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CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
1
Unique D-Tag
CMS Certification Number 34D2071341
Address 3193 West Highway 74, Monroe, NC, 28110
City Monroe
State NC
Zip Code28110
Phone(704) 698-4089

Citation History (1 survey)

Survey - September 29, 2021

Survey Type: Standard

Survey Event ID: E8GH11

Deficiency Tags: D2007 D2007

Summary:

Summary Statement of Deficiencies D2007 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The samples must be examined or tested with the laboratory's regular patient workload by personnel who routinely perform the testing in the laboratory, using the laboratory's routine methods This STANDARD is not met as evidenced by: Based on review of the CMS-209 and review of 2019, 2020, and 2021 CAP (College of American Pathologists) proficiency testing records 9/29/21, the laboratory failed to ensure proficiency testing was rotated among personnel who routinely perform patient testing. Review of the CMS-209 Laboratory Personnel Report (CLIA) revealed 28 TP (testing personnel) were listed on the form. Review of 2019, 2020, and 2021 CAP proficiency testing records revealed proficiency samples for 3 of 12 events were tested by 3 different TP who are no longer employed. Samples for 9 of 12 events were tested by 2 of the 28 testing personnel - TP #1 and TP #9. a. TP #1 tested all samples for the 2019 FH2-B hematology event, the 2020 FH2-B hematology event, the 2020 AQI-C chemistry event, the 2021 FH2-A hematology event, and the 2021 AQI-B chemistry event. b. TP #9 tested all samples for the 2020 FH2-C hematology event, the 2020 AQI-B chemistry event, the 2021 FH2-B hematology event, and the 2021 AQI-A chemistry event. 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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