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06/29/2022PRINTED: 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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Facility number 000691 is a unique identification code assigned to a specific facility for regulatory and reporting purposes.
Entities operating the facility identified by number 000691 are required to file the necessary reports or documentation associated with it.
To fill out facility number 000691, complete the required forms with accurate information regarding the facility's operations, ownership, and compliance details.
The purpose of facility number 000691 is to track and manage regulatory compliance, environmental impact, and operational data for the facility in question.
Information that must be reported includes operational status, safety procedures, ownership details, and any incidents or compliance issues related to the facility.
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