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

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
▼ 52D0887068 Mainstreet Clinic 1001 W Main St Ashland WI 07/26/2018 IU7I11 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0887068 Mainstreet Clinic 1001 W Main St Ashland WI 09/22/2020 XG3V11 Standard
Deficiency Tag Deficiency Description Tag Type
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5403 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5447 CONTROL PROCEDURES Standard
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6033 TECHNICAL CONSULTANT-MODERATE COMPLEXITY Condition
D6035 TECHNICAL CONSULTANT QUALIFICATIONS Standard
▼ 52D0887068 Mainstreet Clinic 1001 W Main St Ashland WI 08/09/2022 QRRK11 Standard
Deficiency Tag Deficiency Description Tag Type
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0887068 Mainstreet Clinic 1001 W Main St Ashland WI 08/13/2024 SY9S11 Standard
Deficiency Tag Deficiency Description Tag Type
D5431 MAINTENANCE AND FUNCTION CHECKS Standard
D6021 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0888142 Milwaukee Womens Medical Services 1428 North Farwell Avenue Milwaukee WI 04/04/2018 IYXB11 Standard
Deficiency Tag Deficiency Description Tag Type
D3037 RETENTION REQUIREMENTS Standard
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5407 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6013 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0888142 Milwaukee Womens Medical Services 1428 North Farwell Avenue Milwaukee WI 10/05/2020 G1J111 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5401 PROCEDURE MANUAL Standard
D5409 PROCEDURE MANUAL Standard
D6013 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0888142 Milwaukee Womens Medical Services 1428 North Farwell Avenue Milwaukee WI 04/06/2022 PD8J11 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0888142 Milwaukee Womens Medical Services 1428 North Farwell Avenue Milwaukee WI 09/24/2024 VJGL11 Standard
Deficiency Tag Deficiency Description Tag Type
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6004 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D0888438 Uw Health - Beaver Dam 705 S University Ave Ste 200-Lab Beaver Dam WI 09/23/2020 R53T11 Standard
Deficiency Tag Deficiency Description Tag Type
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D0890453 Watertown Regional Medical Center 111 Anna St Waterloo WI 05/01/2018 IDVW11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5401 PROCEDURE MANUAL Standard
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D6013 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard