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

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
▼ 03D1097308 Arizona Skin & Laser Therapy Institute 2224 W Northern Ave, Ste D-302 Phoenix AZ 09/20/2022 YMFQ11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5787 TEST RECORDS Standard
D6102 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 03D1097352 Richard Lee Averitte Jr Pllc 19646 N 27th Ave, Ste 305 Phoenix AZ 08/23/2024 J3NJ11 Standard
Deficiency Tag Deficiency Description Tag Type
D5401 PROCEDURE MANUAL Standard
▼ 03D1097848 Northern Arizona Medical Group 3555 Western Ave Kingman AZ 01/07/2026 6SNM11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D5024 HEMATOLOGY Condition
D5401 PROCEDURE MANUAL Standard
D5431 MAINTENANCE AND FUNCTION CHECKS Standard
D5445 CONTROL PROCEDURES Standard
D5469 CONTROL PROCEDURES Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
D6029 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6055 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 03D1098554 Integrated Dermatology Of Yuma 2500 S 8th Ave Ste 101 Yuma AZ 11/14/2018 6WIF11 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
D5433 MAINTENANCE AND FUNCTION CHECKS Standard
▼ 03D1098554 Integrated Dermatology Of Yuma 2500 S 8th Ave Ste 101 Yuma AZ 03/03/2021 91H911 Standard
Deficiency Tag Deficiency Description Tag Type
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
▼ 03D1098554 Integrated Dermatology Of Yuma 2500 S 8th Ave Ste 101 Yuma AZ 10/03/2023 0MMK11 Standard
Deficiency Tag Deficiency Description Tag Type
D5433 MAINTENANCE AND FUNCTION CHECKS Standard
D5607 HISTOPATHOLOGY Standard
▼ 03D1098554 Integrated Dermatology Of Yuma 2500 S 8th Ave Ste 101 Yuma AZ 02/13/2025 3JV611 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 03D1098706 Prostate Diagnostics, Llc 16601 N 40th St Ste 222 Phoenix AZ 02/08/2018 TDRU11 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5423 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5433 MAINTENANCE AND FUNCTION CHECKS Standard
D5601 HISTOPATHOLOGY Standard
▼ 03D1101815 Virtuous Pain Center Dba 3401 S White Mountain Rd Show Low AZ 04/30/2024 CI3311 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5469 CONTROL PROCEDURES Standard
▼ 03D1102253 Arizona Urology, Llc 13555 W Mcdowell Rd, Suite 302 Goodyear AZ 08/02/2022 LEF511 Standard
Deficiency Tag Deficiency Description Tag Type
D5305 TEST REQUEST Standard
D5423 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5437 CALIBRATION AND CALIBRATION VERIFICATION Standard