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
▼ 04D0468729 Gentry Medical Center 643 East Third Street Gentry AR 12/29/2020 0GG911 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0468752 West Washington County Clinic 106 Park St Lincoln AR 08/06/2025 QPK111 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2127 HEMATOLOGY Standard
D2131 HEMATOLOGY Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5781 CORRECTIVE ACTIONS Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6017 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0468859 Siloam Springs Medical Center 451 South Holly Street Siloam Springs AR 05/23/2018 BXBC11 Standard
Deficiency Tag Deficiency Description Tag Type
D5293 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5783 CORRECTIVE ACTIONS Standard
D6032 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0468859 Siloam Springs Medical Center 451 South Holly Street Siloam Springs AR 01/17/2020 VUR811 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5783 CORRECTIVE ACTIONS Standard
▼ 04D0468859 Siloam Springs Medical Center 451 South Holly Street Siloam Springs AR 07/20/2022 17V311 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5783 CORRECTIVE ACTIONS Standard
▼ 04D0468881 Mana Family Medicine Springdale 1109 S West End Street Springdale AR 11/17/2020 CZTO11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
▼ 04D0468881 Mana Family Medicine Springdale 1109 S West End Street Springdale AR 12/06/2022 HFWU11 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
▼ 04D0468881 Mana Family Medicine Springdale 1109 S West End Street Springdale AR 08/20/2024 JOUO11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
▼ 04D0468970 Conway Regional Medical Clinic -Russellville 108 Skyline Drive Russellville AR 06/19/2024 LJO311 Standard
Deficiency Tag Deficiency Description Tag Type
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 04D0468990 Millard Henry Clinic 101 Skyline Dr Russellville AR 01/22/2018 59N112 Standard
Deficiency Tag Deficiency Description Tag Type
D5477 CONTROL PROCEDURES null
D5805 TEST REPORT null