Medical Associates Clinic, Pc- East Campus

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 16D0386152
Address 1000 Langworthy Street, Dubuque, IA, 52001
City Dubuque
State IA
Zip Code52001
Phone563 584-3126
Lab DirectorTIMOTHY TIMMERMAN

Citation History (1 survey)

Survey - April 11, 2024

Survey Type: Standard

Survey Event ID: 2H1911

Deficiency Tags: D2009

Summary:

Summary Statement of Deficiencies D2009 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The individual testing or examining the samples and the laboratory director must attest to the routine integration of the samples into the patient workload using the laboratory's routine methods. This STANDARD is not met as evidenced by: Based on review of proficiency testing (PT) records and confirmed by laboratory personnel identifier #1 (refer to the Laboratory Personnel Report) at 11:08 am on 04 /11/2024, the laboratory director failed to attest to the routine integration of PT samples into the patient workload for two out of seven PT events from 01/01/2022 - 04 /11/2024. The findings include: 1. For 2022 event 2, the laboratory director did not sign the core chemistry and immunology/immunohematology PT attestation statements. 3. For 2023 event 3, the laboratory director and testing personnel did not sign the the immunology/immunohematology PT attestation statement. 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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