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
▼ 52D0388738 Ascension Medical Group At Sheboygan 1703 N Taylor Dr Sheboygan WI 03/05/2021 Q2US11 Standard
Deficiency Tag Deficiency Description Tag Type
D5445 CONTROL PROCEDURES Standard
D6168 TESTING PERSONNEL Condition
D6171 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 52D0388748 Aurora Sheboygan Clinic 2414 Kohler Memorial Dr Sheboygan WI 03/04/2021 V6B711 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 52D0388904 Watertown Regional Medical Center, 132 Hospital Dr Watertown WI 11/10/2022 XSUH11 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
▼ 52D0388938 Watertown Family Practice Associates Sc 127 Hospital Dr Watertown WI 11/01/2018 F8XC11 Standard
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D5213 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5403 PROCEDURE MANUAL Standard
D5447 CONTROL PROCEDURES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0388938 Watertown Family Practice Associates Sc 127 Hospital Dr Watertown WI 09/17/2020 ECBX11 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0388938 Watertown Family Practice Associates Sc 127 Hospital Dr Watertown WI 03/08/2021 J7GM11 Special
Deficiency Tag Deficiency Description Tag Type
D3000 FACILITY ADMINISTRATION Condition
▼ 52D0388938 Watertown Family Practice Associates Sc 127 Hospital Dr Watertown WI 03/08/2021 XJ0X11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0389118 Aurora Health Center-Delavan 1550 Hobbs Dr Delavan WI 01/29/2019 4I6511 Standard
Deficiency Tag Deficiency Description Tag Type
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D0389360 Aurora Health Center-22nd Avenue 7540 22nd Ave Kenosha WI 02/07/2018 786R11 Standard
Deficiency Tag Deficiency Description Tag Type
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D0389541 Aurora Health Center Lake Geneva Acl Laboratory 146 E Geneva Square Lake Geneva WI 12/01/2021 OMKU11 Standard
Deficiency Tag Deficiency Description Tag Type
D5787 TEST RECORDS Standard