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
▼ 52D2163824 Ascension Medical Group-Fox Valley Wisconsin, Inc 5045 W Grande Market Drive Appleton WI 05/02/2024 H3GU11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5807 TEST REPORT Standard
▼ 52D2163824 Ascension Medical Group-Fox Valley Wisconsin, Inc 5045 W Grande Market Drive Appleton WI 11/18/2025 4RBP11 Standard
Deficiency Tag Deficiency Description Tag Type
D2006 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D6005 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6010 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2171289 Oakleaf Clinics- Chippewa 855 Lakeland Drive Chippewa Falls WI 03/16/2022 WY3S11 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2171289 Oakleaf Clinics- Chippewa 855 Lakeland Drive Chippewa Falls WI 03/05/2024 2X6D11 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 52D2173391 Oakleaf Clinics- Dermapathology Chippewa Falls 2815 County Highway I, 4th Floor Chippewa Falls WI 09/24/2020 23PZ11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6092 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2174831 Ahc- Menomonee Falls- Dermatology N84 W16889 Menomonee Ave Menomonee Falls WI 08/16/2023 MQNI11 Complaint
Deficiency Tag Deficiency Description Tag Type
D3041 RETENTION REQUIREMENTS Standard
D6076 LABORATORY DIRECTOR Condition
D6079 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6106 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2174831 Ahc- Menomonee Falls- Dermatology N84 W16889 Menomonee Ave Menomonee Falls WI 05/15/2024 71MP11 Standard
Deficiency Tag Deficiency Description Tag Type
D3041 RETENTION REQUIREMENTS Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2174831 Ahc- Menomonee Falls- Dermatology N84 W16889 Menomonee Ave Menomonee Falls WI 01/13/2026 JZ8O11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2179413 Octapharma Plasma, Inc 7708 Pershing Road Kenosha WI 01/07/2021 2UO111 Standard
Deficiency Tag Deficiency Description Tag Type
D2005 ENROLLMENT Standard
▼ 52D2179413 Octapharma Plasma, Inc 7708 Pershing Road Kenosha WI 06/09/2022 SUK511 Standard
Deficiency Tag Deficiency Description Tag Type
D6063 LABORATORY TESTING PERSONNEL Condition
D6065 TESTING PERSONNEL QUALIFICATIONS Standard