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
▼ 04D0957619 William H Freeman, Md, Pa 600 Club Lane Conway AR 04/15/2024 HP8D11 Standard
Deficiency Tag Deficiency Description Tag Type
D5313 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6032 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0958035 Community Physicians/Sager Pediatric 1101-2 North Progress Ave Siloam Springs AR 05/24/2018 GVEU11 Standard
Deficiency Tag Deficiency Description Tag Type
D1001 CERTIFICATE OF WAIVER TESTS Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
▼ 04D0958035 Community Physicians/Sager Pediatric 1101-2 North Progress Ave Siloam Springs AR 01/16/2020 Q2JQ11 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
▼ 04D0958035 Community Physicians/Sager Pediatric 1101-2 North Progress Ave Siloam Springs AR 01/12/2023 JK4O11 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
▼ 04D0958035 Community Physicians/Sager Pediatric 1101-2 North Progress Ave Siloam Springs AR 08/28/2023 JW9Y11 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0958089 Randy D Roberts, Md 1000 East Matthews Jonesboro AR 08/08/2018 H2GD11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2017 REINSTATEMENT OF NONWAIVED LABORATORIES Condition
D2130 HEMATOLOGY Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6021 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D0958089 Randy D Roberts, Md 1000 East Matthews Jonesboro AR 03/02/2021 IEVK11 Standard
Deficiency Tag Deficiency Description Tag Type
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D0958089 Randy D Roberts, Md 1000 East Matthews Jonesboro AR 09/17/2024 12FQ11 Standard
Deficiency Tag Deficiency Description Tag Type
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard
▼ 04D0962525 Dermatology Center, Pllc 7900 Dallas Street Fort Smith AR 08/11/2022 HX6F11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5473 CONTROL PROCEDURES Standard
▼ 04D0962525 Dermatology Center, Pllc 7900 Dallas Street Fort Smith AR 05/15/2024 DD0V11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5435 MAINTENANCE AND FUNCTION CHECKS Standard