S&C QCOR CLIA 2567s
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CLIA 2567s
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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
▼ 52D0907183 Bellin Hfmc Ashwaubenon 1630 Commanche Ave Green Bay WI 07/02/2025 1PNQ11 Standard
Deficiency Tag Deficiency Description Tag Type
D3029 RETENTION REQUIREMENTS Standard
▼ 52D0908714 Aurora Fond Du Lac Clinic 210 Wisconsin American Dr Fond Du Lac WI 10/12/2021 66J411 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5781 CORRECTIVE ACTIONS Standard
▼ 52D0908714 Aurora Fond Du Lac Clinic 210 Wisconsin American Dr Fond Du Lac WI 08/31/2023 TKNV11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5447 CONTROL PROCEDURES Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 52D0911694 Wildwood Family Clinic Sc 251 East Cottage Grove Rd Cottage Grove WI 04/24/2018 5RWV11 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5447 CONTROL PROCEDURES Standard
D6047 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0911694 Wildwood Family Clinic Sc 251 East Cottage Grove Rd Cottage Grove WI 09/16/2020 ZCOY11 Standard
Deficiency Tag Deficiency Description Tag Type
D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 52D0911694 Wildwood Family Clinic Sc 251 East Cottage Grove Rd Cottage Grove WI 04/04/2022 P33M11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
D6042 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0911694 Wildwood Family Clinic Sc 251 East Cottage Grove Rd Cottage Grove WI 03/13/2024 KJ4C11 Standard
Deficiency Tag Deficiency Description Tag Type
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D3031 RETENTION REQUIREMENTS Standard
D5293 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5469 CONTROL PROCEDURES Standard
▼ 52D0913549 Quadmed Clinic West Allis 555 S 108th St West Allis WI 06/30/2023 5XSH11 Standard
Deficiency Tag Deficiency Description Tag Type
D5445 CONTROL PROCEDURES Standard
D5807 TEST REPORT Standard
▼ 52D0914318 Sheboygan Physicians Group, Sc 1621 N Taylor Dr Sheboygan WI 07/29/2019 6GMB11 Standard
Deficiency Tag Deficiency Description Tag Type
D5547 HEMATOLOGY Standard
D5785 CORRECTIVE ACTIONS Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6070 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D0917345 Bellin Hfmc De Pere 1800 Lawrence Dr De Pere WI 03/11/2026 9CQI11 Standard
Deficiency Tag Deficiency Description Tag Type
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard