Twin Rivers Urology Pc

CLIA Laboratory Citation Details

1
Total Citation
1
Total Deficiency
1
Unique D-Tag
CMS Certification Number 31D1022243
Address 388 Memorial Parkway, Phillipsburg, NJ, 08865
City Phillipsburg
State NJ
Zip Code08865
Phone(908) 387-9209

Citation History (1 survey)

Survey - January 23, 2020

Survey Type: Standard

Survey Event ID: 9VX411

Deficiency Tags: D5805

Summary:

Summary Statement of Deficiencies D5805 TEST REPORT CFR(s): 493.1291(c) The test report must indicate the following: (c)(1) For positive patient identification, either the patient's name and identification number, or a unique patient identifier and identification number. (c)(2) The name and address of the laboratory location where the test was performed. (c)(3) The test report date. (c)(4) The test performed. (c)(5) Specimen source, when appropriate. (c)(6) The test result and, if applicable, the units of measurement or interpretation, or both. (c)(7) Any information regarding the condition and disposition of specimens that do not meet the laboratory's criteria for acceptability. This STANDARD is not met as evidenced by: Based on surveyor review of the Test Report (TR) and interview with the Laboratory Consultant (LC), the laboratory failed to have all test results on the TR from 12/27/17 to the date of the survey. The finding includes: 1. The TR stated "PIN4 is the only IHC cocktail stain, and when performed will be clearly documented on the report" but a review of five TR with PIN4 stains revealed five out of five did not have a test result. 2. The LC confirmed on 1/23/20 at 10:30 am the TR did not include all test results. 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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