(2) (3) (4) (i) · effective date: november 24, 2017 . reason: unsuccessful pt . guido ring,...

CLIA ANNUAL LABORATORY REGISTRY 2017

Once a year the Centers for Medicare and Medicaid Services makes available to physicians and to the general public specific information (including information provided to CMS by the Office of the Inspector General) that is useful in evaluating the performance of laboratories. The Clinical Laboratory Improvement Amendments of 1988 (CLIA) and implementing regulations at 42 CFR 493.1850 require that this listing include the following:

(1) A list of laboratories that have been convicted, under Federal or State laws relating to fraud

and abuse, false billing, or kickbacks.

(2) A list of laboratories that have had principal sanctions imposed; their CLIA certificates suspended, limited, or revoked, and the reasons for the adverse actions.

(3) A list of persons who have been convicted of violating CLIA requirements, as specified in

section 353(1) of the PHS Act, together with circumstances of each case and the penalties imposed.

(4) A list of laboratories on which alternative sanctions have been imposed, showing-- (i) the effective date of the sanctions; (ii) the reason for imposing them; (iii) any corrective action taken by the laboratory; (iv) if the laboratory has achieved compliance, the verified date of compliance.

(5) A list of laboratories whose accreditation has been withdrawn or revoked and the reasons for

the withdrawal or revocation.

(6) All appeals and hearing decisions.

(7) A list of laboratories against which CMS has brought suit under Section 493.1846 and the reasons for those actions.

(8) A list of laboratories that have been excluded from participation in Medicare or Medicaid and

the reasons for exclusion.

Civil settlements reached with clinical laboratories are also noted.

The Laboratory Registry is compiled for the calendar year proceeding the date the information is made available and also contains corrections of any erroneous statements of information that appeared in the previous registry. A final section includes other specific information that may be useful in evaluating the performance of laboratories, as specified in 42 CFR 493.1850(a). It also includes information provided by CLIA exempt states.

2016 CLIA LAB REGISTRY

(AS REQUIRED BY SECTION 353(N) OF THE PUBLIC HEALTH SERVICE ACT)

ACTIVITY 01/01/2017 - 12/31/2017

1. LABORATORIES SUBJECT TO CLIA THAT HAVE BEEN CONVICTED, UNDER FEDERAL OR STATE LAWS RELATING TO FRAUD AND ABUSE, FALSE BILLING, OR KICKBACKS.

*** N O D A T A F O U N D ***

2. LABORATORIES THAT HAVE HAD THEIR CLIA CERTIFICATE SUSPENDED, LIMITED, OR REVOKED, AND THE REASON FOR THE ADVERSE ACTION. (MEDICARE CANCELLATION, A PRINCIPAL SANCTION, HAS BEEN INCLUDED IN THIS CATEGORY.)

MUHAMMAD RAZA, DIRECTOR

SOLTERRA SUBACUTE SERVICES

1501 E ORANGEWOOD AVE

PHOENIX, AZ 85020

CLIA ID# 03D2071368

SANCTION: Cancel Medicare/Medicaid Approval

Revocation of CLIA Certificate

EFFECTIVE DATE: April 11, 2017

April 11, 2017

REASON: Medicare Cancellation/Suspension

Condition Level Non-Compliance


Failure To Submit Acceptable POC or AOC

Lab Owner/Oper Prohibited From Owning Lab

DANIEL YOUNG, DIRECTOR

THERANOS, INC

1365 N SCOTTSDALE RD STE 350

SCOTTSDALE, AZ 85257

CLIA ID# 03D2077896

SANCTION: Suspension of CLIA Certificate

Cancel Medicare/Medicaid Approval

EFFECTIVE DATE: February 4, 2017

March 28, 2017


Condition Level Non-Compliance with IJ

MARK SCHOLZ MD, DIRECTOR

PROSTATE ONCOLOGY SPECIALIST, INC

4676 ADMIRALTY WAY STE 101

MARINA DEL REY, CA 90292

CLIA ID# 05D0547251

SANCTION: Limitation of CLIA Certificate

EFFECTIVE DATE: November 18, 2017

REASON: Cancellation of Medicare Approval Suspension


Unsuccessful PT

AFSHINE EMRANI MD, DIRECTOR

LOS ANGELES HEART SPECIALISTS

18370 BURBANK BLVD STE 401

TARZANA, CA 91356

CLIA ID# 05D0559170


EFFECTIVE DATE: October 2, 2017



Unsuccessful PT

GEORGE KIBLER, DIRECTOR

SURPRISE VALLEY HEALTH CARE DISTRICT LABORATORY

741 MAIN ST

CEDARVILLE, CA 96104

CLIA ID# 05D0618601


EFFECTIVE DATE: May 19, 2017



Unsuccessful PT

DENISE PHAN MD, DIRECTOR

CENTURY MEDICAL GROUP

15243 VANOWEN ST STE 101

VAN NUYS, CA 91405

CLIA ID# 05D0699902


EFFECTIVE DATE: July 28, 2017



Unsuccessful PT

KULDIP GILL MD, DIRECTOR

KULDIP S GILL MD

280 SIERRA COLLEGE DR STE 205

SPRING HILL, CA 95945

CLIA ID# 05D0943651


EFFECTIVE DATE: September 27, 2017



Unsuccessful PT

MICHAEL CHAIKIN MD, DIRECTOR

GCC LABORATORY

633 AERICK ST

INGLEWOOD, CA 90301

CLIA ID# 05D1078088





Unsuccessful PT

VASILIKI ECONOMOU MD, DIRECTOR

PLAXGEN INC

1895 MOWRY AVE STE 101D

FREMONT, CA 94538

CLIA ID# 05D2084226


Cancel Medicare/Medicaid Approval



April 28, 2017

April 28, 2017

REASON: 2 Year Prohibition From Owning, Operating and Directing

Medicare Cancellation/Suspension


Unsuccessful PT



WILLIAM CARRIERE, DIRECTOR

FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC

1215 DUNN AVE

JACKSONVILLE, FL 32218

CLIA ID# 10D0976317


EFFECTIVE DATE: January 13, 2017

REASON: Improper PT Testing Referral Activities

KEITH OBRIEN, DIRECTOR

STATLAB MOBILE

19101 SW 108TH AVE STE 4

MIAMI, FL 33157

CLIA ID# 10D2097278



REASON: Unsuccessful PT

GUIDO RING, DIRECTOR

GUIDO H RING MD

106 4TH AVENUE, WEST

CORDELE, GA 31015

CLIA ID# 11D0968447




Unsuccessful PT

GLENN BOYD, DIRECTOR

GLENN H BOYD, MD

1203 MEMORIAL DRIVE

DALTON, GA 30720

CLIA ID# 11D0976435




Unsuccessful PT

Failure to Correct Deficiencies

STATUS: Laboratory voluntarily Ceased Testing

JAMES YOST, DIRECTOR

PHYSICIANS IMMEDIATE MED OF BUFORD, PC

3425 BUFORD DRIVE

BUFORD, GA 30519

CLIA ID# 11D1068565




Unsuccessful PT


JOHN ROBACK, DIRECTOR

CASTLE MEDICAL, LLC

5700 HIGHLANDS PARKWAY, SUITE 100

SMYRNA, GA 30082

CLIA ID# 11D2017949




KUO LAM LEE M.D., DIRECTOR

MEDCROSS IMAGING, LLC

4375 JOHNS CREEK PKWY, STE 300

SUWANEE, GA 30024

CLIA ID# 11D2105207




October 5, 2017

REASON: Cancellation of Medicare Approval Revocation

2 Year Prohibition From Owning, Operating and Directing





STATUS: Revocation of CLIA Certificate

JEREMY HAYMORE, DIRECTOR

PHYSICIANS IMMEDIATE CARE CENTER

260 FALLS AVE #C

TWIN FALLS, ID 83301

CLIA ID# 13D0914355




DELLA HARWOOD MT (ASCP), DIRECTOR

LABORATORY CORPORATION OF AMERICA

914 W IRONWOOD DR #101

COEUR D'ALENE, ID 83814

CLIA ID# 13D1016580





CHRISTOPER MORGAN, DIRECTOR

STERLING FAMILY MEDICINE

1404 POMMERELL

BURLEY, ID 83318

CLIA ID# 13D2099992


EFFECTIVE DATE: December 23, 2017


ENRIQUE ARANA, DIRECTOR

LX HEALTH ADVOCATE CENTER

4906 N WESTERN

CHICAGO, IL 60625

CLIA ID# 14D2089856




February 19, 2017



ARNOLD FELDMAN, DIRECTOR

FELDMAN INSTITUTE, THE

455 E AIRPORT DRIVE

BATON ROUGE, LA 70806

CLIA ID# 19D1045136


Suspension of CLIA Certificate



February 22, 2017

April 11, 2017

REASON: Condition Level Non-Compliance with IJ





JOHN CANGELOSI, DIRECTOR

CYPRUS CLINICAL LABS OF LOUISIANA, LLC

1811 REES ST, SUITE D

BREAUX BRIDGE, LA 70517

CLIA ID# 19D2089617




EFFECTIVE DATE: March 1, 2017

March 1, 2017

April 25, 2017

REASON: Condition Level Non-Compliance

JOHN CANGELOSI, DIRECTOR

GENTOX LABORATORIES, LLC

1811 REES ST, SUITE C

BREAUX BRIDGE, LA 70517

CLIA ID# 19D2100562





March 1, 2017

April 25, 2017



STATUS: Revocation Pending Hearing


Appeal Filed By Laboratory

NOTE: The CLIA number was revoked following the resolution of the appeal.

