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
▼ 52D0661966 Memorial Hospital Of Lafayette County 800 Clay St Darlington WI 11/15/2018 6GRT11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6004 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0661966 Memorial Hospital Of Lafayette County 800 Clay St Darlington WI 04/15/2021 IMCV11 Standard
Deficiency Tag Deficiency Description Tag Type
D2173 COMPATIBILITY TESTING Standard
▼ 52D0661966 Memorial Hospital Of Lafayette County 800 Clay St Darlington WI 12/07/2022 ELTP11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
▼ 52D0661966 Memorial Hospital Of Lafayette County 800 Clay St Darlington WI 04/26/2024 UXVE11 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2162 ABO GROUP AND D(RHO) TYPING Standard
D2163 ABO GROUP AND D(RHO) TYPING Standard
D6076 LABORATORY DIRECTOR Condition
D6092 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0661966 Memorial Hospital Of Lafayette County 800 Clay St Darlington WI 11/13/2024 FXN411 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
▼ 52D0662031 Odd Fellow Home 1229 S Jackson St Green Bay WI 11/10/2023 OBD011 Complaint
Deficiency Tag Deficiency Description Tag Type
D1001 CERTIFICATE OF WAIVER TESTS Standard
▼ 52D0662099 Vernon Memorial Hospital Inc 507 S Main St Viroqua WI 11/14/2019 QUFI11 Standard
Deficiency Tag Deficiency Description Tag Type
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5477 CONTROL PROCEDURES Standard
▼ 52D0662099 Vernon Memorial Hospital Inc 507 S Main St Viroqua WI 12/16/2021 ZGGZ11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5409 PROCEDURE MANUAL Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5441 CONTROL PROCEDURES Standard
D5445 CONTROL PROCEDURES Standard
D5793 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5807 TEST REPORT Standard
D5821 TEST REPORT Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0662099 Vernon Memorial Hospital Inc 507 S Main St Viroqua WI 11/09/2023 8CM211 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5407 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5775 COMPARISON OF TEST RESULTS Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0662099 Vernon Memorial Hospital Inc 507 S Main St Viroqua WI 11/13/2025 5ETM11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5403 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5473 CONTROL PROCEDURES Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard