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 can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form and Instruction
Supplementary Document
Supporting Statement A
All Historical Document Collections
 Reinstatement with change of a previously approved collection 2025-05-14
Approved without change
 Revision of a currently approved collection 2021-06-22
Approved with change
 Revision of a currently approved collection 2018-03-27
Approved with change
 Extension without change of a currently approved collection 2015-02-23
Approved without change
 Extension without change of a currently approved collection 2012-01-31
Approved without change
 Extension without change of a currently approved collection 2008-08-08
Approved with change
 Extension without change of a currently approved collection 2005-05-16
Approved with change
 Extension without change of a currently approved collection 2003-02-25
Approved without change
 Extension without change of a currently approved collection 1999-12-27
Approved without change
 Extension without change of a currently approved collection 1996-10-29
Approved without change
 Revision of a currently approved collection 1994-10-31
Approved without change
 Reinstatement with change of a previously approved collection 1993-10-04
Approved without change
 Reinstatement with change of a previously approved collection 1992-07-13
Approved without change
 Reinstatement with change of a previously approved collection 1991-03-14
Approved without change
 Reinstatement with change of a previously approved collection 1990-03-12
Approved without change
 Reinstatement with change of a previously approved collection 1988-05-26
Approved without change
 Extension without change of a currently approved collection 1985-02-14
Approved without change
 Revision of a currently approved collection 1984-04-13
Approved with change
 No material or nonsubstantive change to a currently approved collection 1983-05-18
Approved without change
 Extension without change of a currently approved collection 1982-04-12
Approved without change
 New collection (Request for a new OMB Control Number) 1981-02-05