VICKI THOMSON M.D., DIRECTOR

EDINA PEDIATRICS

7025 FRANCE AVE

EDINA, MN 55435

CLIA ID# 24D0403126







Failure to Submit Acceptable POC or AOC

DELIA SMITH M.D., DIRECTOR

MIDDLE MISSISSIPPI ANALYTICAL SERVICES

114 JEFFERSON DAVIS BLVD

NATCHEZ, MS 39120

CLIA ID# 25D0700329




October 22, 2017

REASON: Cancellation of Medicare Approval Revocation





T BART SHAW, DIRECTOR

TEXAS COUNTY MEMORIAL HOSPITAL

1333 S SAM HOUSTON BLVD

HOUSTON, MO 65483

CLIA ID# 26D0446923





WILLIAM BLANK, DIRECTOR

STE GENEVIEVE COUNTY MEM HOSPITAL

800 STE GENEVIEVE DRIVE

SAINTE GENEVIEVE, MO 63670

CLIA ID# 26D0652158




STATUS: Suspension and Limitation Lifted

AINA SILENIEKS, DIRECTOR

JEFFERSON COMMUNITY HEALTH CENTER INC

2200 H STREET

FAIRBURY, NE 68352

CLIA ID# 28D0047585


EFFECTIVE DATE: August 1, 2017


STATUS: Laboratory Voluntarily Ceased Testing

EDDIE PIERCE M.D., DIRECTOR

KEARNEY COUNTY HEALTH SERVICES

727 EAST 1ST STREET

MINDEN, NE 68959

CLIA ID# 28D0047880




STATUS: Compliance Achieved

GASTON MACHADO JR MD, DIRECTOR

HEALTHFIRST RAPID CARE

1675 N MAIN ST

SUMMERVILLE, SC 29483

CLIA ID# 42D1078836





Unsuccessful PT



SHERE CONWAY, DIRECTOR

COVENANT MEDICAL GROUP

DBA FAMILY CLINIC OF OAK RIDGE

100 VERMONT AVENUE

OAK RIDGE, TN 37830

CLIA ID# 44D0311959




Unsuccessful PT

TOSHIO YAMAUCHI, DIRECTOR

TOSHIO YAMAUCHI MD

16651 SOUTHWEST FREEWAY #150

SUGAR LAND, TX 77479

CLIA ID# 45D0495838

SANCTION: Revocation of CLIA Certificate


REASON: Failure to Correct Deficiencies


C LYNN ANDERSON JR, DIRECTOR

VALLEY DAY AND NIGHT CLINIC

1755 W PRICE RD

BROWNSVILLE, TX 78520

CLIA ID# 45D1047501




Unsuccessful PT

NEXT HEALTH, LLC & PIONEER

LABORATORIES LLC, OWNERS

UNITED TOXICOLOGY, LLC

5710 LBJ FREEWAY, SUITE 215

DALLAS, TX 75240

CLIA ID# 45D2023963




Improper PT Testing Referral Activities





AMERICAN LABORATORIES GROUP, LLC


DALLAS, TX 75240

CLIA ID# 45D2100510







HEALTH FIRST LABS, LLC

2801 BRAZOS BLVD, SUITE 4309

EULESS, TX 76039

CLIA ID# 45D2106109





CHARLOTTE VDOVYCHENKO, DIRECTOR

CHARLEY STANLEY LABORATORIES, LLC

2801 BRAZOS BLVD, #4309

EULESS, TX 76039

CLIA ID# 45D2108388








MAHMOOD AIJAZI M.D., DIRECTOR

CAPITAL DIAGNOSTIC LABORATORY, LLC

14 PIDGEON HILL DRIVE - SUITE 150

STERLING, VA 20165

CLIA ID# 49D1107549




November 28, 2017


Cancellation of Medicare Approval Revocation









NOTE: Revocation of CLIA Certificate effective Nov 28, 2017. Suspension and cancellation of Medicare approval effective Oct 4, 2017. Lab Owner and Lab Director prohibited from owning, operating and directing a CLIA lab from Nov 28, 2017 through Nov 28, 2019.

SAFIQUE AHMED, DIRECTOR

LOGAN HEMATOLOGY ONCOLOGY INC

KRUGER BUILDING SUITE 301

LOGAN, WV 25601

CLIA ID# 51D1003218




May 11, 2017

REASON: Failure to Correct Deficiencies



BRUCE HYDE, DIRECTOR

PHARMASAN LABS, INC

375 280TH ST BLDG A

OSCEOLA, WI 54020

CLIA ID# 52D0914898




December 26, 2017



3. A LIST OF PERSONS CONVICTED OF VIOLATING CLIA REQUIREMENTS AS SPECIFIED IN SECTION 353(1) OF THE PUBLIC HEALTH SERVICES ACT, WITH THE CIRCUMSTANCES OF EACH CASE AND THE PENALTIES IMPOSED.

*** N O D A T A F O U N D ***

4. A LIST OF LABORATORIES ON WHICH ALTERNATIVE SANCTIONS HAVE BEEN IMPOSED, SHOWING -

(I) THE EFFECTIVE DATE OF THE SANCTIONS

(II) THE REASON FOR IMPOSING THEM

(III) ANY CORRECTIVE ACTION TAKEN BY THE LABORATORY AND

(IV) IF LABORATORY HAS ACHIEVED COMPLIANCE, THE VERIFIED DATE OF THE COMPLIANCE

MUHAMMAD RAZA, DIRECTOR

SOLTERRA SUBACUTE SERVICES

1501 E ORANGEWOOD AVE

PHOENIX, AZ 85020

CLIA ID# 03D2071368

SANCTION: Civil Money Penalty

Directed Plan of Correction (DPOC)


February 25, 2017





DANIEL YOUNG, DIRECTOR

THERANOS, INC

1365 N SCOTTSDALE RD STE 350

SCOTTSDALE, AZ 85257

CLIA ID# 03D2077896

SANCTION: Directed Portion Plan of Correction (DPPOC)

Suspension of All of Medicare/Medicaid


February 4, 2017



STEPHEN LOCKE, DIRECTOR

MISSISSIPPI COUNTY HOSPITAL SYSTEM

SMC REGIONAL MEDICAL CENTER

611 WEST LEE MAIN BUILDING 1ST FLOOR

OSCEOLA, AR 72370

CLIA ID# 04D0049871





STATUS: Appeal Filed By Laboratory

MARK SCHOLZ MD, DIRECTOR

PROSTATE ONCOLOGY SPECIALIST, INC

4676 ADMIRALTY WAY STE 101

MARINA DEL REY, CA 90292

CLIA ID# 05D0547251

SANCTION: Suspension of Part of Medicare/Medicaid



November 30, 2017



Unsuccessful PT

AFSHINE EMRANI MD, DIRECTOR

LOS ANGELES HEART SPECIALISTS

18370 BURBANK BLVD STE 401

TARZANA, CA 91356

CLIA ID# 05D0559170

SANCTION: Directed Plan of Correction (DPOC)

Suspension of Part of Medicare/Medicaid


October 2, 2017



Unsuccessful PT

PHILIP BOSCH MD, DIRECTOR

PHILIP C BOSCH MD

651 E PENNSYLVANIA AVE STE 201

ESCONDIDO, CA 92025

CLIA ID# 05D0566728




Unsuccessful PT

GEORGE KIBLER, DIRECTOR

SURPRISE VALLEY HEALTH CARE DISTRICT LABORATORY

741 MAIN ST

CEDARVILLE, CA 96104

CLIA ID# 05D0618601




May 19, 2017



Unsuccessful PT

DENISE PHAN MD, DIRECTOR

CENTURY MEDICAL GROUP

15243 VANOWEN ST STE 101

VAN NUYS, CA 91405

CLIA ID# 05D0699902





July 26, 2017

July 28, 2017



Unsuccessful PT

KULDIP GILL MD, DIRECTOR

KULDIP S GILL MD

280 SIERRA COLLEGE DR STE 205

SPRING HILL, CA 95945

CLIA ID# 05D0943651




September 27, 2017


Unsuccessful PT

DAVID BRYSON MD, DIRECTOR

BRYSON CANCER CARE INC

5345 W HILLSDALE DR

VISALIA, CA 93291

CLIA ID# 05D1036874





Unsuccessful PT

MICHAEL CHAIKIN MD, DIRECTOR

GCC LABORATORY

633 AERICK ST

INGLEWOOD, CA 90301

CLIA ID# 05D1078088




November 18, 2017



Unsuccessful PT

VASILIKI ECONOMOU MD, DIRECTOR

PLAXGEN INC

1895 MOWRY AVE STE 101D

FREMONT, CA 94538

CLIA ID# 05D2084226




Directed Portion Plan of Correction (DPPOC)


February 2, 2017

February 4, 2017

March 14, 2017




Unsuccessful PT


DAVID BASWELL M.D., DIRECTOR

PEDIATRIC ASSOCIATES, PC

6190 BARNES RD

COLORADO SPRINGS, CO 80922

CLIA ID# 06D0517592


EFFECTIVE DATE: June 9, 2017


STATUS: Laboratory Voluntarily Ceased Testing

SHAHLA MASOOD, DIRECTOR

SHANDS JACKSONVILLE MEDICAL CENTER

655 W 8TH STREET


CLIA ID# 10D0268926







6484 FT CAROLINE RD


CLIA ID# 10D0269060


Civil Money Penalty


March 14, 2017




1215 DUNN AVE


CLIA ID# 10D0976317



Civil Money Penalty


January 13, 2017

March 14, 2017


KEITH OBRIEN, DIRECTOR

STATLAB MOBILE


MIAMI, FL 33157

CLIA ID# 10D2097278

SANCTION: Suspension of Part of Medicare/Medicaid



ROBERT SIEGEL, DIRECTOR

GWINNETT MEDICAL CENTER DULUTH

3620 HOWELL FERRY ROAD

DULUTH, GA 30096

CLIA ID# 11D0256605





GUIDO RING, DIRECTOR

GUIDO H RING MD

106 4TH AVENUE, WEST

CORDELE, GA 31015

CLIA ID# 11D0968447




February 1, 2017


Unsuccessful PT


GLENN BOYD, DIRECTOR

GLENN H BOYD, MD

1203 MEMORIAL DRIVE

DALTON, GA 30720

CLIA ID# 11D0976435




May 25, 2017


Unsuccessful PT

JAMES YOST, DIRECTOR

PHYSICIANS IMMEDIATE MED OF BUFORD, PC

3425 BUFORD DRIVE

BUFORD, GA 30519

CLIA ID# 11D1068565

SANCTION: Suspension of All of Medicare/Medicaid




Unsuccessful PT

JOHN ROBAK, DIRECTOR

CASTLE MEDICAL, LLC

5700 HIGHLANDS PARKWAY, SUITE 100

SMYRNA, GA 30082

CLIA ID# 11D2017949




October 4, 2017



KUO LAM LEE M.D., DIRECTOR

MEDCROSS IMAGING, LLC

4375 JOHNS CREEK PKWY, STE 300

SUWANEE, GA 30024

CLIA ID# 11D2105207




November 1, 2017





JEREMY HAYMORE, DIRECTOR

PHYSICIANS IMMEDIATE CARE CENTER

260 FALLS AVE #C

TWIN FALLS, ID 83301

CLIA ID# 13D0914355




DELLA HARWOOD MT (ASCP), DIRECTOR


914 W IRONWOOD DR #101

COEUR D'ALENE, ID 83814

CLIA ID# 13D1016580




July 28, 2017


CHRISTOPER MORGAN, DIRECTOR

STERLING FAMILY MEDICINE

1404 POMMERELL

BURLEY, ID 83318

CLIA ID# 13D2099992




DINO VALLERA MD, DIRECTOR

HINSDALE HOSPITAL LABORATORY

120 N OAK STREET

HINSDALE, IL 60521

CLIA ID# 14D0668275




NOTE: CMP

MICHELLE GERDES, DIRECTOR

FAMILY DERMATOLOGY SPECIALISTS, LLC

3421 N CAUSEWAY BOULEVARD SUITE 202

METAIRIE, LA 70002

CLIA ID# 19D0456688






NOTE: History of CLIA noncompliance

GARY ANZALONE M.D., DIRECTOR

CLAIBORNE MEMORIAL HOSPITAL

620 EAST COLLEGE STREET

HOMER, LA 71040

CLIA ID# 19D0463216


STACEY SPARKS, DIRECTOR

ACORN TO OAK PEDIATRICS

1025 HWY 80 E

HAUGHTON, LA 71037

CLIA ID# 19D2122735






RACHEED GHANAMI M.D., DIRECTOR

SOUTHERN VASCULAR ASSOCIATES

5000 AMBASSADOR CAFFERY PKWY, BLDG 1, STE 100

LAFAYETTE, LA 70508

CLIA ID# 19D2125826




GERALD YUKEVICH MD, DIRECTOR

VINEYARD MEDICAL CARE, LLC

364 STATE RD

VINEYARD HAVEN, MA 02568

CLIA ID# 22D2086441





JOSE AYALA, DIRECTOR

NORTHSIDE PEDIATRICS PC

265 FREMONT STREET SUITE 1

BATTLE CREEK, MI 49017

CLIA ID# 23D0377479






EDINA PEDIATRICS

7025 FRANCE AVE

EDINA, MN 55435

CLIA ID# 24D0403126




December 2, 2017

REASON: 2 Year Prohibition from Owning, Operating and Directing




Failure to Submit Acceptable POC or AOC


MELISSA TEPE, DIRECTOR

AFFINIA HEALTHCARE-BIDDLE

1717 BIDDLE AVE

SAINT LOUIS, MO 63106

CLIA ID# 26D1046060




July 20, 2017

REASON: Improper PT Referral Activities

Improper PT Referral Activities


Compliance Achieved

MELISSA TEPE M.D., DIRECTOR

AFFINIA HEALTHCARE

2524 HADLEY STREET

SAINT LOUIS, MO 63106

CLIA ID# 26D2080015




July 20, 2017



ANIL DEWAN, DIRECTOR

SOUTHERN NH MEDICAL CENTER

8 PROSPECT STREET

NASHUA, NH 03060

CLIA ID# 30D0085147



REASON: Improper PT Testing Referral Activities.

NOTE: Laboratory engaged in Improper Proficiency Testing Referral.

JASON SPROUSE, DIRECTOR

MISSION HOSPITAL LABORATORY - MEMORIAL CAMPUS

509 BILTMORE AVENUE

ASHEVILLE, NC 28801

CLIA ID# 34D0248285





WILLIAM HANCOCK, DIRECTOR

LABORATORY CORPORATION OF AMERICA HOLDINGS, INC

1447 YORK COURT

BURLINGTON, NC 27215

CLIA ID# 34D0655059





ARUNDHATI CHATTERJEE, DIRECTOR

LABCORP OF AMERICA HOLDINGS

1912 ALEXANDER DRIVE

RESEARCH TRIANGLE PARK, NC 27709

CLIA ID# 34D0655205





BRYAN DYE, MD, DIRECTOR

PURCELL MUNICIPAL HOSPITAL

1500 N GREEN AVE

PURCELL, OK 73080

CLIA ID# 37D0470030





BRYCE BLISS, DIRECTOR

PUSHMATAHA HOSPITAL LABORATORY

510 E MAIN

ANTLERS, OK 74523

CLIA ID# 37D0475409





LAURI BLESCH, MD, DIRECTOR

UTICA PARK CLINIC - OWASSO

10512 N 110TH EAST AVE, SUITE 300

OWASSO, OK 74055

CLIA ID# 37D0670093




November 27, 2017

DAVID MINOR, MD, DIRECTOR

DAVID B MINOR, MD, PC

1516 SOUTH YORKTOWN PLACE

TULSA, OK 74104

CLIA ID# 37D0924065





JESSICA PAGANA DEFAZIO D.O., DIRECTOR

PAGANA & PAGANA-DEFAZIO FAMILY PRACTICE LLC

1072 MARKET STREET

SUNBURY, PA 17801

CLIA ID# 39D0189114




October 8, 2017




NOTE: Facility engaged in Type II Improper PT referral activiity; Condition noncompliance found on complaint survey and facility paid a Civil Money Penalty of $13,000 and complied with a Directed Plan of Correction.

