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
▼ 05D0547058 Protzel Pathology Laboratory 9735 Wilshire Blvd Ste 241 Beverly Hills CA 04/08/2021 QKB411 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 05D0547058 Protzel Pathology Laboratory 9735 Wilshire Blvd Ste 241 Beverly Hills CA 04/06/2022 LISY11 Special
Deficiency Tag Deficiency Description Tag Type
D3011 FACILITIES Standard
D3041 RETENTION REQUIREMENTS Standard
D5032 CYTOLOGY Condition
D5201 CONFIDENTIALITY OF PATIENT INFORMATION Standard
D5205 COMPLAINT INVESTIGATIONS Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5309 TEST REQUEST Standard
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5391 PREANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5403 PROCEDURE MANUAL Standard
D5629 CYTOLOGY Standard
D5633 CYTOLOGY Standard
D5637 CYTOLOGY Standard
D5641 CYTOLOGY Standard
D5645 CYTOLOGY Standard
D5647 CYTOLOGY Standard
D5655 CYTOLOGY Standard
D5657 CYTOLOGY Standard
D5659 CYTOLOGY Standard
D5663 CYTOLOGY Standard
D5787 TEST RECORDS Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6076 LABORATORY DIRECTOR Condition
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6098 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6130 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6133 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D9999 null Memo
▼ 05D0547058 Protzel Pathology Laboratory 9735 Wilshire Blvd Ste 241 Beverly Hills CA 11/15/2022 LISY12 null
Deficiency Tag Deficiency Description Tag Type
D3013 FACILITIES Standard
D5401 PROCEDURE MANUAL Standard
D6079 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6106 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0547251 Prostate Oncology Specialist, Inc 4650 Admiralty Way, Ste 111 Marina Del Rey CA 09/10/2018 5WDC11 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D2121 HEMATOLOGY Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5781 CORRECTIVE ACTIONS Standard
D6021 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 05D0547251 Prostate Oncology Specialist, Inc 4650 Admiralty Way, Ste 111 Marina Del Rey CA 07/23/2020 SO9Y11 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
▼ 05D0547251 Prostate Oncology Specialist, Inc 4650 Admiralty Way, Ste 111 Marina Del Rey CA 08/01/2022 IDFE11 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
▼ 05D0548135 Community And Mission Hospital Of Huntington Park 2623 E Slauson Ave Huntington Park CA 09/11/2025 QOBI11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D5401 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5543 HEMATOLOGY Standard
D6168 TESTING PERSONNEL Condition
D6171 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 05D0548259 Michael B Scott Md Inc 3637 Martin Luther King Jr Blvd Ste B Lynwood CA 03/08/2018 XDKS11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 05D0548259 Michael B Scott Md Inc 3637 Martin Luther King Jr Blvd Ste B Lynwood CA 02/26/2021 W5DW11 Standard
Deficiency Tag Deficiency Description Tag Type
D2028 BACTERIOLOGY Standard
D6018 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 04/30/2018 1S0R11 Standard
Deficiency Tag Deficiency Description Tag Type
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6042 TECHNICAL CONSULTANT RESPONSIBILITIES Standard