Intermountain West Valley Clinic

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
1
Unique D-Tag
CMS Certification Number 46D2113880
Address 5373 West Lake Park Boulevard, West Valley City, UT, 84120
City West Valley City
State UT
Zip Code84120
Phone801 902-8010
Lab DirectorPARK WILLIS

Citation History (1 survey)

Survey - May 11, 2021

Survey Type: Standard

Survey Event ID: 7LZ811

Deficiency Tags: D5417 D5417

Summary:

Summary Statement of Deficiencies D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(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 record review, direct observation, and interview with the Technical Consultant, KOH reagent was used for patient testing after exceeding the expiration date. Findings include: 1. KOH reagent lot in use had an expiration date of 3/31/21. 2. Patient record review showed that KOH testing has been performed on 3 patients since 3/31/21. 3. In an interview on 5/11/21 at approximately 11:30 am, the Technical Consultant confirmed that patient testing had been performed using expired reagent. 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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