GEORGE JOUR, DIRECTOR

SKINSMART DERMATOLOGY

65 E BUTLER AVENUE, STE 203

NEW BRITAIN, PA 18901

CLIA ID# 39D1084296





Laboratory voluntarily Ceased Testing

GASTON MACHADO JR MD, DIRECTOR

HEALTHFIRST RAPID CARE

1675 N MAIN ST

SUMMERVILLE, SC 29483

CLIA ID# 42D1078836




May 23, 2017


Unsuccessful PT

SHERE CONWAY, DIRECTOR

COVENANT MEDICAL GROUP

DBA FAMILY CLINIC OF OAK RIDGE

100 VERMONT AVENUE

OAK RIDGE, TN 37830

CLIA ID# 44D0311959




September 19, 2017


Unsuccessful PT

CARLA LYN-BOSWELL, DIRECTOR

LA CLINICA CAMELLIA

3030 COVINGTON PIKE STE 200

MEMPHIS, TN 38128

CLIA ID# 44D2040070




MICHAEL COHEN, DIRECTOR

ST JOSEPH REGIONAL HEALTH CENTER (SJRHC) LABORATORY

2801 FRANCISCAN DRIVE

BRYAN, TX 77802

CLIA ID# 45D0498326






Appeal Filed By Laboratory

JORGE KUTUGATA, DIRECTOR

RAINBOW PEDIATRIC CLINIC

902 S AIRPORT DRIVE STE 1

WESLACO, TX 78596

CLIA ID# 45D0503928





PHILLIP CONLIN, DIRECTOR

MARTIN COUNTY HOSPITAL DISTRICT

600 EAST I-20

STANTON, TX 79782

CLIA ID# 45D0509186




Unsuccessful PT


JOSE PENA, DIRECTOR

DONNA DAY AND NIGHT CLINIC

2010 EAST BUSINESS HIGHWAY 83

DONNA, TX 78537

CLIA ID# 45D0952509





ERIC PEARLMAN D.O., DIRECTOR

COPPELL FIRE DEPT

265 EAST PARKWAY BLVD

COPPELL, TX 75019

CLIA ID# 45D1038621





C LYNN ANDERSON JR, DIRECTOR

VALLEY DAY AND NIGHT CLINIC

1755 W PRICE RD

BROWNSVILLE, TX 78520

CLIA ID# 45D1047501




Unsuccessful PT

NOTE: CMP was paid

SAMER SUKI, DIRECTOR

MILLENNIUM PHYSICIANS ASSOCIATION, PLLC

22710 PROFESSIONAL DRIVE SUITE 102

KINGWOOD, TX 77339

CLIA ID# 45D2003185





MEDICUS LABORATORIES, LLC

5710 LBJ FREEWAY

DALLAS, TX 75240

CLIA ID# 45D2010531




August 18, 2017






UNITED TOXICOLOGY, LLC


DALLAS, TX 75240

CLIA ID# 45D2023963







BRUCE WARDLAY, DIRECTOR

BRUCE E WARDLE DO PA

546 W SEMINARY

FORT WORTH, TX 76115

CLIA ID# 45D2040604




BRIDGET HERSCHAP, DIRECTOR

WESTSIDE SURGICAL HOSPITAL

4200 TWELVE OAKS DRIVE

HOUSTON, TX 77027

CLIA ID# 45D2051920





CHAU VU, DIRECTOR

FRIENDSWOOD DERMATOLOGY

COSMETIC & SKIN CANCER CENTER

1111 S FREINDSWOOD DRIVE, STE 107

FRIENDSWOOD, TX 77546

CLIA ID# 45D2070536




STATUS: Compliance Achieved OSCAR MANGINI, DIRECTOR

WEIMAR MEDICAL HOLDINGS DBA WEIMAR MEDICAL CENTER

400 YOUENS DRIVE

WEIMAR, TX 78962

CLIA ID# 45D2093884





NOTE: The hospital laboratory voluntarily closed on October 12, 2017. The laboratory did not correct the deficiencies.



AMERICAN LABORATORIES GROUP, LLC


DALLAS, TX 75240

CLIA ID# 45D2100510







JULIO DELGADO, DIRECTOR

ARUP LABORATORIES, INC

500 CHIPETA WAY

SALT LAKE CITY, UT 84108

CLIA ID# 46D0523979




June 11, 2017





STERLING, VA 20165

CLIA ID# 49D1107549



REASON: Cancellation of Medicare/Medicaid




Failure to Submit Acceptable POC and AOC


NOTE: Revocation of CLIA Certificate effective Nov 28, 2017. Suspension and cancellation of Medicare approval effective Oct 4, 2017. Lab Owner and Lab Director prohibited from owning, operating and directing a CLIA lab from Nov 28, 2017 through Nov 28, 2019.

BRUCE HYDE, DIRECTOR

PHARMASAN LABS, INC

375 280TH ST BLDG A

OSCEOLA, WI 54020

CLIA ID# 52D0914898


5. LABORATORIES WHOSE ACCREDITATION HAS BEEN WITHDRAWN OR REVOKED AND THE REASON FOR THE WITHDRAWAL OR REVOCATION. (INCLUDES ALL OTHER ADVERSE ACTIONS TAKEN BY THE ACCREDITATION ORGANIZATIONS)

BRIAN RAGLAND, DIRECTOR

LABORATORY CORPORATION OF AMERICA HOLDING

1801 FIRST AVE SOUTH

BIRMINGHAM, AL 35233

CLIA ID# 01D0301471 CAP

SANCTION: Cease testing for CK2 (CK-MB), quant/qual.



STATUS: As of 02/13/2018 cease testing still in effect.

RONALD MCCOY, DIRECTOR

AVALON MEDICAL CENTER PC

2400 EAST AVALON AVENUE SUITE C

MUSCLE SHOALS, AL 35661

CLIA ID# 01D0302664 COLA

SANCTION: Cease testing for Platelet Count.



STATUS: As of 12/31/2017 cease testing for Platelet Count still in effect.

DAVID RHYNE, DIRECTOR

PROFESSIONAL MEDICAL ASSOCIATES PC

101 EAST BRUNSON ST SUITE 200

ENTERPRISE, AL 36330


SANCTION: Cease testing for Cholesterol.

Cease testing for White Blood Cell Differential


May 19, 2017


STATUS: Testing for Cholesterol was reinstated on 08/29/2017.

As of 12/31/2017 cease testing for WBC Diff still in effect.

MAMOUN NAJJAR, DIRECTOR

URGENT CARE OF MADISON

3751 SULLIVAN STREET

MADISON, AL 35758


SANCTION: Failure to adhere to COLA imposed required improvements.


REASON: Denial of Accreditation

STATUS: No longer accredited by COLA.

BRIAN POIRIER, DIRECTOR


5005 S 40TH ST, STE 1200

PHOENIX, AZ 85040


SANCTION: Cease testing for T3 (Triiodothyronine).

Cease testing for RBC Count, Body Fluids


August 31, 2017


STATUS: Allowed to resume testing on 01/02/2018

SUSAN WARD-JONES, DIRECTOR

HEALTHY PARTNERS

605 N 2ND STREET

BLYTHEVILLE, AR 72315


SANCTION: Cease testing for White Blood Cell Differential (WBC DIff).



STATUS: As of 12/31/2017 cease testing for WBC Diff still in effect.

JOSEPH LOEWY, DIRECTOR

JOSEPH LOEWY

8631 W 3RD ST STE 825E

LOS ANGELES, CA 90048


SANCTION: Failure to comply with the reasonable requests of COLA.


REASON: Denial of Accreditation

STATUS: Laboratory no longer accredited by COLA.

KEITH AGRE, DIRECTOR

KEITH AGRE MD MED CORP

1125 S BEVERLY DR, STE 110



SANCTION: Cease testing for Sodium.



STATUS: Testing for Sodium was reinstated on 08/02/2017.

LUKE WATSON, DIRECTOR

COMMUNITY AND MISSION HOSPITAL OF HUNTINGTON PARK

2623 E SLAUSON AVE

HUNTINGTON PARK, CA 90255

CLIA ID# 05D0548135 AOA

SANCTION: Cease testing for Antibody Identification.




ILONA KLEINER, DIRECTOR

PEDIATRIC ASSOCIATES MEDICAL GROUP INC

4330 FULTON AVENUE

SHERMAN OAKS, CA 91423


SANCTION: Cease testing for White Blood Cell Differential (WBC Diff).



STATUS: WBC DIff testing was reinstated on 11/20/2017.

