State, Local, or Tribal Governments - Post Cinical Laboratory Survey Questionnaire and Supporting Regulations in 42 CFR 493.1771, 483.1773, and 493.1777

Post Cinical Laboratory Survey Questionnaire and Supporting Regulations in 42 CFR 493.1771, 483.1773, and 493.1777 (CMS-668B)

OMB: 0938-0653

IC ID: 202097

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State, Local, or Tribal Governments - Post Cinical Laboratory Survey Questionnaire and Supporting Regulations in 42 CFR 493.1771, 483.1773, and 493.1777
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-668B Post Clinical Laboratory Survey Questionnaire CMS668B.pdf Yes No Fillable Fileable

Health Health Care Services

 

1,319 301
   
State, Local, and Tribal Governments
 
   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 660 0 15 0 0 645
Annual IC Time Burden (Hours) 165 0 4 0 0 161
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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