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
▼ 52D0394447 Kaukauna Clinic Sc 305 E 12th St Kaukauna WI 03/09/2023 E7X611 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5783 CORRECTIVE ACTIONS Standard
▼ 52D0394447 Kaukauna Clinic Sc 305 E 12th St Kaukauna WI 01/22/2025 4Q7D11 Standard
Deficiency Tag Deficiency Description Tag Type
D5407 PROCEDURE MANUAL Standard
▼ 52D0394465 Thedacare Physicians-Kimberly 520 W Third St Kimberly WI 07/30/2018 MX0811 Special
Deficiency Tag Deficiency Description Tag Type
D2016 SUCCESSFUL PARTICIPATION Condition
D2096 ROUTINE CHEMISTRY Standard
▼ 52D0394498 Bellin Health Marinette Laboratory 2820 Roosevelt Road Marinette WI 10/28/2019 4TMJ11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D0394498 Bellin Health Marinette Laboratory 2820 Roosevelt Road Marinette WI 09/26/2023 NJ4611 Standard
Deficiency Tag Deficiency Description Tag Type
D6021 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0394540 Bellin Health Oconto Falls 107 E Highland Dr Oconto Falls WI 09/11/2024 NX4S11 Standard
Deficiency Tag Deficiency Description Tag Type
D5783 CORRECTIVE ACTIONS Standard
▼ 52D0394632 Bellin Health Algoma 831 Parker Ave Algoma WI 05/16/2018 BQCV11 Standard
Deficiency Tag Deficiency Description Tag Type
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6024 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6026 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0394644 Bellin Hfmc Denmark 595 County Trunk R Denmark WI 05/08/2018 LQXF11 Standard
Deficiency Tag Deficiency Description Tag Type
D2094 ROUTINE CHEMISTRY Standard
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D0394654 Bellin Hfmc Kewaunee 575 Fourth St Kewaunee WI 03/01/2021 7LXD11 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 52D0394654 Bellin Hfmc Kewaunee 575 Fourth St Kewaunee WI 10/18/2022 E5UP11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
D5807 TEST REPORT Standard