Parkside Pediatric Clinic

CLIA Laboratory Citation Details

1
Total Citation
38
Total Deficiencyies
19
Unique D-Tags
CMS Certification Number 23D0683833
Address 2100 Fourth Street, Jackson, MI, 49203
City Jackson
State MI
Zip Code49203
Phone517 787-4332
Lab DirectorKATIKINENI RAO

Citation History (1 survey)

Survey - September 4, 2025

Survey Type: Standard

Survey Event ID: UHLM11

Deficiency Tags: D0000 D5024 D5403 D5441 D5781 D5781 D5785 D5805 D6000 D6000 D6020 D6020 D6024 D6026 D6031 D6033 D6050 D6051 D0000 D5024 D5403 D5429 D5429 D5441 D5783 D5783 D5785 D5805 D6019 D6019 D6024 D6026 D6031 D6033 D6050 D6051 D6052 D6052

Summary:

Summary Statement of Deficiencies D0000 A recertification survey was performed on September 4, 2025 by the State of Michigan Licensing and Regulatory Affairs Department. The laboratory was found to be out of compliance with CLIA regulations (42 CFR Part 493, Laboratory Requirements) for the following condition-level deficiencies: 493.1215 Condition: Hematology. 493.1403 Condition: Laboratories performing moderate complexity testing; laboratory director. 493.1409 Condition: Laboratories performing moderate complexity technical consultant. D5024 HEMATOLOGY CFR(s): 493.1215 If the laboratory provides services in the specialty of Hematology, the laboratory must meet the requirements specified in 493.1230 through 493.1256, 493.1269, and 493. 1281 through 493.1299. This CONDITION is not met as evidenced by: . Based on record review and interviews, the laboratory failed to establish test procedures to include specimen labeling, a step-by-step procedure for performing Complete Blood Count (CBC) testing, CBC reportable ranges, and CBC critical values (refer to D5403), failed to perform and document daily maintenance for its Medonic M-series hematology analyzer (refer to D5429 A), failed to perform and document monthly maintenance for its Medonic M-series hematology analyzer (refer to D5429 B), failed to follow its control procedures to test three control materials each day of testing (refer to D5441), failed to perform

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