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
▼ 52D2192461 Biolife Plasma Services Lp 7801 W Layton Ave Greenfield WI 10/22/2024 OM8L11 Standard
Deficiency Tag Deficiency Description Tag Type
D5439 CALIBRATION AND CALIBRATION VERIFICATION Standard
▼ 52D2193225 Monarch Addiction Recovery Clinics, Sc 521 E Washington Ave Madison WI 08/25/2021 R8E211 Standard
Deficiency Tag Deficiency Description Tag Type
D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE Standard
D6102 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2193225 Monarch Addiction Recovery Clinics, Sc 521 E Washington Ave Madison WI 02/14/2023 C8H211 Standard
Deficiency Tag Deficiency Description Tag Type
D2009 TESTING OF PROFICIENCY TESTING SAMPLES Standard
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
▼ 52D2193939 Froedtert Community Hospital - Pewaukee 209 Pewaukee Road Pewaukee WI 09/21/2021 PHVZ11 Standard
Deficiency Tag Deficiency Description Tag Type
D6006 LABORATORY DIRECTOR RESPONSIBILITIES Standard
▼ 52D2193939 Froedtert Community Hospital - Pewaukee 209 Pewaukee Road Pewaukee WI 03/14/2023 ZLAD11 Standard
Deficiency Tag Deficiency Description Tag Type
D5215 EVALUATION OF PROFICIENCY TESTING PERFORMANCE Standard
D5409 PROCEDURE MANUAL Standard
D5545 HEMATOLOGY Standard
D5787 TEST RECORDS Standard
D6019 LABORATORY DIRECTOR RESPONSIBILITIES Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2193939 Froedtert Community Hospital - Pewaukee 209 Pewaukee Road Pewaukee WI 01/07/2025 II2711 Standard
Deficiency Tag Deficiency Description Tag Type
D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
▼ 52D2201015 Shield T3, Llc 2115 Observatory Dr Madison WI 04/20/2021 495611 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
D3005 FACILITIES Standard
▼ 52D2215576 Aspirus Wausau Hospital 333 Pine Ridge Blvd Wausau WI 02/21/2024 PNZE11 Standard
Deficiency Tag Deficiency Description Tag Type
D5805 TEST REPORT Standard
D6072 TESTING PERSONNEL RESPONSIBILITIES Standard
▼ 52D2218240 Ascension Wisconsin Hospital N88 W14275 Main St, Suite 100 Menomonee Falls WI 11/15/2024 P4EY11 Standard
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D5024 HEMATOLOGY Condition
D5403 PROCEDURE MANUAL Standard
D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT Standard
D5787 TEST RECORDS Standard
▼ 52D2232875 Godx, Inc 510 Charmany Dr Ste 265 Madison WI 04/05/2022 3XP611 Special
Deficiency Tag Deficiency Description Tag Type
D0000 Initial Comments - Not A Deficiency Citation Memo
D0000 Initial Comments - Not A Deficiency Citation Memo
D6047 TECHNICAL CONSULTANT RESPONSIBILITIES Standard
D6053 TECHNICAL CONSULTANT RESPONSIBILITIES Standard