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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/CLIAAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15555709/16/2015FORM
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Complaint in00177595 is a verified assertion that specific issues have been validated through evidence, resulting in a finding of merit.
Individuals or entities who have been directly affected by the issue or have valid concerns typically are required to file complaint in00177595.
To fill out the complaint, gather necessary evidence, provide detailed descriptions of the incidents, and submit the completed form to the appropriate authority.
The purpose of the complaint is to formally document concerns, ensure accountability, and initiate corrective actions where warranted.
The complaint must include the complainant's details, a clear description of the incident, supporting evidence, and any relevant dates.
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