Peterson Dermatology

CLIA Laboratory Citation Details

1
Total Citation
4
Total Deficiencyies
4
Unique D-Tags
CMS Certification Number 11D1073390
Address 305 First Street West, Vidalia, GA, 30474
City Vidalia
State GA
Zip Code30474
Phone(912) 538-9080

Citation History (1 survey)

Survey - August 16, 2018

Survey Type: Standard

Survey Event ID: 8DCS11

Deficiency Tags: D0000 D2000 D5403 D5477

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on August,16 2018. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: D2000 ENROLLMENT AND TESTING OF SAMPLES CFR(s): 493.801 Each laboratory must enroll in a proficiency testing (PT) program that meets the criteria in subpart I of this part and is approved by HHS. The laboratory must enroll in an approved program or programs for each of the specialties and subspecialties for which it seeks certification. The laboratory must test the samples in the same manner as patients' specimens. For laboratories subject to 42 CFR part 493 published on March 14, 1990 (55 FR 9538) prior to September 1, 1992, the rules of this subpart are effective on September 1, 1992. For all other laboratories, the rules of this subpart are effective January 1, 1994. This CONDITION is not met as evidenced by: Based on review of the procedure manuals and staff interview, the laboratory was not enrolled in a proficiency testing(PT) program. Findings: 1. Review of the procedure for Dermatophyte Test Medium (DTM), failed to mention that PT was being performed. 2. Interview with the LD and staff #3 (CMS 209 form), on August 18, 2018, at approximately 2:30 pm in the lab, confirmed that the laboratory was not performing PT for the DTM procedure. D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 2 -- storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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