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
▼ 05D0985281 Daphne Panagotacos Md 32144 Agoura Rd Ste 106 Westlake Village CA 02/14/2023 SSME11 Standard
Deficiency Tag Deficiency Description Tag Type
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6079 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0987004 Urology Center Of Southern California 801 S Main St, Ste 201 Corona CA 06/18/2024 LPWL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5407 PROCEDURE MANUAL Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6082 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0989663 Laboratory Corporation Of America 1122 W Washington Blvd, Ste 340 Los Angeles CA 06/01/2018 180Z11 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 04/11/2018 PBIU11 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
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 08/16/2019 228G11 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
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 11/18/2020 N9HO11 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D6022 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6049 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 08/03/2022 Z4F111 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2107 ENDOCRINOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 08/17/2023 EO4Q11 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2087 ROUTINE CHEMISTRY Standard
D2094 ROUTINE CHEMISTRY Standard
D6004 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6023 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6031 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 04/03/2025 YDEZ11 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D0990631 Executive Physical Program 8900 Wilshire Blvd, Ste 360 Beverly Hills CA 07/17/2025 O1HB11 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard