Silver Falls Dermatology-Woodburn

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 38D1093601
Address 685 Evergreen Road Ne, Woodburn, OR, 97071
City Woodburn
State OR
Zip Code97071
Phone(971) 915-8570

Citation History (1 survey)

Survey - January 25, 2021

Survey Type: Standard

Survey Event ID: 7OSH11

Deficiency Tags: D5417

Summary:

Summary Statement of Deficiencies D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on inspection of the open container of 10% potassium hydroxide (KOH) used by the Physician Assistant (PA) for fungal wet mounts in this lab and discussion with the Quality Compliance manager, the laboratory failed to ensure that only in date reagents are used on patient specimens. Findings include: 1. During the survey 01/25 /2021, the surveyor requested to visually examine the KOH bottle. When it was produced, it was noted to be expired as of 02/18/2020. 2. The Quality Compliance manager confirmed the finding during interview on 01/25/2021 at approximately 1230. 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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