OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Laboratory Personnel Report (CLIA) and Supporting Regulations (CMS-209)

OMB 0938-0151 · HHS/CMS.

OMB 0938-0151

This form is used by the State agency to determine a laboratory's compliance with personnel qualifications under CLIA. This information is needed for a laboratory's CLIA certification and recertification.

The latest form for Laboratory Personnel Report (CLIA) and Supporting Regulations (CMS-209) expires 2028-08-31 and is listed under ICR 202504-0938-016.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-209 Laboratory Personnel Report (CLIA)Form and Instruction
Form CMS-209 Laboratory Personnel Report (CLIA) and Supporting Regulations in 42 CFR 493.1 - 493.2001Form and Instruction
CMS-209 Response Public_Comment 2025.docxSupplementary Document
CMS-209 Response Public_Comment 2025.docx Supplementary Document
CMS-2025-0003-0002.html (document unavailable)Public Comments
CMS-209 Supporting Statement A 2024 CLEAN 12.17.24.docxSupporting Statement A
CMS-209 Supporting Statement A 2024 CLEAN 12.17.24.docxSupporting Statement A
Laboratory Personnel Report (CLIA) and Supporting Regulations in 42 CFR 493.1 - 493.2001 Form and Instruction
Laboratory Personnel Report (CLIA) and Supporting Regulations in 42 CFR 493.1 - 493.2001 Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202504-0938-016 Reinstatement with change of a previously approved collection 2025-05-14
202106-0938-009 Revision of a currently approved collection 2021-06-22 Approved without change
201803-0938-006 Revision of a currently approved collection 2018-03-27 Approved with change
201502-0938-006 Extension without change of a currently approved collection 2015-02-23 Approved with change
201201-0938-005 Extension without change of a currently approved collection 2012-01-31 Approved without change
200808-0938-001 Extension without change of a currently approved collection 2008-08-08 Approved without change
200505-0938-005 Extension without change of a currently approved collection 2005-05-16 Approved with change
200302-0938-008 Extension without change of a currently approved collection 2003-02-25 Approved with change
199912-0938-008 Extension without change of a currently approved collection 1999-12-27 Approved without change
199610-0938-007 Extension without change of a currently approved collection 1996-10-29 Approved without change
199410-0938-016 Revision of a currently approved collection 1994-10-31 Approved without change
199310-0938-011 Reinstatement with change of a previously approved collection 1993-10-04 Approved without change
199207-0938-008 Reinstatement with change of a previously approved collection 1992-07-13 Approved without change
199103-0938-012 Reinstatement with change of a previously approved collection 1991-03-14 Approved without change
199003-0938-003 Reinstatement with change of a previously approved collection 1990-03-12 Approved without change
198805-0938-002 Reinstatement with change of a previously approved collection 1988-05-26 Approved without change
198502-0938-004 Extension without change of a currently approved collection 1985-02-14 Approved without change
198404-0938-002 Revision of a currently approved collection 1984-04-13 Approved without change
198305-0938-008 No material or nonsubstantive change to a currently approved collection 1983-05-18 Approved with change
198204-0938-013 Extension without change of a currently approved collection 1982-04-12 Approved without change
198102-0938-004 New collection (Request for a new OMB Control Number) 1981-02-05 Approved without change