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
▼ 52D0396363 Krohn Clinic Ltd 610 W Adams St Black River Falls WI 03/09/2018 OCH211 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
D5407 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D6029 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D0396363 Krohn Clinic Ltd 610 W Adams St Black River Falls WI 11/17/2020 H4DF11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0396363 Krohn Clinic Ltd 610 W Adams St Black River Falls WI 03/24/2022 Y9DO11 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
D5407 PROCEDURE MANUAL Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5445 CONTROL PROCEDURES Standard
▼ 52D0396363 Krohn Clinic Ltd 610 W Adams St Black River Falls WI 01/31/2024 Y9YV11 Standard
Deficiency Tag Deficiency Description Tag Type
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5451 CONTROL PROCEDURES Standard
▼ 52D0396419 Gundersen Health System Onalaska Clinic 3111 Gundersen Dr Onalaska WI 05/14/2024 OKMR11 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
D5409 PROCEDURE MANUAL Standard
D6070 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D0396419 Gundersen Health System Onalaska Clinic 3111 Gundersen Dr Onalaska WI 12/03/2025 EFD811 Standard
Deficiency Tag Deficiency Description Tag Type
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5403 PROCEDURE MANUAL Standard
D6070 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D0396431 Kickapoo Valley Medical Clinic-Vmh 102 Sunset Ave Soldiers Grove WI 01/03/2018 2XUO12 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL null
▼ 52D0396431 Kickapoo Valley Medical Clinic-Vmh 102 Sunset Ave Soldiers Grove WI 01/26/2022 P1H411 Standard
Deficiency Tag Deficiency Description Tag Type
D6031 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0396431 Kickapoo Valley Medical Clinic-Vmh 102 Sunset Ave Soldiers Grove WI 11/28/2023 JA2611 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5407 PROCEDURE MANUAL Standard
▼ 52D0396431 Kickapoo Valley Medical Clinic-Vmh 102 Sunset Ave Soldiers Grove WI 01/22/2026 00JZ11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard