Excellence Medical Labs

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 10D2261254
Address 1301 Beville Rd Unit 10, Daytona Beach, FL, 32119
City Daytona Beach
State FL
Zip Code32119
Phone386 238-9064
Lab DirectorHUSAM EDDIN

Citation History (1 survey)

Survey - February 3, 2025

Survey Type: Standard

Survey Event ID: OPNP11

Deficiency Tags: D0000 D3031

Summary:

Summary Statement of Deficiencies D0000 Excellence Medical Labs was found to NOT be in compliance with 42 CFR Part 493, Requirements for Laboratories as a result of a initial survey on February 3, 2025. D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. In addition, retain the following: This STANDARD is not met as evidenced by: Based on record review and staff interview, the laboratory failed to retain hematology quality control records between January 18, 2025 and January 30, 2025. Findings include: Review of the laboratory document titled "Daily Laboratory Specimen Log" showed a "Complete Blood Count" was ordered on approximately 24 patients between January 18th, 2025 and January 30, 2025. The laboratory was unable to show quality control documentation for each day of patient testing. Two patients were tested on 1/18/25; Eights patients were tested on 1/22/25; Six patients on 1/27/25; Six patients on 1/29/25; and two patients were tested on 1/30/25. The interview on 2/3/25 at 12:55pm with Testing Person A confirmed the records were missing. 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 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access