2013 laboratory registry

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CLIA ANNUAL LABORATORY REGISTRY 2013

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(5) A list of laboratories whose accreditation has been withdrawn or revoked and the reasons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

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2013 CLIA LAB REGISTRY (AS REQUIRED BY SECTION 353(N) OF THE PUBLIC HEALTH SERVICE ACT)

ACTIVITY 01/01/2013 - 12/31/2013

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 ***

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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.)

BEN HESTER, DIRECTOR ETOWAH PEDIATRICS 170 INDEPENDENT DRIVE RAINBOW CITY, AL 35906 CLIA ID# 01D1048892

SANCTION: LIMITATION OF CLIA CERTIFICATE

EFFECTIVE DATE: SEPTEMBER 10, 2013

REASON: UNSUCCESSFUL PROFICIENCY TESTING

STATUS: LAB VOLUNTARILY CEASED TESTING

ZONG LANG TSAI MD, DIRECTOR DEL AMO MEDICAL LABORATORY, INC 21350 HAWTHORNE BLVD, SUITE 164 TORRANCE, CA 90503 CLIA ID# 05D0913319

SANCTION: CANCEL MEDICARE/MEDICAID APPROVAL

REVOCATION OF CLIA CERTIFICATE SUSPENSION OF CLIA CERTIFICATE

EFFECTIVE DATE: FEBRUARY 01, 2013

MARCH 21, 2013 MARCH 21, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE WITH

IMMEDIATE JEOPARDY FAILURE TO CORRECT DEFICIENCIES

STATUS: HEARING REQUESTED

APPEAL FILED BY LAB SETTLEMENT AGREEMENT

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EDWARD LAI MD M.D., DIRECTOR BIODATA MEDICAL LABORATORIES, INC. 5494 ARROW HWY MONTCLAIR, CA 91763 CLIA ID# 05D0938572



REASON: MEDICARE CANCELLATION/SUSPENSION CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING

ALICE REIER MD, DIRECTOR ALICE REIER MD 3300 WEBSTER ST STE 900 OAKLAND, CA 94609 CLIA ID# 05D1030082


EFFECTIVE DATE: JANUARY 15, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING

RICHY AGAJANIAN, MD, DIRECTOR ONCOLOGY INSTITUTE OF HOPE AND INNOVATION, THE DOWNEY 11480 BROOKSHIRE AVENUE, SUITE 309 DOWNEY, CA 90241 CLIA ID# 05D1076983


REVOCATION OF CLIA CERTIFICATE

EFFECTIVE DATE: MAY 01, 2013 JUNE 20, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE

FAILURE TO CORRECT DEFICIENCIES FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION

STATUS: LABORATORY WITHDREW APPEAL AND ALJ DISMISSED CASE ON

SEPTEMBER 9, 2013.

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JAMES DIBDIN MD, DIRECTOR KESTER DIAGNOSTIC LABORATORY INC 6817 KESTER AVE VAN NUYS, CA 91405 CLIA ID# 05D2025446



REASON: MEDICARE CANCELLATION/SUSPENSION CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING

RICHARD BRUNELLE M.D., DIRECTOR RICHARD R BRUNELLE MD PA 508 S HABANA AVE STE 370 TAMPA, FL 33609 CLIA ID# 10D0290320




GRAHAM MATTHEWS MD, DIRECTOR PERIMETER NORTH FAMILY MEDICINE 900 TOWNE LAKE PARKWAY SUITE 210 WOODSTOCK, GA 30189 CLIA ID# 11D0917331


EFFECTIVE DATE: MARCH 11, 2013


STATUS: LAB VOLUNTARILY CEASED TESTING COMPLIANCE ACHIEVED

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JAMES KYLER, DIRECTOR FORT WAYNE DERMATOLOGY CONSULTANTS INC 5750 FALLS DR FORT WAYNE, IN 46804 CLIA ID# 15D0358006



