T I M M A Diagnostic Laboratory

CLIA Laboratory Citation Details

2
Total Citations
9
Total Deficiencyies
9
Unique D-Tags
CMS Certification Number 05D0960705
Address 5620 Wilbur Ave Ste 330, Tarzana, CA, 91356-1335
City Tarzana
State CA
Zip Code91356-1335
Phone310 918-9920
Lab DirectorSAMUEL MD

Citation History (2 surveys)

Survey - December 15, 2025

Survey Type: null

Survey Event ID: J6FJ11

Deficiency Tags: D0000 D2026 D6089 D2016 D6076

Summary:

Summary Statement of Deficiencies D0000 A proficiency testing desk review survey was performed on December 15, 2025, the laboratory was found not in compliance with the following CONDITION LEVEL DEFICIENCIES D2016 - 42 C.F.R. 493.803 Condition: Successful proficiency testing participation; and D6076 - 42 C.F.R. 493.1441 Condition: Laboratories performing high complexity testing; laboratory director. D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: Based on review of the Certification and Survey Provider Enhanced Reporting (CASPER) - 0155D and American Association of Bioanalysts - Medical Laboratory Evaluation (AAB-MLE) records (2023-M2, 2023-M3, and 2024-M2), the laboratory 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 -- failed to successfully participate in a proficiency testing program approved by HHS for each specialty, subspecialty and analyte or test in which the laboratory is certified under CLIA, the laboratory failed to successfully participate in the analyte Gram stain resulting in unsuccessful performances. See D2026. D2026 BACTERIOLOGY CFR(s): 493.823(d) (d)(1) For any unsatisfactory testing event for reasons other than a failure to participate, the laboratory must undertake appropriate training and employ the technical assistance necessary to correct problems associated with a proficiency testing failure. (2) Remedial action must be taken and documented, and the documentation must be maintained by the laboratory for two years from the date of participation in the proficiency testing event. This STANDARD is not met as evidenced by: Based on review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile and American Association of Bioanalysts - Medical Laboratory Evaluation (AAB-MLE) report, the laboratory failed to achieve satisfactory performance for three events (2023-M2, 2023-M3, and 2024-M2) for the analyte Gram stain (specialty Microbiology): The finding include: Gram stain 0% - 2023 second testing event (M2); 0% - 2023 third testing event (M3); 0% - 2024 second testing event (M2); A review of the 2023 & 2024 scores from AAB- MLE reports confirmed the above subsequent proficiency testing failures. D6076 LABORATORY DIRECTOR CFR(s): 493.1441 The laboratory must have a director who meets the qualification requirements of 493. 1443 of this subpart and provides overall management and direction in accordance with 493.1445 of this subpart. This CONDITION is not met as evidenced by: Based on a proficiency testing desk review of the CASPER 0155D report and American Association of Bioanalysts - Medical Laboratory Evaluation records for 2023-M2, 2023-M3, and 2024-M2 events, the laboratory director failed to provide overall management and direction of the laboratory services. Refer to D6089. D6089 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(4)(i) (e)(4)(i) The proficiency testing samples are tested as required under subpart H of this part; This STANDARD is not met as evidenced by: Based on a proficiency testing desk review of the CASPER 0155D report and American Association of Bioanalysts - Medical Laboratory Evaluation records for 2023-M2, 2023-M3 and 2024-M2 events, the laboratory director failed to ensure successful participation in an HHS proficiency testing program. Refer to D2026. -- 2 of 2 --

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Survey - December 4, 2025

Survey Type: Standard

Survey Event ID: FL4B11

Deficiency Tags: D5221 D6019 D2087 D6016

Summary:

Summary Statement of Deficiencies D2087 ROUTINE CHEMISTRY CFR(s): 493.841(a) (a) Failure to attain a score of at least 80 percent of acceptable responses for each analyte in each testing event is unsatisfactory analyte performance for the testing event. This STANDARD is not met as evidenced by: Based on the surveyor's review of the American Proficiency Institute (API) proficiency testing (PT) records and an interview+ with the office manager (OM), it was determined that the laboratory failed to attain at least 80 percent of the acceptable score in Routine Chemistry for the Total Bilirubin, Magnesium and Triglycerides analytes. The findings include: 1. The surveyor reviewed the PT records wherein API reported an unsatisfactory score of the following: a. Total Bilirubin, first event of 2023 (Q1-2023) Sample Reported Expected CH-01 0.4 0.0 - 0.8 CH-02 0.1 0.0 - 0.4 CH-03 *4.9 3.0 - 4.6 CH-04 1.3 0.7 - 1.5 CH-05 *3.3 2.0 - 3.2 b. Magnesium, first event of 2024 (Q1-2024) Sample Reported Expected CH-01 *2.2 1.0 - 1.7 CH-02 4.6 2.7 - 4.7 CH-03 3.9 2.2 - 3.9 CH-04 *2.3 1.2 - 2.1 CH-05 >4.8 3.5 - 6.0 c. Triglycerides, third event of 2025 (Q3-2025) Sample Reported Expected CH-11 *164 117 - 160 CH-12 267 202 - 275 CH-13 *119 84 - 115 CH-14 178 134 - 183 CH-15 205 151 - 206 Legend: * = unsatisfactory score 2. The OM affirmed by an interview on December 4, 2025, at approximately 9:40 a.m. that the laboratory obtained the unsatisfactory PT scores for Total Bilirubin, Magnesium and Triglycerides analytes mentioned in statement #1. 3. The accuracy and reliability of patient test reported cannot be determined. 4. According to the laboratory's testing declaration form (Lab- 144) submitted on the day of the survey, the laboratory performed approximately 80,665 patient test samples annually for Routine Chemistry including the Total Bilirubin, Magnesium and Triglycerides analytes during the time the laboratory received an unsatisfactory proficiency testing scores. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(d) All proficiency testing evaluation and verification activities must be documented. This STANDARD is not met as evidenced by: Based on the review of the laboratory's policy and procedure, American Proficiency Institute (API) proficiency testing (PT) records and an interview with the office manager (OM) on December 4, 2025; the laboratory failed to perform/document a

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