Daniel Witheiler, Md, Pa

CLIA Laboratory Citation Details

2
Total Citations
13
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 45D0922048
Address 1411 N Beckley Avenue Pavi Iii, Suite 470, Dallas, TX, 75203
City Dallas
State TX
Zip Code75203
Phone214 941-7546
Lab DirectorDANIEL WITHEILER

Citation History (2 surveys)

Survey - March 5, 2025

Survey Type: Standard

Survey Event ID: 57DE11

Deficiency Tags: D5417 D5417 D0000

Summary:

Summary Statement of Deficiencies D0000 The laboratory was found to be in substantial compliance with CLIA regulations 42 CFR Part 493. Standard level deficiencies were cited. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) (d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on surveyor observations, patient MOHs maps, and confirmed in staff interview, the laboratory failed to ensure two of four tissue marking dyes did not exceed their expiration dates prior to patient testing on 03/05/2025. Findings included: 1. During a tour of the histopathology laboratory on 03/05/2025 at 11:21 a.m., the surveyor observed the following expired tissue marking dyes located on the counter: Yellow Tissue Marking Dye - lot #166702; Expiration date: 02/28/2025 Red Tissue Marking Dye - lot #168108; Expiration date: 02/28/2025 2. Review of patient MOHs maps revealed one of one patient whose tissue was stained with the expired yellow tissue marking dye in the preparation of histopathology slides on 03/05/2025: MOHs accession # 25-154 3. During an interview 03/05/2025 at 11:23 a.m. in the laboratory, the Laboratory Manager and Histotechnician confirmed the tissue marking dyes had exceeded their expiration dates and the yellow dye used in patient testing. 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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Survey - February 22, 2023

Survey Type: Standard

Survey Event ID: GISM11

Deficiency Tags: D5311 D0000 D5217 D5311 D5473 D5801 D6046 D5473 D5801 D6046

Summary:

Summary Statement of Deficiencies D0000 Laboratory representatives were present at the entrance conference. The survey process was discussed. An opportunity for questions and comments was given. The exit conference was held with the laboratory representatives. The laboratory was found to be in substantial compliance for the specialties/subspecialties for which it was surveyed. The standard level deficiencies cited were discussed. The process for submitting the corrections was explained. CMS form 2567 will be emailed from the Texas Health and Human Services Commission, Health Facility Compliance Arlington Group. Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

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