Clark Dermatology Llc

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 33D2113003
Address 1324 Victory Boulevard, Staten Island, NY
City Staten Island
State NY

Citation History (1 survey)

Survey - January 27, 2026

Survey Type: Standard

Survey Event ID: V5SO11

Deficiency Tags: D5209

Summary:

Summary Statement of Deficiencies D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on review of Standard Operating Procedures (SOPs), personnel training records, competency evaluation documentation, as well as interview with the Site Manager (SM), the laboratory failed to follow written policies and procedures to assess employee competency. FINDINGS: 1. There was no documentation of Technical Personnel (TP) annual competency evaluation performance for 2024 and 2025. 2. This was contrary to instructions indicated in the current, approved SOP, "Mohs Laboratory Policy & Procedure for Evaluation of Technical Personnel". 3. The SM confirmed the findings on January 27, 2026, at 11:00 A.M. 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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