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
▼ 05D0956602 Alamitos Dermatological Medical Clinic, Inc 27725 Santa Margarita Pkwy Ste 110 Mission Viejo CA 02/03/2022 XF5U11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0956602 Alamitos Dermatological Medical Clinic, Inc 27725 Santa Margarita Pkwy Ste 110 Mission Viejo CA 12/23/2024 47E511 Standard
Deficiency Tag Deficiency Description Tag Type
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5407 PROCEDURE MANUAL Standard
D5441 CONTROL PROCEDURES Standard
D6082 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0957076 Diagnostic Laboratory Science Inc 7711 Garden Grove Blvd Garden Grove CA 12/12/2018 W6VS11 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D2098 ENDOCRINOLOGY Standard
▼ 05D0957076 Diagnostic Laboratory Science Inc 7711 Garden Grove Blvd Garden Grove CA 01/28/2021 76LF11 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6023 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0957436 Michael Keith Wensley, Md Inc 1382 Valencia Ave, Ste F Tustin CA 08/15/2018 6LCS11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0957436 Michael Keith Wensley, Md Inc 1382 Valencia Ave, Ste F Tustin CA 11/21/2018 KGFJ11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0957436 Michael Keith Wensley, Md Inc 1382 Valencia Ave, Ste F Tustin CA 12/12/2019 XB6W11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6095 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0958017 Gail Mallard Warren Md Inc 6107 N 1st St Ste 103 Fresno CA 06/19/2018 M7S511 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6021 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0958479 Kopelson Clinic 414 N Camden Dr Ste 640 Beverly Hills CA 04/15/2025 T8NL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 05D0960705 T I M M A Diagnostic Laboratory 5620 Wilbur Ave Ste 330 Tarzana CA 12/04/2025 FL4B11 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard