View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0938-0544	ICR Reference No: 199502-0938-005
Status: Historical Active	Previous ICR Reference No: 199401-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: SURVEY REPORT FORM (CLIA)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/22/1995
	Date Received in OIRA: 02/21/1995
Terms of Clearance: Approved for use through 12/96 under the condition that the next submission for OMB review incorporates all amendments to CLIA rules that have been finalized by that date.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1996	12/31/1996	06/30/1995
Responses	30,225	0	0
Time Burden (Hours)	16,322	0	16,848
Cost Burden (Dollars)	0	0	0

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