New Jersey Urology

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 31D0889188
Address 776 East Third Avenue, Roselle, NJ, 07203
City Roselle
State NJ
Zip Code07203
Phone(908) 241-5268

Citation History (1 survey)

Survey - March 19, 2019

Survey Type: Standard

Survey Event ID: S71B11

Deficiency Tags: D5805

Summary:

Summary Statement of Deficiencies D5805 TEST REPORT CFR(s): 493.1291(c) The test report must indicate the following: (c)(1) For positive patient identification, either the patient's name and identification number, or a unique patient identifier and identification number. (c)(2) The name and address of the laboratory location where the test was performed. (c)(3) The test report date. (c)(4) The test performed. (c)(5) Specimen source, when appropriate. (c)(6) The test result and, if applicable, the units of measurement or interpretation, or both. (c)(7) Any information regarding the condition and disposition of specimens that do not meet the laboratory's criteria for acceptability. This STANDARD is not met as evidenced by: Based on surveyor review of the Final Reports (FR) and interview with the Office Manager (OM), the laboratory failed to ensure that the Test Report Date (TRD) was indicated on the FR from 4/18/17 to the date of survey. The OM confirmed on 3/19/19 at 12:55 pm that the TRD was not on the FR. 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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