Willamette Dermatology Pc

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
1
Unique D-Tag
CMS Certification Number 38D0965600
Address 19875 Sw 65th Avenue Suite 260, Tualatin, OR, 97062
City Tualatin
State OR
Zip Code97062
Phone(503) 691-1743

Citation History (1 survey)

Survey - June 13, 2019

Survey Type: Standard

Survey Event ID: UB6F11

Deficiency Tags: D5217 D5217

Summary:

Summary Statement of Deficiencies D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on review of Proficiency Testing records and discussion with the staff the laboratory failed to verify the accuracy of the test or procedure twice annually for the Potassium Hydroxide (KOH) test system. Findings include: 1. The surveyor requested and the laboratory failed to provide biannual verification for the KOH test system for 2018 and 2019. 2. The last biannual verification documentation was done by AKK PA- C in October, 1 2017. 3. The Laboratory Director and the Nurse Manager concurred with these findings 06/13//2019 at 15:00 PM. 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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