| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 05P005 | (X3) Date Survey Completed 05/22/2014 |
| Name of Provider or Supplier Donor Network West | Street Address, City, State 12667 Alcosta Blvd, Suite 500, San Ramon, CA | |
| 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) |
| Z0000 | The following reflect the findings of the Centers for Medicare and Medicaid Services (CMS) during a recertification survey from May 19 - 22, 2014. This survey included investigation of a complaint (CA00399941) which was unsubstantiated and no deficiency was cited. |