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End-Stage Renal Dialysis Facility Change of Administrator
This page contains instructions for submitting a change of an administrator for an end-stage renal dialysis facility in Minnesota.
Provide written notice on facility letterhead and include the following:
- Health Facility Identification Number (HFID).
- CMS Certification Number (CCN).
- Name and address of facility.
- Change that has occurred.
- Date of change.
- Letter signed by authorized official.
Mail or email letter to:
Minnesota Department of Health
Health Regulation Division
Licensing and Certification Program
P.O. Box 64900
St. Paul, Minnesota 55164-0900
Attn: Certification Specialist