Ixi Wellness Dallas, Llc

CLIA Laboratory Citation Details

1
Total Citation
34
Total Deficiencyies
18
Unique D-Tags
CMS Certification Number 45D2176678
Address 140 Cypress Station Dr, Ste 121, Houston, TX, 77090
City Houston
State TX
Zip Code77090

Citation History (1 survey)

Survey - May 17, 2021

Survey Type: Complaint, Standard

Survey Event ID: P8GI11

Deficiency Tags: D0000 D3009 D5209 D5403 D5423 D5425 D5441 D5449 D5423 D5425 D5441 D5449 D5791 D5805 D6000 D6093 D5209 D5300 D5311 D5401 D5300 D5311 D5401 D5403 D5791 D5805 D6000 D6007 D6076 D6086 D6093 D6007 D6076 D6086

Summary:

Summary Statement of Deficiencies D0000 An initial survey was performed on 4/27/21, 4/28/21 and 5/10/21 in response to complaint TX00377562 The laboratory was found out of compliance with the CLIA regulations. Immediate jeopardy findings were identified. The conditions not met were: D5300 - 42 C.F.R. 493.1240 Condition: Preanalytic systems; D6000 - 42 C.F. R. 493.1403 Condition: Laboratories performing moderate complexity testing; laboratory director; D6076 - 42 C.F.R. 493.1441 Condition: Laboratories performing high complexity testing; laboratory director The laboratory voluntarily started to perform patient testing per the manufacturer's instructions on 5/18/21 as evidenced by a letter signed by the laboratory director on 5/17/21. The complaint TX00377562 was substantiated. Noted deficiencies and plans of correction were discussed with the laboratory representative at the exit conference. The facility representatives were given an opportunity to provide evidence of compliance with noted deficiencies and no such evidence was provided prior to survey exit. Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

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