Information Collection

57.155 Point of Care Testing Results - CSV

IC 271935 under ICR 202602-0920-005 · OMB 0920-1317.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 57.155 Point of Care Testing Results 57.155 Point of Care Testing Results - CSV	Form and Instruction
Form 0920-1317 Point of Care Testing Results - 11FEB2026 57.155 Point of Care Testing Results - CSV	Form and Instruction
57.155 Point of Care Testing Results 57.155_Point of Care Testing_Jan 2025_Clean.docx	Form and Instruction
0920-1317 Point of Care Testing Results - 11FEB2026 57.155 Point of Care Testing-Clean.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

57.155

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	57.155			N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1317			N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,135

Number of Respondents for Small Entity: 0

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	470,250	0	470,250
Annual IC Time Burden (Hours)	86,213	-7,837	94,050
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.

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