Av Dermatology & Surgery Center

CLIA Laboratory Citation Details

1
Total Citation
3
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 05D0713931
Address 44215 15th St W Ste 309, Lancaster, CA, 93534
City Lancaster
State CA
Zip Code93534
Phone(661) 949-0004

Citation History (1 survey)

Survey - November 14, 2025

Survey Type: Standard

Survey Event ID: I79I11

Deficiency Tags: D5203 D6082 D5407

Summary:

Summary Statement of Deficiencies D5203 SPECIMEN IDENTIFICATION AND INTEGRITY CFR(s): 493.1232 The laboratory must establish and follow written policies and procedures that ensure positive identification and optimum integrity of a patient's specimen from the time of collection or receipt of the specimen through completion of testing and reporting of results. This STANDARD is not met as evidenced by: Based on the surveyor's review of patient testing records, log sheet, final reports, and an interview with the office manager (OM) on November 14, 2025; it was determined that the laboratory failed to follow established policies and procedures to ensure positive identification and optimum integrity of a patient's specimen from the time of collection or receipt of the specimen through completion of testing and reporting of results. The findings include: 1. The surveyor reviewed five patient records for Dermatopathology and identified one discrepancy. The last name of Patient 103125- 10 varied across all records, such as the patient log sheet, Mohs map card, slides, and electronic chart. 2. No

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