Information Collection

Request for CLIA categorization

IC 180758 under ICR 201910-0910-003 · OMB 0910-0607.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0607 can be found here:

Documents and Forms

Document Name Document Type
0607_Guidance.pdf Other-Guidance; Administrative Proce

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for CLIA categorization	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Guidance; Administrative Procedures for CLIA Categorization			0607_Guidance.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	400	-500	900
Annual IC Time Burden (Hours)	400	-500	900
Annual IC Cost Burden (Dollars)	2,000	-44,800	46,800

Documents for IC

Title	Document	Date Uploaded
No associated records found

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