Dermatology & Cosmetic Center Pllc

CLIA Laboratory Citation Details

2
Total Citations
9
Total Deficiencyies
9
Unique D-Tags
CMS Certification Number 23D2273712
Address 5097 Miller Road Suite 1, Flint, MI, 48507
City Flint
State MI
Zip Code48507
Phone(833) 322-3376

Citation History (2 surveys)

Survey - June 30, 2025

Survey Type: Standard

Survey Event ID: 3RI011

Deficiency Tags: D5435

Summary:

Summary Statement of Deficiencies D5435 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(b)(2) (b)(2)(i) Define a function check protocol that ensures equipment, instrument, and test system performance that is necessary for accurate and reliable test results and test result reporting. (b)(2)(ii) Perform and document the function checks, including background or baseline checks, specified in paragraph (b)(2)(i) of this section. Function checks must be within the laboratory's established limits before patient testing is conducted. This STANDARD is not met as evidenced by: Based on observation, record review and interview with the Office Manager (OM), the laboratory failed to establish a preventative maintenance protocol for a thermometer for 19 (November 2023 to July 2025) of 19 months reviewed. Findings include: 1. During a laboratory tour on 06/30/2025 at 9:30 a.m., the surveyor observed a ThermPro thermometer in use. The thermometer lacked documentation of a calibration or maintenance date. 2. Review of laboratory procedures revealed the absence of a written policy addressing preventive maintenance or calibration of thermometers. 3. During an interview on 06/30/2025 at 10:00 a.m., the OM confirmed that the thermometer was used for monitoring ambient room temperature and no annual maintenance or calibration had been performed on the thermometer. 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 - October 23, 2023

Survey Type: Standard

Survey Event ID: KUJT11

Deficiency Tags: D6082 D6096 D6106 D5028 D5403 D5423 D5779 D6076

Summary:

Summary Statement of Deficiencies D5028 HISTOPATHOLOGY CFR(s): 493.1219 If the laboratory provides services in the subspecialty of Histopathology, the laboratory must meet the requirements specified in 493.1230 through 493.1256, 493. 1273, and 493.1281 through 493.1299. This CONDITION is not met as evidenced by: . Based on record review and interviews, the laboratory failed to establish a test procedure to include microscopic examination for its histopathology testing (refer to D5403), failed to establish performance specifications for its histopathology testing before reporting patient test results (refer to D5423), and failed to perform

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