(CMS-3427) End Stage Renal Disease Application and Survey and Certification Report Form and Supporting Regulations

OMB 0938-0360

OMB 0938-0360

This form is a facility identification and screening measurement used to initiate the certification and recertification of ESRD facilities.

The latest form for (CMS-3427) End Stage Renal Disease Application and Survey and Certification Report Form and Supporting Regulations expires 2022-03-31 and can be found here.


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