YIQIONG MAO, DIRECTOR

KAISER FOUNDATION HOSPITAL FONTANA LABORATORY

9961 SIERRA AVE ROOM 1208

FONTANA, CA 92335


SANCTION: Probation


REASON: Failure To Submit Acceptable POC or AOC

STATUS: As of 02/13/2018 probation still in effect.

DUYET VO, DIRECTOR

SOUTHWEST HEALTHCARE SYSTEM CLINICAL LABORATORY

36485 INLAND VALLEY DRIVE

WILDOMAR, CA 92595


SANCTION: Probation




RICHARD MACK D.O., DIRECTOR

KINDRED HOSPITAL-SF BAY AREA

2800 BENEDICT DR

SAN LEANDRO, CA 94577

CLIA ID# 05D0600653 JC

SANCTION: Cease testing for pCO2.




ANDREA EDWARDS, DIRECTOR

ANDREA GAYE EDWARDS, MD INC

1663 DOMINICAN WAY STE 210

SANTA CRUZ, CA 95065


SANCTION: Cease testing for Hemoglobin

Denial of Accreditation


September 8, 2017


Failure to adhere to COLA imposed required improvements.


JAMES DRURY, DIRECTOR

DAVIDSON, DRURY, & CHANG INC

8635 WEST 3RD STREET, SUITE 1050-W



SANCTION: Cease testing for Prothrombin Time (PT)



STATUS: On 06/27/2017 laboratory voluntarily withdrew from COLA.

Laboratory no longer accredited by COLA.

STEVEN STRUVE, DIRECTOR

MERCY MED CENTR RESPIRATORY CARE DEPT

2175 ROSALINE AVE

REDDING, CA 96001


SANCTION: Cease testing for Routine Chemistry (pH, pO2, pCO2).




CONRAD LU, DIRECTOR

ST VINCENT MED CTR PULM/ABG LAB

2131 WEST THIRD STREET



SANCTION: Probation



STATUS: Laboratory removed from probation on 11/14/2017.

EKNATH DEO, DIRECTOR

COAST HEMATOLOGY ONCOLOGY ASSOCIATES, INC

3300 E. SOUTH STREET STE #209

LONG BEACH, CA 90805


SANCTION: Cease testing for White Blood Cell Differential (WBC Diff), White Blood Cell Count (Leukocyte Count)(WBC), Red Blood Cell Count (Erythrocyte Count)(RBC), Hemoglobin, Hematocrit, Platelet Count.



STATUS: On 06/15/2017 the laboratory voluntarily withdrew from COLA.


DONALD SIMPSON MD, DIRECTOR

CALIFORNIA DIAGNOSTIC LABORATORIES

7316 DEERING AVE

CANOGA PARK, CA 91303


SANCTION: Cease testing for Infectious Mononucleosis Antibodies (Mono).



STATUS: On 08/30/2017 the laboratory removed Infectious Mononucleosis Antibodies testing from their test menu.

MITCHELL BECKER, DIRECTOR

PHYSICIANS OFFICE LABORATORY

2336 SANTA MONICA BLVD STE 201

SANTA MONICA, CA 90404


SANCTION: Cease testing for Aspartate Aminotransferase (AST)





HOLLY YAMADA, DIRECTOR

HEMEDIAGNOSTICS LAB, INC

2119 SOUTH MYRTLE AVE

MONROVIA, CA 91016


SANCTION: Revocation of accreditation


REASON: Laboratory performance does not meet CAPstandards of accreditation.

STATUS: As of 02/13/2018 laboratory not accredited by CAP.

VEENA SINGH, DIRECTOR

BIOCEPT INC

5810 NANCY RIDGE DR

SAN DIEGO, CA 92121


SANCTION: Probation



STATUS: As of 02/13/2018 Probation still in effect.

LEENA ZOPEY M.D., DIRECTOR

MLK JR. OUTPATIENT CENTER

1670 E 120TH ST



SANCTION: Cease testing for pO2.



STATUS: Permanently ceased testing for pO2 on 08/15/2017.

LEONARD LAZARUS, DIRECTOR

SDXRAY & LAB INC

8772 CUYAMACA ST, STE 102

SANTEE, CA 92071


SANCTION: Denial of Accreditation


REASON: Failure to adhere to COLA imposed required improvements.


TERESA WIESAK, DIRECTOR

ACACIO FERTILITY CENTER

27882 FORBES RD STE 200

LAGUNA NIGUEL, CA 92677


SANCTION: Probation




AARON SASSOON, DIRECTOR

CHOC CHILDRENS HOSPITAL OF ORANGE COUNTY

1201 W LAVETA AVE

ORANGE, CA 92868


SANCTION: Probation



STATUS: Removed from Probation on 10/31/2017.

RICHARD SAFRIN, DIRECTOR

APPLIED PROTEOMICS

3545 JOHN HOPKINS CT STE 150

SAN DIEGO, CA 92121


SANCTION: Probation




WILLIAM PAXTON, MD, DIRECTOR

SERAMETRIX

2235 FARADAY AVE STE N

CARLSBAD, CA 92008





STATUS: As of 02/13/2018 laboratory not accredited by CAP.

MICHELLE KROPOTSCH, DIRECTOR

ST VINCENT GENERAL HOSPITAL DISTRICT LAB

822 W 4TH ST

LEADVILLE, CO 80461


SANCTION: Cease testing for Albumin.



STATUS: As of 12/31/2017 cease testing for Albumin still in effect.

ALEX CUDKOWICZ, DIRECTOR

UPPER SAN JUAN HEALTH SERVICE DISTRICT

95 SOUTH PAGOSA BLVD

PAGOSA SPRINGS, CO 81147





STATUS: Sodium testing was reinstated on 10/06/2017.

JAYASHREE KRISHNAN, DIRECTOR

WASHINGTON HOSPITAL CENTER

MAIN LABORATORY

110 IRVING STREET NW

WASHINGTON, DC 20010


SANCTION: Probation




MICHAEL WEITZ, DIRECTOR

WEITZ & RITTER MD PA


MIAMI, FL 33173






ELIZABETH REILLY HAYS, DIRECTOR

MARIANO D CIBRAN MD CORP D/B/A

ST PETERSBURG PEDIATRIC

7500 PARK BLVD

PINELLAS PARK, FL 33781


SANCTION: Cease testing for Hematocrit.



STATUS: As of 12/31/2017 cease testing for Hematocrit still in effect.

ALBERT TAWIL, DIRECTOR

ALBERT TAWIL MD PA

508 S HABANA AVE STE 360

TAMPA, FL 33609





STATUS: Hematocrit testing was reinstated on 09/25/2017.

MARIO ALMEIDA, DIRECTOR

MARIO A ALMEIDA MD

7000 SW 62ND AVE STE 605

SOUTH MIAMI, FL 33143


SANCTION: Cease testing for White Blood Cell Differential (WBC DIff), White Blood Cell Count (WBC Ct), Red Blood Cell Count (RBC Ct), Platelet Count, Hemoglobin, Hematocrit.



STATUS: As of 12/31/2017 cease testing for WBC Diff, WBC Ct, RBCCt, Platelet Ct, Hemoglobin & Hematocrit still in effect.

JORGE CACERES, DIRECTOR

FIRST QUALITY LABORATORY

11460 INTER CHANGE CIRCLE NORTH

MIRAMAR, FL 33025


SANCTION: Cease testing for Immunoglobulins IgM.



STATUS: As of 12/31/2017 cease testing for Immunoglobulin IgM still in effect.

HOWARD LINZER, DIRECTOR

AFTER HOURS PEDIATRICS INC

6250 LANTANA RD STE 12

LAKE WORTH, FL 33463






MOHAMMAD KAMAL M.D., DIRECTOR

OCALA CANCER INSTITUTE

2820 SE 3RD CT STE 200

OCALA, FL 34471


SANCTION: Cease testing for Hemoglobin, Red Blood Cell Count (RBC Count).





ALINA BUDEJEN, DIRECTOR

CENTURY CLINICAL LAB

1395 SHOTGUN RD

SUNRISE, FL 33326


SANCTION: Cease testing for Hepatitis B Core Antibody.



STATUS: Hepatitis B Core Antibody testing was reinstated on 11/09/2017.

SANGITA SAHAY, DIRECTOR

DIAGNOSTIC & CLINICAL CARE SERVICES INC DBA

DOCCS - LABORATORY

2100 WICKHAM RD

MELBOURNE, FL 32935


SANCTION: Cease testing for Chloride.



STATUS: Chloride testing was reinstated on 11/08/2017.

SHURUN ZHOA, DIRECTOR

MEDICAL TOX LABS LLC

3450 FLETCHER AVE STE 230B

TAMPA, FL 33613





STATUS: Sodium testing was reinstated 11/20/2017.

JOHN HAMYING, DIRECTOR

CENTRAL FLORIDA HEALTH CARE INC-MULBERRY

106 NW 9TH AVE

MULBERRY, FL 33860


SANCTION: Cease testing for White Blood Cell Differential (WBC DIff).



STATUS: On 02/10/2017 the laboratory removed WBC Diff testing fromtheir test menu.

NICHOLAS LANCIA, DIRECTOR

CHI MEMORIAL HOSPITAL - GEORGIA

100 GROSS CRESCENT CIRCLE

FORT OGLETHORPE, GA 30742


SANCTION: Probation




HELENLOUISE MOORE, DIRECTOR

CORNERSTONE MEDICAL ASSOC- PEDIATRIC ASSOC

116 SOUTH HOUSTON RD

WARNER ROBINS, GA 31088






JOHN INMAN III M.D., DIRECTOR

VERANDA, PC, THE

2701 MEREDYTH DRIVE

ALBANY, GA 31707




REASON: Laboratory performance does not meet CAP standards of accreditation.

STATUS: As of 02/13/2017 Laboratory not accredited by CAP.

ANTHONY MOSER, DIRECTOR

PHOEBE WORTH MEDICAL CENTER

807 SOUTH ISABELLA STREET

SYLVESTER, GA 31791


SANCTION: Probation



STATUS: Removed from probation on 12/12/2017.

HANS GROSSNIKLAUS, DIRECTOR

EMORY CLINIC AMBULATORY SURGERY CENTER

1365 CLIFTON ROAD BUILDING B

ATLANTA, GA 30322


SANCTION: Cease testing for Hematology (Hematocrit, Hemoglobin).




EDWARD MEIER MD, DIRECTOR

REDMOND FAMILY CARE CENTER - WEST ROME

2112 SHORTER AVENUE, SUITE 200

ROME, GA 30165






BERNADETTE MANDES WILDEMORE, DIRECTOR

LABSOLUTIONS

1451 NORTHSIDE DRIVE, NW

ATLANTA, GA 30318






OLARONKE OGUNREMI, DIRECTOR

MEMORIAL HOSPITAL

1900 STATE STREET

CHESTER, IL 62233


SANCTION: Cease Testing for ABO Group.



STATUS: Allowed to resume testing on 01/30/2017.

JOAN GUITART, DIRECTOR

NORTHWESTERN MEDICAL FACULTY FOUND INC

DEPT OF DERMATOLOGY

676 N ST CLAIR ST, STE 1765 (ARKES)

CHICAGO, IL 60611


SANCTION: Probation




KATIE ALDIS, DIRECTOR

ASSOCIATES IN FAMILY CARE OF OLATHE

15435 W. 134 ST, STE 103

OLATHE, KS 66062


SANCTION: Cease testing for White Blood Cell Differential (WBC Diff)



STATUS: WBC Diff testing was reinstated on 11/09/2017.

JILL RANSDELL, DIRECTOR

JAMES B HAGGIN MEMORIAL HOSPITAL,THE

464 LINDEN AVE

HARRODSBURG, KY 40330


SANCTION: Cease testing for Thyroxine(T4) and Triiodothyronine (T3).



STATUS: On 08/29/2017 laboratory removed T3 & T4 tests from their test menu.

ANN MARSHALL, DIRECTOR

ROCKCASTLE HOSP

145 NEWCOMB AVE

MOUNT VERNON, KY 40456


SANCTION: Probation




OTIS BARNUM, DIRECTOR

NATCHITOCHES MEDICAL SPECIALISTS

1029 KEYSER AVENUE

NATCHITOCHES, LA 71457






RONALD SROKA, DIRECTOR

CROFTON FAMILY PRACTICE

1684 VILLAGE GREEN

CROFTON, MD 21114


SANCTION: Cease testing for Aerobic &/or Anaerobic Organisms-unlimited sources (Microbiology/Bacteriology).



STATUS: On 12/07/2017 the laboratory removed Microbiology/Bacteriology testing from their test menu.

WILLIAM CRAIG, DIRECTOR

JOHNS HOPKINS IMAGING AT WHITE MARSH

4924 CAMPBELL BLVD, STE 110

BALTIMORE, MD 21236


SANCTION: Cease testing for Creatinine.



STATUS: Allowed to resume testing for Creatinine on 10/05/2017.

JOHN HANSON, DIRECTOR

COASTAL LAB PARTNERS, LLC

747 MAIN ST

CONCORD, MA 01742


SANCTION: Probation




THOMAS GRAVES, DIRECTOR

BAY AREA FAMILY PHYSICIANS

34301 23 MILE ROAD SUITE 100

NEW BALTIMORE, MI 48047


SANCTION: Cease testing for Cholesterol, HDL Cholesterol & Triglyceride.



STATUS: Testing for Cholesterol, HDL Cholesterol & Triglyceride was reinstated on 08/29/2017.

SAIMAN KAHN, DIRECTOR

FAMILY PRACTICE CARE, PLLC

28351 SCHOENHERR RD.

WARREN, MICHIGAN 48088




REASON: Failure to adhere to COLA imposed required improvements


NAZAR SARAFA, DIRECTOR

GARDEN CITY MEDICAL CLINIC

1715 MIDDLEBELT ROAD

GARDEN CITY, MI 48135


SANCTION: Cease testing for Thyroid Stimulating Hormone (TSH).



STATUS: On 12/04/2017 the laboratory voluntarily withdrew from COLA. Laboratory no longer accredited by COLA.

TANVIR QURESHI, DIRECTOR

TANVIR I QURESHI MD PC

5290 WEST BROOKSHIRE COURT

MONROE, MI 48161


SANCTION: Cease testing for Triglyceride.



STATUS: Triglyceride testing was reinstated on 08/29/2017.

SYED DANISH, DIRECTOR

SOUTHGATE MEDICAL CLINIC

13819 TRENTON RD

SOUTHGATE, MI 48195


SANCTION: Cease testing for Cortisol, Thyroid Stimulating Hormone (TSH), Thyroxine Free (FT4), Triiodothyronine (T3), Cholesterol, HDL Cholesterol, Triglyceride & Rheumatoid Factor (RF).



STATUS: As of 12/31/2017 cease testing for Cortisol, TSH, FT4, T3, Cholesterol, HDL Cholesterol, Triglyceride & RF still in effect.

SETH FORMAN, DIRECTOR

WEST BLOOMFIELD PEDIATRICS PLLC

6400 FARMINGTON RD STE 10

WEST BLOOMFIELD, MI 48322


SANCTION: Cease testing for Streptococcus Group A.



STATUS: On 08/29/2017 the laboratory removed Streptococcus Group A testing from their test menu.

RIZWAN DANISH, DIRECTOR

GENESEE CANCER & BLOOD DISEASE

TREATMENT CENTER PC/DR DANISH

302 KENSINGTON AVENUE

FLINT, MI 48503






HARRY SHECTER, DIRECTOR

FORD BIO MEDICAL LABORTORY

5601 SCHAEFER ROAD

DEARBORN, MI 48126


SANCTION: Cease testing for Bilirubin, Total.



STATUS: As of 12/31/2017 cease testing for Bilirubin Total still in effect.

JANET POULIK, DIRECTOR

CHILDREN'S HOSPITAL OF MICHIGAN SPECIALTY CENTER

3950 BEAUBIEN

DETROIT, MI 48201


SANCTION: Probation




PAUL LAPPINGA, DIRECTOR

SANFORD BEMIDJI MEDICAL CENTER

ATTN LABORATORY

BEMIDJI, MN 56601


SANCTION: Probation




FRED APPLE Ph.D., DIRECTOR

HENNEPIN COUNTY MEDICAL CENTER

701 PARK AVE - LABORATORY 812

MINNEAPOLIS, MN 55415


SANCTION: Cease testing for Digoxin & Theophylline.



STATUS: As of 02/13/2018 cease testing for Digoxin and Theophylline still in effect.


EDINA PEDIATRICS

7025 FRANCE AVE

EDINA, MN 55435


SANCTION: Cease testing for Hemoglobin, White Blood Cell Differential.

Denial of Accreditation.


May 18, 2017


Failure to adhere to COLA imposed required improvements


ROBERT BRITT, DIRECTOR

KINGS DAUGHTERS MEDICAL CENTER -BLOOD GAS LAB

427 HIGHWAY 51 NORTH

BROOKHAVEN, MS 39601


SANCTION: Probation




TOMEKIA POPE, DIRECTOR

MERCY FAMILY MEDICAL CLINIC

1306 HARDY STREET

HATTIESBURG, MS 39401


SANCTION: Cease testing for White Blood Cell Differential (WBC Diff), White Blood Cell Count (WBC Ct), Red Blood Cell Count (RBC Ct), Platelet Count, Hemoglobin, Hematocrit.

