Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Federal Government - Survey Report Form Clinical Laboratory Improvement Amendments (CLIA) and supporting regulations in 42 CFR 493.1-493.2001 New 43 22 0 Form and Instruction CMS-1557
Private Sector - Survey Report Form Clinical Laboratory Improvement Amendments (CLIA) and supporting regulations in 42 CFR 493.1-493.2001 Modified 9556 4778 0 Form and Instruction CMS-1557
State, Local, or Tribal Governments - Survey Report Form Clinical Laboratory Improvement Amendments (CLIA) and supporting regulations in 42 CFR 493.1-493.2001 New 645 323 0 Form and Instruction CMS-1557
Total burden requested under this ICR: 10244 5123 0  
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