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
▼ 04D0933981 Northwest Medical Plaza- Westside 4077 Elm Springs Rd Ste 105 Springdale AR 03/23/2021 L6UF11 Standard
Deficiency Tag Deficiency Description Tag Type
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 04D0933981 Northwest Medical Plaza- Westside 4077 Elm Springs Rd Ste 105 Springdale AR 02/08/2023 GZWW11 Standard
Deficiency Tag Deficiency Description Tag Type
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
▼ 04D0937388 Baptist Health Family Clinic - South 8600 South 36th Terrace Ste A Fort Smith AR 08/09/2022 ZZTN11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0938641 Chi St Vincent Medical Group Hot Springs 319 East 13th Street Murfreesboro AR 04/13/2021 FRDX11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0939043 Mercy Laboratory Services - Highway 102 3101 Se 14th Street Bentonville AR 05/22/2018 VGXG11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
▼ 04D0939857 St Vincent Family Clinic-Rodney Parham 10000 Rodney Parham Little Rock AR 01/02/2018 BTFL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
▼ 04D0939862 Chi St Vincent Primary And Convenient Care - Kanis 10301 Kanis Suite 1 Little Rock AR 01/03/2018 P3CH11 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5469 CONTROL PROCEDURES Standard
▼ 04D0939862 Chi St Vincent Primary And Convenient Care - Kanis 10301 Kanis Suite 1 Little Rock AR 08/09/2024 83NE11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6063 LABORATORY TESTING PERSONNEL Condition
D6065 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 04D0939863 St Vincent Family Clinic - Jacksonville 1110 W Main Street Jacksonville AR 02/04/2020 9Z4W11 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
▼ 04D0939863 St Vincent Family Clinic - Jacksonville 1110 W Main Street Jacksonville AR 01/08/2025 1PXM11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
D2131 HEMATOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard