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
▼ 52D2256363 Covid Clinic, Inc 4323 W Wisconsin Ave Appleton WI 03/30/2022 PS7M11 Complaint
Deficiency Tag Deficiency Description Tag Type
D1001 CERTIFICATE OF WAIVER TESTS Standard
▼ 52D2256367 Covid Clinic, Inc 95 N Mooreland Rd Unit A1a Brookfield WI 03/17/2022 0BF411 Complaint
Deficiency Tag Deficiency Description Tag Type
D1001 CERTIFICATE OF WAIVER TESTS Standard
▼ 52D2258004 Froedtert Hospital - Bluemound Campus 601 N 99th St Milwaukee WI 03/01/2023 MY8J11 Standard
Deficiency Tag Deficiency Description Tag Type
D5787 TEST RECORDS Standard
▼ 52D2258004 Froedtert Hospital - Bluemound Campus 601 N 99th St Milwaukee WI 06/28/2024 DU9O11 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D2261136 Csl Plasma, Inc 2960 S Chase Ave Milwaukee WI 04/26/2023 VXQO11 Standard
Deficiency Tag Deficiency Description Tag Type
D6017 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6063 LABORATORY TESTING PERSONNEL Condition
D6065 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 52D2263032 Dermatology And Cosmetic Physicians, Sc 1088 S Main St Fond Du Lac WI 04/25/2023 SYIX11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5445 CONTROL PROCEDURES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 52D2263032 Dermatology And Cosmetic Physicians, Sc 1088 S Main St Fond Du Lac WI 07/09/2024 UMSC11 Standard
Deficiency Tag Deficiency Description Tag Type
D5473 CONTROL PROCEDURES Standard
D5787 TEST RECORDS Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2264430 Thedacare Medical Center-Orthopedic Spine And Pain 2400 E Capitol Dr Appleton WI 05/24/2023 2M4311 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D3031 RETENTION REQUIREMENTS Standard
▼ 52D2264430 Thedacare Medical Center-Orthopedic Spine And Pain 2400 E Capitol Dr Appleton WI 08/27/2024 T9N111 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
▼ 52D2274544 Affiliated Dermatologists, Sc 10050 S 27th Street Oak Creek WI 03/24/2025 PZVT11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard