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PRINTED: 01/04/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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The form facility was found is a documentation used to report specific information about certain facilities, typically related to compliance with environmental regulations.
Entities operating facilities that fall under specific regulatory requirements, usually in the environmental sector, are required to file this form.
To fill out the form, follow the instructions provided with the form, ensure all required fields are completed, and provide accurate information regarding the facility's operations and compliance.
The purpose of the form is to ensure that facilities comply with regulatory standards and to provide necessary information for monitoring and enforcement by regulatory agencies.
Information that must be reported includes facility identification details, operational data, compliance status, and any relevant environmental impact information.
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