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
▼ 05D2164178 Csi Medical Group 3311 Mission Drive Santa Cruz CA 03/14/2024 07KM11 Standard
Deficiency Tag Deficiency Description Tag Type
D5793 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5821 TEST REPORT Standard
D6087 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D2164222 Life Ivf Center Los Angeles 289 W Huntington Dr Ste 400 Arcadia CA 09/11/2020 G49011 Standard
Deficiency Tag Deficiency Description Tag Type
D5213 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6018 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D2164222 Life Ivf Center Los Angeles 289 W Huntington Dr Ste 400 Arcadia CA 11/30/2022 IYH811 Standard
Deficiency Tag Deficiency Description Tag Type
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6030 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 05D2165559 Boswell Dermatology 6730 N West Avenue Fresno CA 07/09/2024 XCJF11 Standard
Deficiency Tag Deficiency Description Tag Type
D3043 RETENTION REQUIREMENTS Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6082 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D2165560 Advanced Dermatology Center 1624 W Olive Ave Ste B Burbank CA 04/05/2023 W5FD11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5309 TEST REQUEST Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 05D2165560 Advanced Dermatology Center 1624 W Olive Ave Ste B Burbank CA 01/31/2025 5QZQ11 Standard
Deficiency Tag Deficiency Description Tag Type
D3011 FACILITIES Standard
D5435 MAINTENANCE AND FUNCTION CHECKS Standard
D6084 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6097 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D2166466 Premier Dermatology And 168 N Brent St, Ste 403b Ventura CA 12/23/2020 XR8Z11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5401 PROCEDURE MANUAL Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6082 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 05D2166472 Pacific Dermatology Institute 18523 Corwin Rd Ste G Apple Valley CA 06/06/2023 J04T11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 05D2166539 Sasha Salloum Md Inc, A Professional Medical Corp 1045 E Pennsylvania Ave Escondido CA 08/10/2022 JMDS11 Standard
Deficiency Tag Deficiency Description Tag Type
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 05D2166864 Sunrise Diagnostics Laboratories Inc 4111 Ocean View Blvd Montrose CA 06/20/2023 USAU11 Standard
Deficiency Tag Deficiency Description Tag Type
D3003 FACILITIES Standard
D3005 FACILITIES Standard
D6083 LABORATORY DIRECTOR RESPONSIBILITIES Standard