Low Testosterone Men's Clinic

CLIA Laboratory Citation Details

3
Total Citations
34
Total Deficiencyies
14
Unique D-Tags
CMS Certification Number 45D2044214
Address 5604 Colleyville Blvd Suite H, Colleyville, TX, 76034
City Colleyville
State TX
Zip Code76034
Phone(817) 416-5698

Citation History (3 surveys)

Survey - June 16, 2022

Survey Type: Standard

Survey Event ID: 8HPH11

Deficiency Tags: D0000 D1001 D5311 D0000 D1001 D5311

Summary:

Summary Statement of Deficiencies D0000 Laboratory representatives were present at the entrance conference. The survey process was discussed. An opportunity for questions and comments was given. The exit conference was held with the laboratory representatives. The laboratory was found to be in substantial compliance for the specialties/subspecialties for which it was surveyed. The standard level deficiencies cited were discussed. The process for submitting the corrections was explained. CMS form 2567 will be emailed from the Texas Health and Human Services Commission, Health Facility Compliance Arlington Group. 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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Survey - June 2, 2021

Survey Type: Standard

Survey Event ID: G0QS11

Deficiency Tags: D0000 D5311 D5417 D0000 D5311 D5417

Summary:

Summary Statement of Deficiencies D0000 An entrance conference was held with the laboratory representative. The survey process was discussed, and survey forms were provided. An opportunity for questions and comments was given. Noted deficiencies and plans of correction were discussed with the laboratory representatives at the exit conference. The laboratory representatives were given an opportunity to provide evidence of compliance with the noted deficiencies, and no such evidence was provided prior to survey exit. The facility was found to be in COMPLIANCE with applicable Conditions of Participation in the CLIA program, and recertification is recommended. 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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Survey - January 15, 2019

Survey Type: Standard

Survey Event ID: FLT511

Deficiency Tags: D0000 D2007 D5211 D5400 D5415 D5429 D5441 D6000 D6007 D6018 D0000 D2007 D2015 D2015 D5211 D5400 D5415 D5429 D5441 D6000 D6007 D6018

Summary:

Summary Statement of Deficiencies D0000 Noted deficiencies and plans of correction were discussed with the laboratory representative at the entrance and exit conferences. The facility representative was given an opportunity to provide evidence of compliance with the noted deficiency, and no such evidence was provided prior to survey exit. The facility was found to be NOT in compliance with the CLIA conditions for specialties/subspecialties surveyed for 45 CFR 493.1250 Analytic Systems 493.1403 Moderate Complexity Laboratory Director 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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