intro Email.docx Email Invite	IC Document
RefLab- F- APHL Notice.docx APHL eUpdate	IC Document
RefLab- G- Reminder.docx Email Reminder Nonresponders	IC Document
RefLab- H- APHL Reminder.docx APHL eUpdate Reminder	IC Document
RefLab- SSA.docx SSA	IC Document
RefLab- SSB.docx SSB	IC Document

IC Title:

Reference Labs

Agency IC Tracking Number:

14VO

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
Form	none				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	55	55
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Word Data Collection Instrument		04/24/2014
Satisfaction Report		04/24/2014
CDC IDLs List		04/24/2014
Email Invite		04/24/2014
APHL eUpdate		04/24/2014
Email Reminder Nonresponders		04/24/2014
APHL eUpdate Reminder		04/24/2014
SSA		04/24/2014
SSB		04/24/2014

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].