Cease testing for Neisseria gonorrhoeae, Chlamydia.


December 28, 2017


STATUS: As of 12/31/2017 cease testing for WBC Diff, WBC Ct, RBC Ct, Platelet Count, Hemoglobin, Hematocrit Neisseria gnorrhoeae & Chlamydia still in effect.

ZAHID KALEEM, DIRECTOR

PARKLAND HEALTH CENTER-BONNE TERRE

7245 RAIDER ROAD

BONNE TERRE, MO 63628


SANCTION: Cease testing for hCG Serum & TSH.




KONNI EINFALT MT ASCP, DIRECTOR

REGIONAL WEST PHYSICIANS CLINIC SOUTH PLAZA

3911 AVENUE B SUITE 1100

SCOTTSBLUFF, NE 69361





STATUS: PT testing was reinstated on 11/20/2017.

RONALD SLAUGHTER, DIRECTOR

LAB EXPRESS LLC

4550 E CHARLESTON BLVD

LAS VEGAS, NV 89104





STATUS: On 12/07/2017 the laboratory removed Prothrombin Time testing from their test menu.

MICHAEL MARKOFF, DIRECTOR

MIDDLETOWN PEDIATRICS PA

529 HIGHWAY 35

RED BANK, NJ 07701






JAMES SPIGEL, DIRECTOR

TRICORE REFERENCE LABORATORIES - LCMC

211 SUDDERTH DRIVE

RUIDOSO, NM 88345


SANCTION: Cease testing for Compatibility Testing.



STATUS: As of 02/13/2018 cease testing for Compatibility Testing still in effect.

RICHARD BLAU, DIRECTOR

RICHARD H BLAU MD-ARTHRITIS INSTITUTE

120 BETHPAGE ROAD

HICKSVILLE, NY 11801


SANCTION: Cease testing for Immunoglobulins IgA.



STATUS: As of 12/31/2017 cease testing for Immunoglobulins IgA still in effect.

NORMAN TUROWSKY, DIRECTOR

NORMAN TUROWSKY MD PC

3601 HEMPSTEAD TPKE SUITE 121

LEVITTOWN, NY 11756


SANCTION: Cease testing for Thyroxine free (FT4), Triiodothyronine (T3), Thyroid Stimulating Hormone (TSH).



STATUS: As of 12/31/2017 cease testing for FT4, T3 & TSH still in effect.

RICHARD GOLD, DIRECTOR

SMITHTOWN MEDICAL SPECIALISTS PC

215 EAST MAIN STREET

SMITHTOWN, NY 11787


SANCTION: Cease testing for HDL Cholesterol & Sodium.

Cease testing for Cholesterol.


October 20, 2017


STATUS: HDL Cholesterol & Sodium testing were reinstated on 10/20/2017.

As of 12/31/2017 cease testing for Cholesterol still in effect.

VERONICA SANTILLI, DIRECTOR

BROOK-ISLAND PEDIATRIC GROUP PC

312 AVENUE U

BROOKLYN, NY 11223


SANCTION: Cease testing for Streptococcus Group A.



STATUS: Streptococcus Group A testing was reinstated on 08/30/2017.

ROHITH SARAVANAN M.D., DIRECTOR

MASH URGENT CARE - OLEAN

A DIVISION OF MEDFIRST URGENT CARE, PLLC

921 WAYNE ST

OLEAN, NY 14760


SANCTION: Cease testing for Red Blood Cell Count (RBC Ct)



STATUS: As of 12/31/2017 cease testing for RBC Ct still in effect.

ANGELICTA RUSHING, DIRECTOR

BOICE WILLIS CLINIC IMMEDIATE CARE LAB

921 NORTH WINSTEAD AVENUE

ROCKY MOUNT, NC 27804


SANCTION: Cease testing for Infectious mononucleosis (Mono).



STATUS: Mono testing was reinstated on 09/25/2017.

SAMMUEL SUN Ph.D., DIRECTOR

NCCRM MAIN LAB

400 ASHVILLE AVENUE, SUITE 200

CARY, NC 27511


SANCTION: Probation



November 16, 2017


Laboratory performance does not meet CAP standards of accreditation.


ESSAM ESKANDER, DIRECTOR

CAROLINA MEDICAL CENTER PA

102 SEVENTH AVENUE

CHADBOURN, NC 28431


SANCTION: Cease testing for Glucose.



STATUS: As of 12/31/2017 cease testing for Glucose still in effect.

JAMES PRIDGEN, DIRECTOR

HOLLY RIDGE HEALTHCARE, PA

308 US HIGHWAY 17 NORTH

HOLLY RIDGE, NC 28445





STATUS: On 10/16/2017 the laboratory removed WBC Diff testing fromtheir test menu.

TIMOTHY BARKER, DIRECTOR

PIEDMONT HEALTHCARE PA DBA LAKE NORMAN FAMILY PRAC

357 WILLIAMSON ROAD

MOORESVILLE, NC 28117


SANCTION: Cease testing for Red Blood Cell Count (RBC Ct) & Hematocrit.



STATUS: RBC Ct & Hematocrit testing were reinstated on 09/14/2017.

PHIL RADFORD, DIRECTOR

RADEAS, LLC

11635 NORTH PARK DRIVE SUITE 340

WAKE FOREST, NC 27587


SANCTION: Cease testing for Lithium.



STATUS: On 11/10/2017 the laboratory removed Lithium testing from their test menu.

EDWARD LIPFORD, DIRECTOR

CAROLINAS HEALTHCARE SYSTEMS LABORATORY

5040 AIRPORT CENTER PARKWAY

CHARLOTTE, NC 28208


SANCTION: Cease testing for Complement C3.



STATUS: As of 02/13/2018 cease testing for Complement C3 still in effect.

HENRY EMERY JR, DIRECTOR

LIBERTY FAMILY PHYSICIANS

1928 WEDDINGTON ROAD

WEDDINGTON, NC 28104


SANCTION: Cease testing for hCG, Beta Serum Quantitative.



STATUS: As of 12/31/2017 cease testing for hCG, Beta Serum Quantitative still in effect.

BRANDON GUTHERY, DIRECTOR

MCALESTER REG HLTH CTR - S BERNARD LAB

1 CLARK BASS BOULEVARD PO BOX 1228

MCALESTER, OK 74501


SANCTION: Probation




RALPH NELSON, DIRECTOR

IMMEDIATE CARE OF OKLAHOMA-HEALTHPLEX

3400 W TECUMSEH RD SUITE 100

NORMAN, OK 73072






NICHOLE STEIDLER, DIRECTOR

VISTA PATHOLOGY LABORATORY LLC

1032 E JACKSON STREET

MEDFORD, OR 97504


SANCTION: Probation



STATUS: Laboratory removed from Probation 10/10/2017.

HERBERT AUERBACH D.O., DIRECTOR

ABINGTON MEMORIAL HOSPITAL

PATHOLOGY DEPT 1200 OLD YORK RD

ABINGTON, PA 19001


SANCTION: Cease testing for Complement C3.



STATUS: As of 02/13/2018 cease testing for Complement C3 still in effect.

WILLIAM SIMS, DIRECTOR

JEFFERSON REGIONAL MEDICAL CENTER

RESPIRATORY LAB

575 COAL VALLEY ROAD

JEFFERSON HILLS, PA 15025


SANCTION: Cease testing for Chloride & Sodium.



STATUS: As of 02/13/2018 cease testing for Chloride & Sodium still in effect.

DAVID KYLE JR, DIRECTOR

CORNERSTONE FAMILY MEDICINE

801 E GREENVILLE STREET

ANDERSON, SC 29621


SANCTION: Cease testing for Platelet Count, White Blood Cell Count (WBC Ct), Hemoglobin, Hamatocrit, Red Blood Cell Count (RBC Ct), White Blood Cell Differential (WBC Diff).



STATUS: On 03/08/2017 the laboratory voluntarily withdrew from COLA. Laboratory is no longer accredited by COLA.

STEVEN BANDER, DIRECTOR

BSW PRIMARY CARE WYLIE

2300 FM, 544 #270

WYLIE, TX 75098


SANCTION: Cease testing for Red Blood Cell Count (RBC Ct)

Cease testing for White Blood Cell Differential (WBC Diff).


February 1, 2017


STATUS: RBC Ct & WBC Diff testing were reinstated on08/29/2017.

JOHN WRIGHT, DIRECTOR

PORT LAVACA CLINIC ASSOCS PA

1200 N VIRGINIA

PORT LAVACA, TX 77979


SANCTION: Cease testing Sodium.



