Numale Wisconsin Gb, Sc

CLIA Laboratory Citation Details

2
Total Citations
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 52D2091821
Address 1525 Park Place, Ashwaubenon, WI, 54304
City Ashwaubenon
State WI
Zip Code54304
Phone920 784-2600
Lab DirectorADAM AICHER

Citation History (2 surveys)

Survey - January 10, 2023

Survey Type: Standard

Survey Event ID: E5PM11

Deficiency Tags: D0000

Summary:

Summary Statement of Deficiencies D0000 The laboratory was found to be in substantial compliance with CLIA regulations (42 CFR Part 493, effective April 24, 2003). No deficiencies were cited. 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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Survey - December 19, 2018

Survey Type: Standard

Survey Event ID: Q14811

Deficiency Tags: D2007

Summary:

Summary Statement of Deficiencies D2007 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The samples must be examined or tested with the laboratory's regular patient workload by personnel who routinely perform the testing in the laboratory, using the laboratory's routine methods This STANDARD is not met as evidenced by: Based on surveyor review of proficiency testing (PT) records from 2017 and interview with the Director of Operations (staff A), the laboratory did not perform proficiency testing using the laboratory's routine methods for testing patient samples. Findings include: 1. PT records from event one in 2017 include a "Performance Review and

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