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
▼ 52D2145549 Prevea Altoona Mob 3119 Woodman Drive Altoona WI 09/06/2018 DFJN11 Standard
Deficiency Tag Deficiency Description Tag Type
D2000 ENROLLMENT AND TESTING OF SAMPLES Condition
D5449 CONTROL PROCEDURES Standard
▼ 52D2145549 Prevea Altoona Mob 3119 Woodman Drive Altoona WI 03/15/2022 BQ3L11 Standard
Deficiency Tag Deficiency Description Tag Type
D6175 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2148953 Aurora Fertility Services 6815 118th Ave, Fertility Clinic Kenosha WI 01/30/2019 DPIC11 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 52D2148953 Aurora Fertility Services 6815 118th Ave, Fertility Clinic Kenosha WI 01/07/2021 0I8X11 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D6103 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
D6177 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2149063 Women's Care Of Wisconsin 200 Theda Clark Medical Plaza Suite 130 Neenah WI 09/23/2019 PYII11 Complaint
Deficiency Tag Deficiency Description Tag Type
D2000 ENROLLMENT AND TESTING OF SAMPLES Condition
D2011 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D2013 TESTING OF PROFICIENCY TESTING SAMPLES Standard
▼ 52D2150315 Madison Medical Affiliates, Inc 12831 N Port Washington Rd Mequon WI 02/24/2023 FJM311 Standard
Deficiency Tag Deficiency Description Tag Type
D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES Standard
D5401 PROCEDURE MANUAL Standard
D5403 PROCEDURE MANUAL Standard
D5801 TEST REPORT Standard
D5805 TEST REPORT Standard
D6046 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
▼ 52D2150315 Madison Medical Affiliates, Inc 12831 N Port Washington Rd Mequon WI 09/13/2024 Y3S711 Standard
Deficiency Tag Deficiency Description Tag Type
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES Standard
▼ 52D2150696 Aurora Health Center- Manitowoc 3509 Dewey St Manitowoc WI 05/07/2019 XTRH11 Standard
Deficiency Tag Deficiency Description Tag Type
D5409 PROCEDURE MANUAL Standard
D5445 CONTROL PROCEDURES Standard
▼ 52D2152243 Prohealth Medical Group, Inc - N16w24131 Riverwood Dr Waukesha WI 07/11/2019 1ARG11 Standard
Deficiency Tag Deficiency Description Tag Type
D6168 TESTING PERSONNEL Condition
D6171 TESTING PERSONNEL QUALIFICATIONS Standard
▼ 52D2152903 Prevea Health Rice Lake 1051 West Ave Rice Lake WI 09/06/2022 L6NY11 Standard
Deficiency Tag Deficiency Description Tag Type
D2010 TESTING OF PROFICIENCY TESTING SAMPLES Standard