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 012512 (X3) Date Survey Completed 11/17/2022
Name of Provider or Supplier Fmc Dialysis Services Selma Street Address, City, State 905 Medical Center Parkway, Selma, 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' A recertification survey was conducted on 11/15/22 to 11/17/22 at Fresenius Medical Care Dialysis Services Selma with standard level deficiencies cited.