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View ICR - OIRA Conclusion

OMB Control No: 0938-0544	ICR Reference No: 199401-0938-007
Status: Historical Active	Previous ICR Reference No: 199306-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: SURVEY REPORT FORM (CLIA)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/01/1994
	Date Received in OIRA: 01/31/1994
Terms of Clearance: Approved for use through 3/95 unless the implementing CLIA regulations are amended, in which case CLIA should revise these survey guidelines as appropriate and expeditiously resubmit for OMB review.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1995	06/30/1995	01/31/1994
Responses	31,200	0	31,200
Time Burden (Hours)	16,848	0	16,848
Cost Burden (Dollars)	0	0	0

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