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
▼ 05D1067205 Palo Alto Medical Foundation For Health, 701 E El Camino Real, 2nd Fl Mountain View CA 08/28/2024 HK6Y11 Standard
Deficiency Tag Deficiency Description Tag Type
D2020 BACTERIOLOGY Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 05D1070461 Golden State Dermatology Associates 2490 Hospital Dr, Ste 201 Mountain View CA 04/27/2021 9YDK11 Standard
Deficiency Tag Deficiency Description Tag Type
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 05D1070461 Golden State Dermatology Associates 2490 Hospital Dr, Ste 201 Mountain View CA 08/16/2023 788L11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5805 TEST REPORT Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 05D1070679 Valley Urology Inc 6113 N Fresno St Ste 101 Fresno CA 07/16/2019 6QFS11 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5471 CONTROL PROCEDURES Standard
D5601 HISTOPATHOLOGY Standard
D6064 TESTING PERSONNEL QUALIFICATIONS Standard
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D1070679 Valley Urology Inc 6113 N Fresno St Ste 101 Fresno CA 03/15/2022 I6PE11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5469 CONTROL PROCEDURES Standard
D6020 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D1070679 Valley Urology Inc 6113 N Fresno St Ste 101 Fresno CA 07/17/2025 S6R311 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D2016 SUCCESSFUL PARTICIPATION Condition
D2028 BACTERIOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D1071297 Ravi Shankar Md 44215 15th St West Ste 115 Lancaster CA 02/02/2022 GMIV11 Standard
Deficiency Tag Deficiency Description Tag Type
D2089 ROUTINE CHEMISTRY Standard
D6015 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D1071297 Ravi Shankar Md 44215 15th St West Ste 115 Lancaster CA 06/26/2025 KWOX11 Standard
Deficiency Tag Deficiency Description Tag Type
D2087 ROUTINE CHEMISTRY Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D6036 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 05D1071362 Scripps Clinic Medical Laboratories 9535 Waples St Ste 150 San Diego CA 05/15/2019 7XDV11 Standard
Deficiency Tag Deficiency Description Tag Type
D2075 GENERAL IMMUNOLOGY Standard
D2121 HEMATOLOGY Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D1074973 Prithipal S Sethi, Md, Inc 3133 W March Lane Ste 1040 Stockton CA 08/10/2022 FJNH11 Special
Deficiency Tag Deficiency Description Tag Type
D5032 CYTOLOGY Condition
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5305 TEST REQUEST Standard
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5391 PREANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5403 PROCEDURE MANUAL Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5629 CYTOLOGY Standard
D5633 CYTOLOGY Standard
D5637 CYTOLOGY Standard
D5641 CYTOLOGY Standard
D5645 CYTOLOGY Standard
D5647 CYTOLOGY Standard
D5655 CYTOLOGY Standard
D5657 CYTOLOGY Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5805 TEST REPORT Standard
D5815 TEST REPORT Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6076 LABORATORY DIRECTOR Condition
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6115 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6130 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6133 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D9999 null Memo