S&C QCOR CLIA 2567s
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CLIA 2567s
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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
▼ 04D0689262 Dallas County Medical Center 201 Clifton Street Fordyce AR 04/30/2021 W9EP11 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 04D0689262 Dallas County Medical Center 201 Clifton Street Fordyce AR 10/26/2021 IILY11 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
▼ 04D0689262 Dallas County Medical Center 201 Clifton Street Fordyce AR 03/30/2023 IJWO11 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5441 CONTROL PROCEDURES Standard
D5477 CONTROL PROCEDURES Standard
D5813 TEST REPORT Standard
▼ 04D0689262 Dallas County Medical Center 201 Clifton Street Fordyce AR 11/21/2024 EHH711 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D3015 REQUIREMENTS FOR TRANSFUSION SERVICES Standard
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0689677 Baptist Health Family Clinic Ellsworth Road 5428 Ellsworth Road, Suite A & B Fort Smith AR 01/25/2018 PM4T11 Standard
Deficiency Tag Deficiency Description Tag Type
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0690634 Harrison Family Practice Clinic - Washington Reg 715 West Sherman Suite G Harrison AR 05/16/2018 ZZB611 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0691658 Family Medical Care 2225 Hwy 110 West Heber Springs AR 02/07/2024 DR9111 Standard
Deficiency Tag Deficiency Description Tag Type
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6033 TECHNICAL CONSULTANT-MODERATE COMPLEXITY Condition
D6043 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 04D0692790 Uams Cancer Institute Dermatology Oncology Clinic 4301 West Markham St Little Rock AR 05/06/2021 5RMI11 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6084 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6128 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 04D0692790 Uams Cancer Institute Dermatology Oncology Clinic 4301 West Markham St Little Rock AR 02/22/2023 N13S11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6107 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0693601 Lakeside Family Medicine 124 Hollywood Avenue Hot Springs AR 10/18/2022 8PHB11 Standard
Deficiency Tag Deficiency Description Tag Type
D5429 MAINTENANCE AND FUNCTION CHECKS Standard