Grand River Medical Group West

CLIA Laboratory Citation Details

1
Total Citation
3
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 16D2184312
Address 4025 Westmark Dr Ste 100, Dubuque, IA, 52002
City Dubuque
State IA
Zip Code52002
Phone(563) 583-9300

Citation History (1 survey)

Survey - July 31, 2023

Survey Type: Standard

Survey Event ID: 0P8311

Deficiency Tags: D5016 D5469 D5783

Summary:

Summary Statement of Deficiencies D5016 ROUTINE CHEMISTRY CFR(s): 493.1210 If the laboratory provides services in the subspecialty of Routine Chemistry, the laboratory must meet the requirements specified in 493.1230 through 493.1256, 493. 1267, and 493.1281 through 493.1299. This CONDITION is not met as evidenced by: Based on review of the Alfa Wasserman ACE Alkaline Phosphatase (ALP) reagent package insert, the manufacturer's quality control (QC) package inserts, the laboratory QC records, the Quality Control Program procedure, and confirmed by laboratory personnel identifier #1 (refer to the Laboratory Personnel Report) at approximately 1: 30 pm on 7/31/2023, the laboratory failed to verify the criteria for acceptable control ranges as specified in D5469 and failed to document

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