| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 012306 | (X3) Date Survey Completed 06/24/2021 |
| Name of Provider or Supplier Childrens Hospital Of Alabama Esrd | Street Address, City, State 1600 7th Avenue South, Birmingham, 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) |
| V0000 | "CORE" |