EFFECTIVE DATE: APRIL 30, 2013 APRIL 30, 2013

REASON: CANCELLATION OF MEDICARE APPROVAL REVOCATION

LORI LYNCH, DIRECTOR LABORATORY SERVICES GROUP 955 S HEBRON AVE STE C EVANSVILLE, IN 47714 CLIA ID# 15D0361780

SANCTION: REVOCATION OF CLIA CERTIFICATE

EFFECTIVE DATE: JULY 31, 2013


STATUS: LAB VOLUNTARILY CEASED TESTING LAB TERMINATED

KAMLESH DAVE, DIRECTOR FIRST STOP URGENT CARE MADISON 311 E CLIFTY DR MADISON, IN 47250 CLIA ID# 15D2012150


EFFECTIVE DATE: OCTOBER 01, 2013


STATUS: SUSPENSION AND LIMITATION LIFTED COMPLIANCE ACHIEVED ALL SANCTIONS WERE LIFTED AS OF 12/3/13

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DANIEL GRALNEK, DIRECTOR UROLOGIC ASSOCIATES OF IOWA CITY PC 2943 NORTHGATE DRIVE IOWA CITY, IA 52245 CLIA ID# 16D0386507




MAGGIE TRAN, DIRECTOR VIP DBA PEDIATRIC ASSOCIATES 1717 HIGH STREET SUITE 3A HOPKINSVILLE, KY 42240 CLIA ID# 18D0326113




JANOS VOROS, DIRECTOR WOMENS CENTER THE 120 MEADOWCREST ST SUITE 350 GRETNA, LA 70056 CLIA ID# 19D0871029



REASON: CANCELLATION OF MEDICARE APPROVAL REVOCATION CONDITION LEVEL NONCOMPLIANCE FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION

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AMANDA LACOMB, DIRECTOR LAKE AREA LABORATORIES LLC 1322 ELTON ROAD, SUITE F, ROOM 9 JENNINGS, LA 70546 CLIA ID# 19D2002974



EFFECTIVE DATE: MAY 23, 2013

JULY 02, 2013 MAY 23, 2013

REASON: 2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT

CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY CANCELLATION OF MEDICARE APPROVAL REVOCATION FAILURE TO CORRECT DEFICIENCIES FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION

AMANDA LACOMB, DIRECTOR LAKE AREA LABORATORIES LLC 421 NORTH AVENUE F, ROOM 10 CROWLEY, LA 70526 CLIA ID# 19D2003420




JULY 02, 2013 MAY 13, 2013


WITH IMMEDIATE JEOPARDY MEDICARE CANCELLATION/SUSPENSION REVOCATION OF CLIA CERTIFICATE FAILURE TO CORRECT DEFICIENCIES

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AMANDA LACOMBE, DIRECTOR LAKE AREA LABORATORIES 2153 NORTH FOSTER, ROOM #12 BATON ROUGE, LA 70806 CLIA ID# 19D2007919




JULY 02, 2013 MAY 23, 2013


2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEORPARDY FAILURE TO CORRECT DEFICIENCIES

AMANDA LACOMB, DIRECTOR LAKE AREA LABORATORIES LLC 59295 RIVER WEST DRIVE, SUITE C, ROOM #13 PLAQUEMINE, LA 70764 CLIA ID# 19D2038508



EFFECTIVE DATE: MAY 23, 2013 JULY 02, 2013 MAY 23, 2013


CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEORPARDY FAILURE TO CORRECT DEFICIENCIES

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BENJAMIN RIVNAY PH.D., DIRECTOR SCHREIBER ENDOCRINE LAB 675 MAIN STREET MELROSE, MA 02176 CLIA ID# 22D2003807



EFFECTIVE DATE: FEBRUARY 11, 2013 MAY 21, 2013

REASON: REVOCATION OF CLIA CERTIFICATE

2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT MEDICARE CANCELLATION/SUSPENSION

STATUS: THE LABORATORY'S CLIA CERTIFICATE WAS REVOKED EFFECITVE MAY 21, 2013.

