Atrium Health Wfb General Dermatology Laboratory -

CLIA Laboratory Citation Details

2
Total Citations
4
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 34D2200341
Address 5826 Samet Drive Suite 103, High Point, NC, 27265
City High Point
State NC
Zip Code27265
Phone(336) 905-6300

Citation History (2 surveys)

Survey - February 26, 2026

Survey Type: Standard

Survey Event ID: T24D11

Deficiency Tags: D6107 D6086

Summary:

Summary Statement of Deficiencies D6086 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(3)(ii) (e)(3)(ii) Verification procedures used are adequate to determine the accuracy, precision, and other pertinent performance characteristics of the method; and This STANDARD is not met as evidenced by: Based on review of the laboratory's policies and procedures and review of SOX10 validation records 2/26/26, the laboratory director failed to ensure that verification procedures used were adequate to verify the performance specifications of the SOX10 immunohistochemical stain prior to use for patient testing. Findings: Review of the laboratory's "Sry-related HMg-Box gene 10 (SOX10) Validation Procedure" revealed "... Interpretation of Results: The completed slides and Immuno Checklist and QC sheet are given to the Mohs surgeon for interpretation. Changes are made based on their interpretation of the slides provided. The stains are repeated based on recommendations/comments from the Mohs surgeon(s). Once all have come to agreement on the quality and reporoducibility of the SOX10 staining is sufficient for patient testing, the full validation packet is provided to the Laboratory Director for approval and final signature. ..." Review of SOX10 validation records revealed a log with a list of ten cases used to perform the validation and a notatation that each case was acceptable. The records did not include a summary/timeline of the steps taken to validate the SOX10 immunohistochemical stain, did not include any changes or adjustments made to the original protocol, and did not indicate the date that patient testing began. D6107 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(15) (e)(15) Specify, in writing, the responsibilities and duties of each consultant and each Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 2 -- supervisor, as well as each person engaged in the performance of the preanalytic, analytic, and postanalytic phases of testing, that identifies which examinations and procedures each individual is authorized to perform, whether supervision is required for specimen processing, test performance or result reporting and whether supervisory or director review is required prior to reporting patient test results. This STANDARD is not met as evidenced by: Based on review of policies and procedures, review of job descriptions, review of 2024 and 2025 competency evaluation records, and interview with the laboratory director 2/26/26, the laboratory director failed to specify in writing the duties and responsibilities for 3 of 3 histotechnicians. Review of the laboratory's "Quality Assurance Procedure" revealed "... Personnel All laboratory personnel are Histology Technicians who are ASCP certified and meet requirements for High-Complexity testing according to CLIA guidelines. ... The laboratory director performs direct observation for annual competency evaluation reviews and documentation is kept in the policy and procedure manual. ..." Review of the laboratory's "Testing personnel responsibilities" revealed general duties such as "Follow the laboratory's procedures for specimen handling and processing, test analyses, reporting and maintaining records of patient test results ...". The responsibilities did not indicate that histotechnicians are authorized to perform grossing. Review of 2024 and 2025 histotechnician competency evaluations revealed the competency evaluations for 3 of 3 histotechnicians did not indicate review of grossing competency by the laboratory director. During interview at approximately 10:00 a.m., the laboratory director stated that she performs most of the grossing in the laboratory, but histotechnicians do occasionally perform grossing. The laboratory director confirmed that grossing was not specifically listed as one of the histotechnician job duties. -- 2 of 2 --

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Survey - November 18, 2024

Survey Type: Standard

Survey Event ID: CLHI11

Deficiency Tags: D5417 D5417

Summary:

Summary Statement of Deficiencies D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on observation and interview with the histotechnician 11/18/24, the laboratory failed to discard supplies that had exceeded their expiration dates. Findings: During a tour of the laboratory at approximately 2:00 p.m., the surveyor observed the following expired supplies in the microscope room adjacent to the laboratory, available for use: 1. 1 bottle of Delasco 1% Toluidine Blue Aqueous Solution, lot #K20CG2 with expiration date 12/31/22; 2. 1 set of Fisherbrand Hema 3, including: a. 1 bottle of Hema 3 Fixative, lot #100035 with expiration date 11/2021; b. 1 bottle of Hema 3 Solution I, lot #100036 with expiration date 2/2022; c. 1 bottle of Hema 3 Solution II, lot #100037 with expiration date 2/2022. During interview at approximately 2:15 p. m., the histotechnician stated she was unaware the supplies were in that location and she was unsure what they were used for. 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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