Clinical Laboratory Improvement Amendments Application Form 42 CFR 493.1-.2001 (CMS-116)

Clinical Laboratory Improvement Amendments Application Form 42 CFR 493.1-.2001

OMB: 0938-0581

IC ID: 8193

Information Collection (IC) Details

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Clinical Laboratory Improvement Amendments Application Form 42 CFR 493.1-.2001 (CMS-116)
 
No Modified
 
Mandatory
 
42 CFR 493.1-2001

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-116 CLIA Application for Certification Final CLIA116.11.6.13.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

242,000 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   0 %

  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 34,200 0 2,680 0 0 31,520
Annual IC Time Burden (Hours) 25,650 0 2,010 0 0 23,640
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk Crosswalk_2013_sept_13_2013.doc 03/04/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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