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

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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
▼ 05D0609327 Dr Stuart Jacobs Md 5345 N El Dorado St, Ste 12 Stockton CA 07/09/2019 T27211 Standard
Deficiency Tag Deficiency Description Tag Type
D5200 GENERAL LABORATORY SYSTEMS Condition
D5403 PROCEDURE MANUAL Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5449 CONTROL PROCEDURES Standard
D5601 HISTOPATHOLOGY Standard
D6076 LABORATORY DIRECTOR Condition
D6082 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0609327 Dr Stuart Jacobs Md 5345 N El Dorado St, Ste 12 Stockton CA 09/23/2019 T27212 Standard
Deficiency Tag Deficiency Description Tag Type
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6107 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0610033 John C Fremont Healthcare District 5189 Hospital Rd Mariposa CA 03/06/2019 76LL11 Standard
Deficiency Tag Deficiency Description Tag Type
D2173 COMPATIBILITY TESTING Standard
▼ 05D0610033 John C Fremont Healthcare District 5189 Hospital Rd Mariposa CA 09/28/2021 L8G711 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
▼ 05D0610978 Yosemite Pathology Medical Group Inc 782 Delnero Dr Sonora CA 05/25/2022 EH6J11 Special
Deficiency Tag Deficiency Description Tag Type
D2000 ENROLLMENT AND TESTING OF SAMPLES Condition
D5623 CYTOLOGY Standard
D5625 CYTOLOGY Standard
D5629 CYTOLOGY Standard
D5633 CYTOLOGY Standard
D5637 CYTOLOGY Standard
D6076 LABORATORY DIRECTOR Condition
D6088 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6102 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6130 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D9999 null Memo
▼ 05D0610978 Yosemite Pathology Medical Group Inc 782 Delnero Dr Sonora CA 06/08/2022 Z8MM11 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
▼ 05D0611720 Redwood Empire Dermatology, Inc 6574 Oakmont Dr, Ste B Santa Rosa CA 09/04/2019 JXT911 Standard
Deficiency Tag Deficiency Description Tag Type
D3027 RETENTION REQUIREMENTS Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5601 HISTOPATHOLOGY Standard
D6082 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0611720 Redwood Empire Dermatology, Inc 6574 Oakmont Dr, Ste B Santa Rosa CA 08/31/2022 1ORF11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5405 PROCEDURE MANUAL Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 05D0611720 Redwood Empire Dermatology, Inc 6574 Oakmont Dr, Ste B Santa Rosa CA 08/27/2025 H4Y011 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6086 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0612335 Sonoma Specialty Hospital 501 Petaluma Ave Sebastopol CA 04/13/2018 L1MC11 Standard
Deficiency Tag Deficiency Description Tag Type
D2000 ENROLLMENT AND TESTING OF SAMPLES Condition
D2021 BACTERIOLOGY Standard
D2087 ROUTINE CHEMISTRY Standard
D2098 ENDOCRINOLOGY Standard
D2099 ENDOCRINOLOGY Standard
D2121 HEMATOLOGY Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5775 COMPARISON OF TEST RESULTS Standard