| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 883829 | (X3) Date Survey Completed 02/09/2026 |
| Name of Provider or Supplier Humboldt Family Walk-In Clinic Llc | Street Address, City, State 1600 Coleman Drive, Humboldt, TN | |
| 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) |
| J0000 | An unannounced visit was made on 2/9/2026, at 9:00 AM for a recertification survey. The facility was cited Standard level deficiencies in the Conditions of Coverage for Rural Health Clinics. An exit conference was held on 2/9/2026, at 1:40 PM with the Owner, and she was informed of deficient findings during the survey. |