S&C QCOR CLIA 2567s
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CLIA 2567s
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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
▼ 52D0691476 Interstate Blood Bank Inc 1530 W National Ave Milwaukee WI 09/28/2021 IUNY11 Standard
Deficiency Tag Deficiency Description Tag Type
D2004 ENROLLMENT Standard
D5407 PROCEDURE MANUAL Standard
▼ 52D0693080 Uw Stevens Point Student Health 910 Fremont St Stevens Point WI 04/16/2025 1HWL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 52D0693572 Lakeshore Medical Clinic, Llc D/B/A Aurora Health 2000 E Layton Ave Ste 120 Saint Francis WI 02/03/2021 I3W311 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 52D0693572 Lakeshore Medical Clinic, Llc D/B/A Aurora Health 2000 E Layton Ave Ste 120 Saint Francis WI 08/09/2022 BZGL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5437 CALIBRATION AND CALIBRATION VERIFICATION Standard
▼ 52D0695974 Shoreview Pediatrics Sc 2524 E Webster Place #301 Milwaukee WI 04/05/2018 W6J211 Standard
Deficiency Tag Deficiency Description Tag Type
D3037 RETENTION REQUIREMENTS Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5449 CONTROL PROCEDURES Standard
D5477 CONTROL PROCEDURES Standard
D5785 CORRECTIVE ACTIONS Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6013 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6020 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6030 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6031 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0695974 Shoreview Pediatrics Sc 2524 E Webster Place #301 Milwaukee WI 10/06/2020 L6I311 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5449 CONTROL PROCEDURES Standard
D5477 CONTROL PROCEDURES Standard
D6030 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0695974 Shoreview Pediatrics Sc 2524 E Webster Place #301 Milwaukee WI 04/26/2022 CF3R11 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5445 CONTROL PROCEDURES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 52D0695974 Shoreview Pediatrics Sc 2524 E Webster Place #301 Milwaukee WI 02/28/2024 I0ZG11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D0698762 Med College Of Wi Dept Of Dermatology, 8701 Watertown Plank Rd, Tbrc Room C3698 Milwaukee WI 07/20/2021 DAN311 Standard
Deficiency Tag Deficiency Description Tag Type
D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 52D0704796 Thedacare Physicians-Appleton West 4480 W Spencer St Appleton WI 05/09/2018 8TXX11 Standard
Deficiency Tag Deficiency Description Tag Type
D5801 TEST REPORT Standard