S&C QCOR CLIA 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
CLIA 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

US State or Territory:

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
▼ 52D0396448 Gundersen Health System Sparta Clinic 1111 West Wisconsin Street Sparta WI 05/15/2024 B0GT11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
▼ 52D0396462 Gundersen Health System Tomah Clinic 505 Gopher Drive Tomah WI 05/22/2024 CQKB11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D6047 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0396462 Gundersen Health System Tomah Clinic 505 Gopher Drive Tomah WI 09/30/2025 5LRM11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
▼ 52D0396474 Tomah Health 501 Gopher Drive Tomah WI 11/20/2024 JH2311 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2097 ROUTINE CHEMISTRY Standard
D3031 RETENTION REQUIREMENTS Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5807 TEST REPORT Standard
D6076 LABORATORY DIRECTOR Condition
D6092 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0396494 Hirsch Clinic-Vmh 407 S Main St Ste 400 Viroqua WI 02/04/2019 10BZ11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5403 PROCEDURE MANUAL Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0396494 Hirsch Clinic-Vmh 407 S Main St Ste 400 Viroqua WI 06/23/2021 T3NH11 Standard
Deficiency Tag Deficiency Description Tag Type
D5445 CONTROL PROCEDURES Standard
▼ 52D0396494 Hirsch Clinic-Vmh 407 S Main St Ste 400 Viroqua WI 03/07/2023 W7QU11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
D5409 PROCEDURE MANUAL Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0396499 Gundersen Health System Viroqua Clinic 407 S Main St Ste 200 Viroqua WI 05/16/2024 7XDG11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5409 PROCEDURE MANUAL Standard
▼ 52D0396499 Gundersen Health System Viroqua Clinic 407 S Main St Ste 200 Viroqua WI 11/14/2025 TW8X11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D0396502 Bland Clinic-Vmh 100 Melby St Westby WI 09/10/2021 LRBP11 Standard
Deficiency Tag Deficiency Description Tag Type
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard