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
▼ 04D1034085 Premier Dermatology Pllc 901 Se Plaza Ave, Suite 5 Bentonville AR 07/23/2021 RIOQ11 Standard
Deficiency Tag Deficiency Description Tag Type
D6107 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D1034085 Premier Dermatology Pllc 901 Se Plaza Ave, Suite 5 Bentonville AR 09/07/2023 V1T011 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D1034085 Premier Dermatology Pllc 901 Se Plaza Ave, Suite 5 Bentonville AR 05/15/2025 169711 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D1038322 Hendrix Medical Clinic 2709 West Kingshighway, Suite 6 Paragould AR 01/19/2021 BPDH11 Standard
Deficiency Tag Deficiency Description Tag Type
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 04D1038322 Hendrix Medical Clinic 2709 West Kingshighway, Suite 6 Paragould AR 12/30/2021 VLE611 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
▼ 04D1038322 Hendrix Medical Clinic 2709 West Kingshighway, Suite 6 Paragould AR 07/31/2026 F54Y11 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
▼ 04D1038350 Arkansas Surgical Hospital Llc 5201 North Shore Drive North Little Rock AR 09/24/2025 U8MM11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5779 CORRECTIVE ACTIONS Standard
▼ 04D1039733 Unity Health Searcy Medical Center West Clinic 2505 West Beebe Capps Expressway Searcy AR 07/17/2025 ZCCR11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 04D1040463 Northwest Medical Plaza At Pinnacle 2000 S 42nd St, Suite #100 Rogers AR 07/11/2019 B98711 Standard
Deficiency Tag Deficiency Description Tag Type
D6032 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 04D1047702 Mana Urgent Care Wedington 1188 Salem Road, Suite 6 Fayetteville AR 10/11/2018 3X2P11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D6032 LABORATORY DIRECTOR RESPONSIBILITIES Standard