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
▼ 03D0533657 White Mountain Regional Medical Center 118 S Mountain Ave Springerville AZ 02/28/2018 GTI012 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES null
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT null
D5391 PREANALYTIC SYSTEMS QUALITY ASSESSMENT null
D5401 PROCEDURE MANUAL null
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT null
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT null
D5439 CALIBRATION AND CALIBRATION VERIFICATION null
D5445 CONTROL PROCEDURES null
D5473 CONTROL PROCEDURES null
D5503 BACTERIOLOGY null
D5775 COMPARISON OF TEST RESULTS null
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT null
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT null
D6076 LABORATORY DIRECTOR null
D6086 LABORATORY DIRECTOR RESPONSIBILITIES null
D6092 LABORATORY DIRECTOR RESPONSIBILITIES null
D6093 LABORATORY DIRECTOR RESPONSIBILITIES null
D6094 LABORATORY DIRECTOR RESPONSIBILITIES null
D6102 LABORATORY DIRECTOR RESPONSIBILITIES null
D6108 LABORATORY TECHNICAL SUPERVISOR null
D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES null
D6128 TECHNICAL SUPERVISOR RESPONSIBILITIES null
▼ 03D0533657 White Mountain Regional Medical Center 118 S Mountain Ave Springerville AZ 08/10/2018 Z6PS11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2128 HEMATOLOGY Standard
D2130 HEMATOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D0533657 White Mountain Regional Medical Center 118 S Mountain Ave Springerville AZ 12/12/2018 PRJQ11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2128 HEMATOLOGY Standard
D2130 HEMATOLOGY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6016 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D0533657 White Mountain Regional Medical Center 118 S Mountain Ave Springerville AZ 12/19/2019 HZUW11 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5293 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5400 ANALYTIC SYSTEMS Condition
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5445 CONTROL PROCEDURES Standard
D5477 CONTROL PROCEDURES Standard
D5543 HEMATOLOGY Standard
D5775 COMPARISON OF TEST RESULTS Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D5801 TEST REPORT Standard
D6076 LABORATORY DIRECTOR Condition
D6092 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6108 LABORATORY TECHNICAL SUPERVISOR Condition
D6128 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 03D0533657 White Mountain Regional Medical Center 118 S Mountain Ave Springerville AZ 06/17/2020 J57811 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2160 ABO GROUP AND D(RHO) TYPING Standard
D2162 ABO GROUP AND D(RHO) TYPING Standard
D2163 ABO GROUP AND D(RHO) TYPING Standard
D6076 LABORATORY DIRECTOR Condition
D6089 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D0533657 White Mountain Regional Medical Center 118 S Mountain Ave Springerville AZ 03/29/2023 KQ0Z11 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D2153 ABO GROUP AND D(RHO) TYPING Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D5445 CONTROL PROCEDURES Standard
D5477 CONTROL PROCEDURES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6042 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6076 LABORATORY DIRECTOR Condition
D6089 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 03D0533930 Forefront Dermatology, Sc Dba Arizona 2820 Glassford Hill Rd #107 Prescott Valley AZ 10/04/2019 T26Z11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5407 PROCEDURE MANUAL Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5433 MAINTENANCE AND FUNCTION CHECKS Standard
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 03D0533930 Forefront Dermatology, Sc Dba Arizona 2820 Glassford Hill Rd #107 Prescott Valley AZ 10/23/2024 Z6YY11 Standard
Deficiency Tag Deficiency Description Tag Type
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5821 TEST REPORT Standard
▼ 03D0533969 Laboratory Corporation Of America 1210 Gail Gardner Way Suite A Prescott AZ 03/22/2018 Q9ZV11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 03D0534242 Laboratory Corporation Of America 1750 S Railroad Springs Road, #10 Flagstaff AZ 01/08/2020 6K5S11 Standard
Deficiency Tag Deficiency Description Tag Type
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard