Form CMS-10639 Request Letter to Facilities Records
National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) (CMS-10639)
CMS_10639_NHSN Request Letter to Facilities_Records_Template
National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP)
OMB: 0938-1340
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1340 can be found here:
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