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
▼ 53D0662194 Memorial Hospital Of Converse County 111 South 5th Street Douglas WY 07/30/2018 6ME911 Standard
Deficiency Tag Deficiency Description Tag Type
D5293 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5407 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5445 CONTROL PROCEDURES Standard
D5449 CONTROL PROCEDURES Standard
D6063 LABORATORY TESTING PERSONNEL Condition
D6065 TESTING PERSONNEL QUALIFICATIONS Standard
D6108 LABORATORY TECHNICAL SUPERVISOR Condition
D6111 TECHNICAL SUPERVISOR QUALIFICATIONS Standard
▼ 53D0662194 Memorial Hospital Of Converse County 111 South 5th Street Douglas WY 04/10/2019 6ME913 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5473 CONTROL PROCEDURES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 53D0662194 Memorial Hospital Of Converse County 111 South 5th Street Douglas WY 09/04/2020 WIRO11 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D6063 LABORATORY TESTING PERSONNEL Condition
D6065 TESTING PERSONNEL QUALIFICATIONS Standard
D6086 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6128 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 53D0662194 Memorial Hospital Of Converse County 111 South 5th Street Douglas WY 05/12/2022 1OUM11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5403 PROCEDURE MANUAL Standard
D5407 PROCEDURE MANUAL Standard
D5445 CONTROL PROCEDURES Standard
D5449 CONTROL PROCEDURES Standard
D6168 TESTING PERSONNEL Condition
D6171 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 53D0663229 Big Horn Pediatrics Pc 1308 West 4th Street Gillette WY 01/28/2019 8WH912 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2028 BACTERIOLOGY Standard
▼ 53D0663229 Big Horn Pediatrics Pc 1308 West 4th Street Gillette WY 09/02/2020 F28011 Standard
Deficiency Tag Deficiency Description Tag Type
D5477 CONTROL PROCEDURES Standard
▼ 53D0663229 Big Horn Pediatrics Pc 1308 West 4th Street Gillette WY 05/09/2022 80WL11 Standard
Deficiency Tag Deficiency Description Tag Type
D2000 ENROLLMENT AND TESTING OF SAMPLES Condition
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5211 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5401 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5801 TEST REPORT Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6014 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6017 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6021 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 53D0663229 Big Horn Pediatrics Pc 1308 West 4th Street Gillette WY 06/22/2023 HF0111 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2026 BACTERIOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 53D0666054 Tyler L Quest Md Pc 1119 East 3rd St Casper WY 04/10/2019 0DGC11 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 53D0666137 Star Valley Medical Center 901 Adams Street Afton WY 04/29/2018 G0U311 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2017 REINSTATEMENT OF NONWAIVED LABORATORIES Condition