S&C QCOR CLIA 2567s
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CLIA 2567s
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Time Interval

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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

Use these filters if you know the name (or partial name) of the facility you are searching for.

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
▼ 03D2124326 Copper Queen Community Hospital 100 E 5th St Douglas AZ 05/15/2020 6RC011 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2116 TOXICOLOGY Standard
D2118 TOXICOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D2124326 Copper Queen Community Hospital 100 E 5th St Douglas AZ 02/02/2021 B0G811 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2094 ROUTINE CHEMISTRY Standard
D2096 ROUTINE CHEMISTRY Standard
D2116 TOXICOLOGY Standard
D2118 TOXICOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D2124326 Copper Queen Community Hospital 100 E 5th St Douglas AZ 07/12/2021 QM3Z11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2094 ROUTINE CHEMISTRY Standard
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D2124326 Copper Queen Community Hospital 100 E 5th St Douglas AZ 05/16/2023 8X0K11 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2094 ROUTINE CHEMISTRY Standard
D2096 ROUTINE CHEMISTRY Standard
D2116 TOXICOLOGY Standard
D2118 TOXICOLOGY Standard
D3031 RETENTION REQUIREMENTS Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5469 CONTROL PROCEDURES Standard
D5473 CONTROL PROCEDURES Standard
D5545 HEMATOLOGY Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6076 LABORATORY DIRECTOR Condition
D6089 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 03D2125615 Robert Tomec Md Home Office 1820 W Calle De Pompas Phoenix AZ 11/19/2019 C61911 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
▼ 03D2126022 Pima Heart Asc, Llc 1238 W Orange Grove Rd, Ste 101 Tucson AZ 05/23/2023 HBDG11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6029 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D2126022 Pima Heart Asc, Llc 1238 W Orange Grove Rd, Ste 101 Tucson AZ 06/24/2025 8NF711 Standard
Deficiency Tag Deficiency Description Tag Type
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
▼ 03D2128012 Premier Medical Group Laboratory 5005 S Ash Ave Suite A-2 Tempe AZ 06/07/2018 IF7811 Standard
Deficiency Tag Deficiency Description Tag Type
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
▼ 03D2128012 Premier Medical Group Laboratory 5005 S Ash Ave Suite A-2 Tempe AZ 02/11/2020 KH6Z11 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5435 MAINTENANCE AND FUNCTION CHECKS Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5801 TEST REPORT Standard
D6031 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D2128012 Premier Medical Group Laboratory 5005 S Ash Ave Suite A-2 Tempe AZ 12/15/2022 96OK11 Standard
Deficiency Tag Deficiency Description Tag Type
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5801 TEST REPORT Standard
D6102 LABORATORY DIRECTOR RESPONSIBILITIES Standard