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

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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
▼ 02D1002123 Avante Medical Center 915 West Northern Lights Blvd Anchorage AK 12/07/2022 3LVW11 Standard
Deficiency Tag Deficiency Description Tag Type
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
▼ 02D1009028 Mountain West Derm Blackhart Pllc 3841 Piper Street Suite T4-020 Anchorage AK 02/09/2021 B5VR11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 02D1009618 Ahvi Cath Lab/Asc 3220 Providence Drive E3-083 Anchorage AK 08/22/2022 ZID511 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
▼ 02D1019114 Southeast Medical Clinic 641 West Willoughby Ave, Suite 201 Juneau AK 02/15/2022 1Y9L11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 02D1019114 Southeast Medical Clinic 641 West Willoughby Ave, Suite 201 Juneau AK 08/10/2022 F9NP11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
▼ 02D1019114 Southeast Medical Clinic 641 West Willoughby Ave, Suite 201 Juneau AK 04/09/2024 DTHJ11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2028 BACTERIOLOGY Standard
▼ 02D1019114 Southeast Medical Clinic 641 West Willoughby Ave, Suite 201 Juneau AK 01/08/2025 Q1K511 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2130 HEMATOLOGY Standard
▼ 02D1021693 Dr David Barnes Internal Medicine 3719 E Meridian Loop, Suite A Wasilla AK 04/22/2019 WIXW11 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 02D1031794 Alaska Regional Hospital Poc Testing 2801 Debarr Road Anchorage AK 12/06/2018 BRK311 Standard
Deficiency Tag Deficiency Description Tag Type
D5775 COMPARISON OF TEST RESULTS Standard
▼ 02D1031794 Alaska Regional Hospital Poc Testing 2801 Debarr Road Anchorage AK 03/11/2021 WBUP11 Standard
Deficiency Tag Deficiency Description Tag Type
D5807 TEST REPORT Standard