| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 852540 | (X3) Date Survey Completed 04/20/2018 |
| Name of Provider or Supplier Camilla Dialysis | Street Address, City, State 251 Us 19 N, Camilla, GA | |
| 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) |
| E0000 | At the time of the survey, Mitchell County Dialysis was in compliance with 42 CFR Part 494.62, Emergency Preparedness Plan for End Stage Renal Dialysis Facilities, as a result of a Recertification survey. No deficiencies were cited. |