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06/20/2022PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/CLIAAND PLAN OF CORRECTIONIDENTIFICATION

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Survey date 053122 refers to a specific date, May 31, 2022, designated for a particular data collection or reporting requirement.

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Entities or individuals specified by the governing body or organization overseeing the survey are required to file survey date 053122.

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