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PRINTED: 11/13/2017 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Facility number 009569 may be required by individuals or businesses who are applying for special permits, licenses, or certifications related to a particular facility.
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Facility number 009569 is a unique identification number assigned to a specific facility for tracking and regulatory purposes.
The facility owner or operator is required to file facility number 009569.
Facility number 009569 can be filled out by providing the necessary information about the facility, such as location, size, and activities conducted.
The purpose of facility number 009569 is to ensure regulatory compliance and track information about the specific facility.
Information such as facility location, size, activities conducted, and any potential hazards must be reported on facility number 009569.
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