Information Collection Request

CLIA Proficiency Testing (PT) (CMS-10690)

ICR 202206-0938-003 · OMB 0938-1357 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10690 Supporting Statement Part A final 7-11-22.docx Supporting Statement A Uploaded 2022-07-11 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
234841 PT Program Reapproval Unchanged
234840 Submission of PT Data by Laboratories Removed
234838 Clarification for Reporting of Microbiology Organism Indentification Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2025 36 Months From Approved
350 0 0
431 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Clarification for Reporting of Microbiology Organism Indentification
PT Program Reapproval
Submission of PT Data by Laboratories

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 350 0 0 350 0 0
Annual Time Burden (Hours) 431 0 0 431 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No