Brian E Dubow, Md

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 05D0544604
Address 435 N Roxbury Dr Ste 204, Beverly Hills, CA, 90210-5004
City Beverly Hills
State CA
Zip Code90210-5004
Phone310 888-4070
Lab DirectorBRIAN DUBOW

Citation History (1 survey)

Survey - June 10, 2025

Survey Type: Standard

Survey Event ID: LGZO11

Deficiency Tags: D5821 D6098

Summary:

Summary Statement of Deficiencies D5821 TEST REPORT CFR(s): 493.1291(k) (k)When errors in the reported patient test results are detected, the laboratory must do the following: (k)(1) Promptly notify the authorized person ordering the test and, if applicable, the individual using the test results of reporting errors. (k)(2) Issue corrected reports promptly to the authorized person ordering the test and, if applicable, the individual using the test results. (k)(3) Maintain duplicates of the original report, as well as the corrected report. This STANDARD is not met as evidenced by: Based on the surveyor's review of the laboratory's quality assessment policy /procedure, five (5) Dermatopathology patient records, and an interview with the medical assistant (MA), it was determined that the laboratory failed to correctly document patient information upon its occurrence. The findings include: 1. The surveyor reviewed 5 Dermatopathology patients. One out of 5 was mispelled on the Moh's map card that affected other records such as patient log and slides. 2. The laboratory practice was to use patient's name and date of service only as major identifiers. Patient number 5 with initials IJ, serviced on 2/19/2025 was affected by the mispelled name as mentioned in statement#1. No

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