Childrens Physicians - Eagle Run

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
1
Unique D-Tag
CMS Certification Number 28D0921020
Address 13808 West Maple Road #100, Omaha, NE, 68164
City Omaha
State NE
Zip Code68164
Phone402 955-3000
Lab DirectorDAVID KAUFMAN

Citation History (1 survey)

Survey - February 19, 2020

Survey Type: Standard

Survey Event ID: EJ2V11

Deficiency Tags: D5819 D5819

Summary:

Summary Statement of Deficiencies D5819 TEST REPORT CFR(s): 493.1291(j) All test reports or records of the information on the test reports must be maintained by the laboratory in a manner that permits ready identification and timely accessibility. This STANDARD is not met as evidenced by: Based on surveyor record review and interview with the technical consultant the laboratory failed to maintain complete blood count instrument print out test records in a manner that permits identification and accessibility. Findings are: 1. Review of complete blood count instrument print out test records for February 2020 revealed one instrument print out test record, from 2/10/2020, with incorrect patient identification. 2. Interview with the technical consultant on 2/19/2020 at 10:55AM confirmed the one instrument print out test record had incorrect patient identification. 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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