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06/07/2023PRINTED: 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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The purpose of complaint in00402472 is to formally document and report an issue that requires attention and to initiate an investigation or resolution process.

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Information that must be reported includes the complainant's contact details, a detailed description of the incident, dates and times of occurrence, and any relevant evidence or documentation.

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