Covid Clinic, Inc

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 52D2256363
Address 4323 W Wisconsin Ave, Appleton, WI, 54913
City Appleton
State WI
Zip Code54913
Phone(920) 733-6599

Citation History (1 survey)

Survey - March 30, 2022

Survey Type: Complaint

Survey Event ID: PS7M11

Deficiency Tags: D1001

Summary:

Summary Statement of Deficiencies D1001 CERTIFICATE OF WAIVER TESTS CFR(s): 493.15(e) Laboratories eligible for a certificate of waiver must-- (1) Follow manufacturers' instructions for performing the test; and (2) Meet the requirements in subpart B, Certificate of Waiver, of this part. This STANDARD is not met as evidenced by: Based on surveyor review of the manufacturer's instructions and interview with testing personnel, testing personnel did not follow the manufacturer's procedures for tests performed with the Accula SARS CoV-2 Test System. Findings include: 1. The manufacturer's instructions for the Accula SARS CoV-2 Test state, "Write the patient identification (ID) information and testing date on the Test Cassette label in the area provided." 2. Interview with testing personnel (staff A) on March 30, 2022 at approximately 1:45 PM revealed testing personnel did not write the patient information or testing date on the test cassettes prior to inserting them into the Accula Dock for processing. 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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