Information Collection

Registrations and Recertifications for Entities other than Hospitals

IC 190347 under ICR 202601-0915-001 · OMB 0915-0327.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2.1 340B Registration CHC and FQHCLA.pdf Registrations and Recertifications for Entities other than Hospitals	Form
Form 2.2 340B Registration STD and TB.pdf Registrations and Recertifications for Entities other than Hospitals	Form
Form 2.3 340B Registration-Covered Entities All Other Non-Hospitals.pdf Registrations and Recertifications for Entities other than Hospitals	Form
Form 2.4 340B Recertfication STD and TB.pdf Registrations and Recertifications for Entities other than Hospitals	Form
Form 2.5 340B Recertification CHC and FQHCLA.pdf Registrations and Recertifications for Entities other than Hospitals	Form
Form 2.6 340B Recertification Covered Entities All Other Non-Hospital..pdf Registrations and Recertifications for Entities other than Hospitals	Form
2.1 340B Registration CHC and FQHCLA.pdf 340B Registration-Community Health Center.docx.pdf	Form
2.2 340B Registration STD and TB.pdf 340B Registration-STD.TB.pdf	Form
2.3 340B Registration-Covered Entities All Other Non-Hospita 340B Registration-Covered Entities All Other.docx.pdf	Form
2.4 340B Recertfication STD and TB.pdf 340B Recertfication-STD.TB.pdf	Form
2.5 340B Recertification CHC and FQHCLA.pdf 340B Recertification-Community Health Center and Look alike.pdf	Form
2.6 340B Recertification Covered Entities All Other Non-Hosp 340B Recertification-Covered Entities All Other.pdf	Form
340B Registration-Community Health Center Redline.pdf 340B Registration-Community Health Center Redline	IC Document
340B Registration-Covered Entities All Other Redline.docx.pdf 340B Registration-Covered Entities All Other Redline.docx	IC Document
340B Registration-STD.TB Redline.pdf 340B Registration-STD.TB Redline	IC Document
340B Recertfication-STD Redline.pdf 340B Recertfication-STD Redline	IC Document
340B Recertification-Community Health Center and Look alike Redline.pdf 340B Recertification-Community Health Center and Look alike Redline	IC Document
340B Recertification-Covered Entities All Other redline.pdf 340B Recertification-Covered Entities All Other redline	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Registrations and Recertifications for Entities other than Hospitals

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2.1	Yes	Yes	Fillable Fileable
Form	2.2	Yes	Yes	Fillable Fileable
Form	2.3	Yes	Yes	Fillable Fileable
Form	2.4	Yes	Yes	Fillable Fileable
Form	2.5	Yes	Yes	Fillable Fileable
Form	2.6	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12,527

Number of Respondents for Small Entity: 1,308

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	24,267	5,114	19,153
Annual IC Time Burden (Hours)	7,372	1,302	6,070
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
340B Registration-Community Health Center Redline		01/08/2026
340B Registration-Covered Entities All Other Redline.docx		01/08/2026
340B Registration-STD.TB Redline		01/08/2026
340B Recertfication-STD Redline		01/08/2026
340B Recertification-Community Health Center and Look alike Redline		01/08/2026
340B Recertification-Covered Entities All Other redline		01/08/2026

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].