STATUS: As of 12/31/2017 cease testing for Sodium still in effect.

HARRY HERNANDEZ, DIRECTOR

HARRY HERNANDEZ DO

1339 FAIR AVENUE

SAN ANTONIO, TX 78223





STATUS: Hematocrit testing was reinstated 10/10/2017.

JAVIER BOCANEGRA, DIRECTOR

COMMUNITY FAMILY MEDICINE PA

1616 CALLAGHAN ROAD







GARY MADDEN, DIRECTOR

UNIFIED WOMEN'S HEALTHCARE OF TEXAS, PLLC

DBA MIDLAND WOMEN'S CLINIC

2500 WEST ILLINOIS AVE SUITE 100

MIDLAND, TX 79701





STATUS: WBC Diff testing was reinstated on 09/07/2017.

CHARLES BURNS, DIRECTOR

MEDICAL CENTER HOSPITAL LABORATORY

ATTN MAIN LAB

ODESSA, TX 79761


SANCTION: Cease testing for Fibrinogen.



STATUS: As of 02/13/2017 cease testing for Fibrinogen still in effect.

JUAN HERRERA, DIRECTOR

PROMISE HOSPITAL OF DALLAS

7955 HARRY HINES BOULEVARD

DALLAS, TX 75235


SANCTION: Cease testing for Prothrombin Time (PT/INR).



STATUS: PT/INR testing was reinstated on 08/24/2017.

MARION RUNDELL MD, DIRECTOR

CLEAR LAKE REGIONAL MEDICAL CENTER

500 MEDICAL CENTER BOULEVARD

WEBSTER, TX 77598





STATUS: As of 02/13/2018 cease testing for Compatibility Testing still in effect.

DR GOIN, DIRECTOR

CALVARY MED PA

8484 WILL CLAYTON PKWY

HUMBLE, TX 77339


SANCTION: Cease testing for Bilirubin, Total.



STATUS: As of 12/31/2017 cease testing for Bilirubin, Total still in effect.

KELLY LE, DIRECTOR

PREMIER MEDICINE

6800 ALMA DRIVE

PLANO, TX 75023



EFFECTIVE DATE: April26, 2017



CRAIG MANIFOLD, DIRECTOR

SAN ANTONIO AIRLIFE

4502 MEDICAL DRIVE



SANCTION: Cease testing for pH (Blood Gases), PCO2, PO2, Lactic Acid (Lactate).




JAMES MAPES, DIRECTOR

MYRIAD RBM, INC

3300 DUVAL RD STE 110

AUSTIN, TX 78759


SANCTION: Cease testing for Immunoglobulins IgE.



STATUS: As of 12/31/2017 cease testing for Immunoglobulins IgE still in effect.

SUMANA GANGI, DIRECTOR

SOUTHERN ENDOCRINOLOGY ASSOCIATES

1621 N BELTLINE ROAD, SUITE A

MESQUITE, TX 75149





STATUS: Sodium testing was reinstated on 11/20/2017.

ROBERT BREDT, DIRECTOR

ATRIUM MEDICAL CENTER

11929 W AIRPORT BLVD STE 110

STAFFORD, TX 77477


SANCTION: Probation




OLUTOLA ADETONA, DIRECTOR

PRACTICAL APPROACH PEDIATRICS PLLC

9480 HUEBNER ROAD SUITE 400



SANCTION: Cease testing for PCO2, PO2, Blood Gases.



STATUS: PCO2, PO2, Blood Gases testing was reinstated on 11/09/2017.

VICTOR DE LA TORRE, DIRECTOR

MOHAMMED IDRIS MD

5405 N MCCOLL

MCALLEN, TX 78504


SANCTION: Cease testing for Thyroid Stimulating Hormone (TSH).




NOE MEDINA, DIRECTOR

TAVAREZ MEDICAL CLINIC

1801 S 5TH STREET SUITE 101

MCALLEN, TX 78503


SANCTION: Cease testing for Platelet Count, White Blood Cell Count (WBC Ct), Hemoglobin, Hematocrit, Red Blood Cell Count (RBC Ct), White Blood Cell Differential (WBC Diff).




CHRISTOPHER VALLE, DIRECTOR

CHI ST LUKE'S HEALTH EMERGENCY CENTER LAKES AREA

MONTGOMERY

18057 HIGHWAY 105 WEST SUITE 220

MONTGOMERY, TX 77356






ASIT CHOKSI M.D., DIRECTOR

CHI ST. LUKE’S PINECROFT HOSPITAL

9201 PINECROFT

THE WOODLANDS, TX 77380






FOYEKE IKAAYTOR, DIRECTOR

LIFE SAVERS EMERGENCY ROOM

17685 TOMBALL PARKWAY

HOUSTON, TX 77479






PRAGNA SHETH, DIRECTOR

SOLSTAS LAB - CARILION STONEWALL JACKSON HOSPITAL

1 HEALTH CIRCLE

LEXINGTON, VA 24450





STATUS: Permanently ceased testing for Compatibility Testing on 11/06/2017.

MARIGNY ROBERTS, DIRECTOR

LEWISGALE HOSPITAL ALLEGHANY

1 ARH LANE

LOW MOOR, VA 24457





STATUS: Allowed to resume Compatibility Testing on 02/12/2018.

DAVID BOSTWICK, DIRECTOR

GRANGER GENETICS, LLC

601 BIOTECH DRIVE - SUITE 301

RICHMOND, VA 23235






AMR BEHIRI, DIRECTOR

ADVANCED HEALTH LAB SERVICES

212 LINDEN DRIVE - SUITE 158

WINCHESTER, VA 22601


SANCTION: Cease testing for Digoxin, Cortisol, hCG Total Serum Quantitative, Thyroxine (T4), Thyroxine Free (FT4), Triiodothyronine (T3), Valproic Acid, Phenytoin, Thyroid Stimulating Hormone (TSH), Urea (BUN), Magnesium, HDL Cholesterol, Albumin.



STATUS: As of 12/31/2017 cesase testing for Digoxin, Cortisol, hCG, T4, FT4, T3, Valproic Acid, Phenytoin, TSH, BUN,Magnesium, HDL Cholesterol, Albumin still in effect.

PAM KOTYNSKI MT (ASCP), DIRECTOR

SRH - RESPIRATORY THERAPY

1400 E KINCAID ST

MOUNT VERNON, WA 98274






RANDALL RIGGS M.D., DIRECTOR

INKARE

611 2ND AVE STE B

SPOKANE, WA 99202






6. ALL APPEALS AND HEARING DECISIONS. FOR DETAILED INFORMATION REGARDING THE FOLLOWING LISTING SEE CLIA HEARING DECISION INDEX AT HTTP://WWW.CMS.GOV/CLIA/HEARINGGROUP.ASP

*** N O D A T A F O U N D ***

http://www.cms.gov/CLIA/HEARINGGROUP.ASP

7. A LIST OF LABORATORIES AGAINST WHICH CMS HAS BROUGHT SUIT UNDER SECTION 493.1846 AND THE REASON FOR THOSE ACTIONS.

*** N O D A T A F O U N D ***

8. A LIST OF LABORATORIES THAT HAVE BEEN EXCLUDED FROM PARTICIPATION IN MEDICARE OR MEDICAID AND THE REASON FOR EXCLUSION.




STERLING, VA 20165

CLIA ID# 49D1107549

REASON: Revocation of CLIA Certificate effective Nov 28, 2017. Suspension and cancellation of Medicare approval effective Oct 4, 2017. Lab Owner and Lab Director prohibited from owning, operating and directing a CLIA lab from Nov 28, 2017 through Nov 28, 2019.

9. CORRECTION OF ANY ERRONEOUS STATEMENTS OF INFORMATION THAT APPEARED IN THE 2016 REGISTRY.

The following Laboratory information was inadvertently omitted from 2016 Laboratory Registry.

DANIEL FERGUSON, DIRECTOR

MEDCOMP SCIENCES LLC

20203 MACHOST ROAD

ZACHARY, LA 70791

CLIA ID# 19D2050143


Directed Portion Plan of Correction (DPPOC)


October 5, 2016



10. OTHER ACTIONS. THIS SECTION INCLUDES OTHER SPECIFIC INFORMATION THAT MAY BE USEFUL IN EVALUATING THE PERFORMANCE OF LABORATORIES AS SPECIFIED IN 493 CFR 1859(A). IT ALSO INCLUDES INFORMATION PROVIDED BY CLIA EXEMPT STATES.

*** N O D A T A F O U N D ***

(2) (3) (4) (i) · effective date: november 24, 2017 . reason: unsuccessful pt . guido ring,...

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