S&C QCOR CLIA 2567s
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CLIA 2567s
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Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific CLIA deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CLIA ID and Facility Name

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Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 03D2092106 Center For Dermatology, Pllc 11209 Tatum Blvd, Ste 175 Phoenix AZ 07/23/2024 FHVN11 Standard
Deficiency Tag Deficiency Description Tag Type
D5433 MAINTENANCE AND FUNCTION CHECKS Standard
D5803 TEST REPORT Standard
▼ 03D2092106 Center For Dermatology, Pllc 11209 Tatum Blvd, Ste 175 Phoenix AZ 10/21/2025 IJF211 Standard
Deficiency Tag Deficiency Description Tag Type
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5401 PROCEDURE MANUAL Standard
D5801 TEST REPORT Standard
▼ 03D2092594 Omni Dermatology, Inc 9305 W Thomas Rd, Ste 305 Phoenix AZ 04/06/2018 49L611 Standard
Deficiency Tag Deficiency Description Tag Type
D5211 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
▼ 03D2092598 Omni Dermatology, Inc 11851 N 51st Ave Ste E130 Glendale AZ 05/17/2019 OBSE11 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 03D2092598 Omni Dermatology, Inc 11851 N 51st Ave Ste E130 Glendale AZ 06/25/2024 ZSRL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5801 TEST REPORT Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 03D2092598 Omni Dermatology, Inc 11851 N 51st Ave Ste E130 Glendale AZ 09/15/2025 4GN811 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5401 PROCEDURE MANUAL Standard
▼ 03D2093418 Lake Havasu Primary Care 89 Civic Center Blvd Lake Havasu City AZ 01/24/2025 Z51N11 Complaint
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D1001 CERTIFICATE OF WAIVER TESTS Standard
▼ 03D2095148 Phoenix Sperm Bank 1492 S Mill Ave, Ste 306 Tempe AZ 02/27/2018 6CTN11 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
▼ 03D2098042 Kevin Concannon Llc Dba Em Diagnostics 7812 E Acoma Dr Ste 7 Scottsdale AZ 11/29/2022 EILN11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5301 TEST REQUEST Standard
D5391 PREANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5400 ANALYTIC SYSTEMS Condition
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5445 CONTROL PROCEDURES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5801 TEST REPORT Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6076 LABORATORY DIRECTOR Condition
D6087 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6102 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D2101446 Omni Dermatology, Inc 4515 S Mcclintock Dr Ste 101 Tempe AZ 03/27/2018 RXX411 Standard
Deficiency Tag Deficiency Description Tag Type
D5433 MAINTENANCE AND FUNCTION CHECKS Standard