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.

CLIA ID Facility Name Address City State Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 04D0467679 Pediatric Associates Of West Memphis 108 West Tyler West Memphis AR 05/09/2024 QIPT11 Standard
Deficiency Tag Deficiency Description Tag Type
D5813 TEST REPORT Standard
▼ 04D0467710 Family Medicine Assoc Of Blytheville 1521 N Tenth Suite C Blytheville AR 01/16/2020 J0WO11 Standard
Deficiency Tag Deficiency Description Tag Type
D5449 CONTROL PROCEDURES Standard
▼ 04D0467710 Family Medicine Assoc Of Blytheville 1521 N Tenth Suite C Blytheville AR 07/20/2022 5IWX11 Standard
Deficiency Tag Deficiency Description Tag Type
D1001 CERTIFICATE OF WAIVER TESTS Standard
D5441 CONTROL PROCEDURES Standard
▼ 04D0467710 Family Medicine Assoc Of Blytheville 1521 N Tenth Suite C Blytheville AR 03/29/2023 CN7H11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0467710 Family Medicine Assoc Of Blytheville 1521 N Tenth Suite C Blytheville AR 03/25/2025 Z40C11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2107 ENDOCRINOLOGY Standard
D2108 ENDOCRINOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0467710 Family Medicine Assoc Of Blytheville 1521 N Tenth Suite C Blytheville AR 02/25/2026 2SR811 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0467710 Family Medicine Assoc Of Blytheville 1521 N Tenth Suite C Blytheville AR 07/31/2026 VTCH11 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0467719 Mississippi County Hospital System 1520 North Division Street Blytheville AR 07/26/2018 Z0H011 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5783 CORRECTIVE ACTIONS Standard
▼ 04D0467800 Helena Regional Medical Center 1801 Martin Luther King Jr Drive Helena AR 02/13/2025 QGTA11 Standard
Deficiency Tag Deficiency Description Tag Type
D2000 ENROLLMENT AND TESTING OF SAMPLES Condition
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5441 CONTROL PROCEDURES Standard
▼ 04D0467888 Baptist Urgent Clinic 411 South Falls Blvd Wynne AR 01/19/2018 BAL512 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES null