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
▼ 52D1045440 Shoreline Skin Corporation 3427 Superior Ave Sheboygan WI 08/14/2019 G3A611 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 52D1045440 Shoreline Skin Corporation 3427 Superior Ave Sheboygan WI 08/16/2021 WNGC11 Standard
Deficiency Tag Deficiency Description Tag Type
D3031 RETENTION REQUIREMENTS Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D1056222 Ahc Waterford 818 Forrest Ln Waterford WI 12/09/2020 2VPN11 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
▼ 52D1056222 Ahc Waterford 818 Forrest Ln Waterford WI 04/12/2022 UN7E11 Standard
Deficiency Tag Deficiency Description Tag Type
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D1060886 Forefront Dermatology, Sc 3935 Lightning Dr Appleton WI 02/12/2021 XO5311 Standard
Deficiency Tag Deficiency Description Tag Type
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D1060886 Forefront Dermatology, Sc 3935 Lightning Dr Appleton WI 10/12/2022 4KUU11 Standard
Deficiency Tag Deficiency Description Tag Type
D5787 TEST RECORDS Standard
▼ 52D1077523 Pediatric And Young Adult Medicine 1610 Maxwell Drive, Suite 245 Hudson WI 11/05/2018 P9CW11 Standard
Deficiency Tag Deficiency Description Tag Type
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6033 TECHNICAL CONSULTANT-MODERATE COMPLEXITY Condition
D6042 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6043 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6054 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D1078013 Northlakes Community Health Center 7665 Us Hwy 2 Iron River WI 01/12/2018 UB7U12 Standard
Deficiency Tag Deficiency Description Tag Type
D2007 TESTING OF PROFICIENCY TESTING SAMPLES null
D2009 TESTING OF PROFICIENCY TESTING SAMPLES null
D2015 TESTING OF PROFICIENCY TESTING SAMPLES null
D5403 PROCEDURE MANUAL null
D5793 ANALYTIC SYSTEMS QUALITY ASSESSMENT null
D6018 LABORATORY DIRECTOR RESPONSIBILITIES null
D6019 LABORATORY DIRECTOR RESPONSIBILITIES null
D6031 LABORATORY DIRECTOR RESPONSIBILITIES null
▼ 52D1078013 Northlakes Community Health Center 7665 Us Hwy 2 Iron River WI 01/14/2020 7CII11 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT Standard
D5437 CALIBRATION AND CALIBRATION VERIFICATION Standard
D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR Condition
D6004 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6026 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D1079047 Aspirus Rhinelander Clinic Laboratory 1630 N Chippewa Dr Rhinelander WI 04/15/2025 NX6O11 Standard
Deficiency Tag Deficiency Description Tag Type
D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5441 CONTROL PROCEDURES Standard