Goldsboro Pediatrics, Pa

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 34D0239916
Address 2706 Medical Office Place, Goldsboro, NC, 27534
City Goldsboro
State NC
Zip Code27534
Phone919 734-4736
Lab DirectorSIEGFRIED YEH

Citation History (1 survey)

Survey - January 7, 2022

Survey Type: Standard

Survey Event ID: 8BY211

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 review of manufacturer's instructions for use (IFU) and interview with laboratory manager 1/7/22, the laboratory failed to ensure authorized Fact Sheets for patients and providers were included with SARS-CoV-2 test result reports. Findings: Review of IFU for Quidel Sofia-SARS Antigen Fluorescent Immunoassay (FIA) revealed on page 14 "Conditions of Authorization for the Laboratory...Authorized laboratories using your product will include with test result reports, all Authorized Fact Sheets." Interview with laboratory manager at approximately 11:20 a.m. confirmed the laboratory failed to provide authorized Fact Sheets with test result reports. She stated they were unaware Fact Sheets had to be provided. 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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