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
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 11/16/2020 TT0W11 Standard
Deficiency Tag Deficiency Description Tag Type
D2123 HEMATOLOGY Standard
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 04/20/2021 M0JP11 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
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 09/12/2022 TP2811 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
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 12/14/2022 M0BG11 Standard
Deficiency Tag Deficiency Description Tag Type
D2088 ROUTINE CHEMISTRY Standard
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 04/13/2023 CKC311 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
▼ 05D0550065 William A Pullen Md 1301 20th St, Ste 550 Santa Monica CA 06/08/2023 C3MI11 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
▼ 05D0550092 St John's Physician Partners 2001 Santa Monica Blvd, Ste 560w Santa Monica CA 07/17/2024 U08411 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D5391 PREANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6007 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6036 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 05D0550213 Saint John's Physician Partners 2001 Santa Monica Blvd, Ste 970w Santa Monica CA 03/15/2021 OHCJ11 Standard
Deficiency Tag Deficiency Description Tag Type
D2099 ENDOCRINOLOGY Standard
D6087 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0550324 Westside Internal Medicine Laboratory 2121 Wilshire Blvd, 3rd Fl Lab Santa Monica CA 06/18/2019 KN1D11 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
▼ 05D0550324 Westside Internal Medicine Laboratory 2121 Wilshire Blvd, 3rd Fl Lab Santa Monica CA 02/10/2022 OZNC11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5401 PROCEDURE MANUAL Standard
D6031 LABORATORY DIRECTOR RESPONSIBILITIES Standard