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
▼ 52D2006332 Prevea Health Arcadia 945 S Detloff Dr Arcadia WI 04/04/2019 PWXL11 Standard
Deficiency Tag Deficiency Description Tag Type
D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6125 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 52D2011214 Forefront Dermatology, Sc 801 York St Manitowoc WI 11/13/2018 D5CK11 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5409 PROCEDURE MANUAL Standard
D5807 TEST REPORT Standard
D6086 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6092 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2011214 Forefront Dermatology, Sc 801 York St Manitowoc WI 03/02/2021 V66Z11 Standard
Deficiency Tag Deficiency Description Tag Type
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D5781 CORRECTIVE ACTIONS Standard
▼ 52D2011991 Healing Corner, Llc 19115 W Capitol Dr, Ste 117 Brookfield WI 01/22/2019 4V5011 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2015 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D3031 RETENTION REQUIREMENTS Standard
D3037 RETENTION REQUIREMENTS Standard
D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL Standard
D5407 PROCEDURE MANUAL Standard
D5409 PROCEDURE MANUAL Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D6076 LABORATORY DIRECTOR Condition
D6079 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6091 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6097 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6106 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6168 TESTING PERSONNEL Condition
D6171 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 52D2015844 Forefront Dermatology, Sc 1245 Cheyenne Ave Ste 301 Grafton WI 03/30/2021 TLI311 Standard
Deficiency Tag Deficiency Description Tag Type
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2015844 Forefront Dermatology, Sc 1245 Cheyenne Ave Ste 301 Grafton WI 08/23/2022 UKRB11 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5429 MAINTENANCE AND FUNCTION CHECKS Standard
D6094 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2018716 Ghcscw Madison College Community Clinic 1705 Hoffman St, Suite 150 Madison WI 06/28/2021 20T711 Standard
Deficiency Tag Deficiency Description Tag Type
D2006 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D3005 FACILITIES Standard
D3011 FACILITIES Standard
D5400 ANALYTIC SYSTEMS Condition
D5401 PROCEDURE MANUAL Standard
D5403 PROCEDURE MANUAL Standard
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5423 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D5441 CONTROL PROCEDURES Standard
D5481 CONTROL PROCEDURES Standard
D5805 TEST REPORT Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6097 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6115 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6117 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 52D2018716 Ghcscw Madison College Community Clinic 1705 Hoffman St, Suite 150 Madison WI 04/13/2023 PNJW11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
▼ 52D2032824 Forefront Dermatology, Sc 1300 S Green Bay Rd, Ste 100 Racine WI 09/30/2019 3MNH11 Standard
Deficiency Tag Deficiency Description Tag Type
D5028 HISTOPATHOLOGY Condition
D5203 SPECIMEN IDENTIFICATION AND INTEGRITY Standard
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard
▼ 52D2032824 Forefront Dermatology, Sc 1300 S Green Bay Rd, Ste 100 Racine WI 11/15/2021 GJQY11 Standard
Deficiency Tag Deficiency Description Tag Type
D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT Standard