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
▼ 52D2077860 Aurora Health Center - West Bend, Gateway Ct 1100 Gateway Ct West Bend WI 02/12/2020 RX8Y11 Standard
Deficiency Tag Deficiency Description Tag Type
D5445 CONTROL PROCEDURES Standard
▼ 52D2078791 Urgent Care Physicians, Ltd 3329 E Express Ct Appleton WI 10/08/2021 L9UN11 Complaint
Deficiency Tag Deficiency Description Tag Type
D1001 CERTIFICATE OF WAIVER TESTS Standard
▼ 52D2084863 Jessie Crawford Recovery Center Inc 1925 Washington Ave Racine WI 01/25/2021 W4Y511 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5022 TOXICOLOGY Condition
D5317 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5401 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5437 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5783 CORRECTIVE ACTIONS Standard
D5803 TEST REPORT Standard
D5805 TEST REPORT Standard
D6013 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6020 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6026 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2085414 Affiliated Dermatologists N96 W17035 Division Rd, Suite A Germantown WI 06/27/2022 YQIB11 Standard
Deficiency Tag Deficiency Description Tag Type
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D2085435 Hshs St Vincent Hospital Cancer Centers 835 S Main Street, Suite C Oconto Falls WI 11/28/2022 FDR411 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6033 TECHNICAL CONSULTANT-MODERATE COMPLEXITY Condition
D6035 TECHNICAL CONSULTANT QUALIFICATIONS Standard
▼ 52D2087422 Power Of Change Inc 2821 N Vel R Phillips Ave, Suite 131 Milwaukee WI 02/20/2018 V71U11 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D3007 FACILITIES Standard
D3031 RETENTION REQUIREMENTS Standard
D5022 TOXICOLOGY Condition
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5403 PROCEDURE MANUAL Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5481 CONTROL PROCEDURES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6076 LABORATORY DIRECTOR Condition
D6091 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6092 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6108 LABORATORY TECHNICAL SUPERVISOR Condition
D6118 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6123 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 52D2087422 Power Of Change Inc 2821 N Vel R Phillips Ave, Suite 131 Milwaukee WI 02/17/2020 NY3611 Standard
Deficiency Tag Deficiency Description Tag Type
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5309 TEST REQUEST Standard
D5391 PREANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5403 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5785 CORRECTIVE ACTIONS Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6175 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2088282 New Dermatology Group Ltd 2500 E Capitol Dr, 3rd Floor Appleton WI 09/11/2024 GB1711 Standard
Deficiency Tag Deficiency Description Tag Type
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D2091821 Numale Wisconsin Gb, Sc 1525 Park Place Ashwaubenon WI 12/19/2018 Q14811 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
▼ 52D2091821 Numale Wisconsin Gb, Sc 1525 Park Place Ashwaubenon WI 01/10/2023 E5PM11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard