Amg Manitowoc 4100 Dewey

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
1
Unique D-Tag
CMS Certification Number 52D0963259
Address 4100 Dewey St, Manitowoc, WI, 54220
City Manitowoc
State WI
Zip Code54220
Phone(920) 686-5700

Citation History (1 survey)

Survey - May 8, 2019

Survey Type: Standard

Survey Event ID: 2S2W11

Deficiency Tags: D5409 D5409

Summary:

Summary Statement of Deficiencies D5409 PROCEDURE MANUAL CFR(s): 493.1251(e) The laboratory must maintain a copy of each procedure with the dates of initial use and discontinuance as described in 493.1105(a)(2). This STANDARD is not met as evidenced by: Based on surveyor review of procedures and interview with the general supervisor, the laboratory has not maintained a copy of the i-STAT troponin procedure with the date of discontinuance. Findings include: 1. Review of the i-STAT troponin procedure showed no indication the lab discontinued performing this procedure. 2. Interview with the general supervisor on May 8, 2019 at 9:15 AM confirmed the laboratory discontinued the i-STAT troponin procedure on August 8, 2018. The interview also confirmed the laboratory had not retained a copy of the procedure with the date of discontinuance. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 1 --

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