Privia Medical Group Of North Texas Laboratory

CLIA Laboratory Citation Details

1
Total Citation
38
Total Deficiencyies
19
Unique D-Tags
CMS Certification Number 45D2176501
Address 2909 Lackland Rd, Fort Worth, TX, 76116
City Fort Worth
State TX
Zip Code76116
Phone(817) 740-8400

Citation History (1 survey)

Survey - March 9, 2022

Survey Type: Standard

Survey Event ID: ISTD11

Deficiency Tags: D0000 D5311 D5313 D5317 D5401 D5413 D5449 D5473 D5783 D5785 D5805 D6000 D6007 D6033 D6036 D6000 D0000 D5300 D5300 D5311 D5313 D5317 D5417 D5401 D5413 D5417 D5449 D5473 D5783 D5785 D5805 D6053 D6007 D6033 D6036 D6127 D6053 D6127

Summary:

Summary Statement of Deficiencies D0000 An entrance conference was held with the laboratory representatives. The survey process was discussed, and survey forms were provided. An opportunity for questions and comments was given. Noted deficiencies and plans of correction were discussed with the laboratory representatives at the exit conference. The laboratory representatives were given an opportunity to provide evidence of compliance with the noted deficiencies, and no such evidence was provided prior to survey exit. The facility was found to be NOT in compliance with the CLIA conditions for specialties /subspecialties surveyed for 42 CFR 493.1240 Pre-Analytic Systems 493.1403 Laboratory Director, (moderate complexity) 493.1409 Technical Consultant, (moderate complexity) Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

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