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
▼ 52D1093324 Bellin Health Fmc Bellevue 3263 Eaton Rd Green Bay WI 03/17/2021 HBEW11 Standard
Deficiency Tag Deficiency Description Tag Type
D5425 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 52D1095337 Forefront Dermatology, Sc 111 Wisconsin American Dr Fond Du Lac WI 02/24/2020 YEWX11 Standard
Deficiency Tag Deficiency Description Tag Type
D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 52D1095337 Forefront Dermatology, Sc 111 Wisconsin American Dr Fond Du Lac WI 01/23/2024 LRFL11 Standard
Deficiency Tag Deficiency Description Tag Type
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5805 TEST REPORT Standard
▼ 52D1101784 Quest Diagnostics Llc 130 Warren Street, Bldg C Beaver Dam WI 10/24/2023 ENYT11 Standard
Deficiency Tag Deficiency Description Tag Type
D5403 PROCEDURE MANUAL Standard
▼ 52D1101789 Ameripath Milwaukee Sc Dba Ameripath Great Lakes 506 East State Parkway, Suite A Schaumburg IL 10/09/2019 4J1Y11 Standard
Deficiency Tag Deficiency Description Tag Type
D5400 ANALYTIC SYSTEMS Condition
D5403 PROCEDURE MANUAL Standard
D5601 HISTOPATHOLOGY Standard
D6093 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6106 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D1104619 Fleming Dermatopathology 4324 W Bradley Road Brown Deer WI 01/18/2022 UY5W11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D2002460 Thedacare Physicians Darboy W5282 Amy Ave Appleton WI 02/22/2018 R4WX11 Standard
Deficiency Tag Deficiency Description Tag Type
D5447 CONTROL PROCEDURES Standard
▼ 52D2002460 Thedacare Physicians Darboy W5282 Amy Ave Appleton WI 09/10/2020 ZR6U11 Standard
Deficiency Tag Deficiency Description Tag Type
D5783 CORRECTIVE ACTIONS Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D2005390 Madison Womens Health Llp 5801 Research Park Blvd Ste 400 Madison WI 04/29/2025 YGB811 Standard
Deficiency Tag Deficiency Description Tag Type
D5024 HEMATOLOGY Condition
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5401 PROCEDURE MANUAL Standard
D6004 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2005812 Forefront Dermatology, Sc 2351 State Rd 44 Oshkosh WI 10/12/2022 XC9M11 Standard
Deficiency Tag Deficiency Description Tag Type
D5787 TEST RECORDS Standard