Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 01C0001002 (X3) Date Survey Completed 04/10/2025
Name of Provider or Supplier Mobile-Sc, Ltd Street Address, City, State 6144 A Airport Boulevard, Mobile, AL
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
Q0000 A recertification survey was conducted on 4/8/25 to 4/10/25 at Mobile Surgery Center, an Ambulatory Surgical Center with five Operating Rooms and three Procedure Rooms.

Standard Level deficiencies were cited and will require an acceptable Plan of Correction.