ROBERT IRELAND, DIRECTOR ALFREDO R CHAN MD PC 105 WEBSTER ST UNIT 6 HANOVER, MA 02339 CLIA ID# 22D2016010



EFFECTIVE DATE: FEBRUARY 13, 2013 MAY 14, 2013


2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT

STATUS: REVOCATION OF CLIA CERTIFICATE THE LABORATORY'S CLIA CERTIFICATE WAS REVOKED EFFECTIVE MAY 14, 2013

DENNIS DIETZEN, DIRECTOR STOVER MEDICAL SUPPORT SERVICES 206 SOUTH MAIN STREET O FALLON, MO 63366 CLIA ID# 26D0691515




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ESTELA CHAN, DIRECTOR WEBSTER COUNTY COMMUNITY HOSPITAL SIXTH AVENUE & FRANKLIN STREET RED CLOUD, NE 68970 CLIA ID# 28D0679420


EFFECTIVE DATE: APRIL 05, 2013


JACK TROPER, DIRECTOR BORO PARK OBSTETRICS AND GYNECOLOGY PC 5925 15TH AVENUE BROOKLYN, NY 11219 CLIA ID# 33D1019019



REASON: FAILURE TO CORRECT DEFICIENCIES MEDICARE CANCELLATION/SUSPENSION

DAVID GROSSMAN MD M.D., DIRECTOR LUCAS COUNTY REGIONAL HEALTH DISTRICT 635 NORTH ERIE STREET TOLEDO, OH 43624 CLIA ID# 36D0674771

SANCTION: CIVIL MONEY PENALTY OF $1,000 PER DAY

EFFECTIVE DATE: DECEMBER 11, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY

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CHANDRE GOWDA MD DIRECTOR, DIRECTOR MAIN STREET FAMILY MEDICINE 881 EAST MAIN STREET COLUMBUS, OH 43205 CLIA ID# 36D1062944




DAVID WEAVER, DIRECTOR WEAVER DRUG TESTING LABORATORY, LLC 1619 S BOULDER TULSA, OK 74119 CLIA ID# 37D1054904



EFFECTIVE DATE: NOVEMBER 12, 2013 DECEMBER 31, 2013 NOVEMBER 12, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE \

JUSTINIANO CASTRO MONTALVO, DIRECTOR INSTITUTO DEL CANCER Y ENFERMEDADES DE LA SANGRE CALLE ANDRES GARCIA #53 URB GARCIA ARECIBO, PR 00612 CLIA ID# 40D0999180


REVOCATION OF CLIA CERTIFICATE LIMITATION OF CLIA CERTIFICATE

EFFECTIVE DATE: OCTOBER 29, 2013 OCTOBER 29, 2013 OCTOBER 29, 2013 REASON: MEDICARE CANCELLATION/SUSPENSION

CONDITION LEVEL NONCOMPLIANCE FAILURE TO CORRECT DEFICIENCIES


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PAUL NOURSE, DIRECTOR LAKE WHITNEY MEMORIAL HOSPITAL/LAB LAKE WHITNEY MEDICAL CENTER 200 N SAN JACINTO ST WHITNEY, TX 76692 CLIA ID# 45D0488454


SUSPENSION OF CLIA CERTIFICATE

EFFECTIVE DATE: SEPTEMBER 05, 2013 SEPTEMBER 05, 2013 REASON: CONDITION LEVEL NONCOMPLIANCE

WITH IMMEDIATE JEOPARDY

STATUS: COMPLIANCE ACHIEVED

BENJAMIN RIVNAY, DIRECTOR TAYLOR FAMILY PRACTICE 22999 HWY 59 N, STE 142 KINGWOOD, TX 77339 CLIA ID# 45D0973218



REASON: 2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT MEDICARE CANCELLATION/SUSPENSION CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY IMPROPER PROFICIENCY TESTING REFERRAL ACTIVITIES

STATUS: APPEAL FILED BY LAB

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ROBERT BASS, DIRECTOR ROBERT G BASS JR MD 1202 EAST SONTERRA BLVD ST 701 SAN ANTONIO, TX 78258 CLIA ID# 45D0975510




AUGUST 26, 2013 FEBRUARY 05, 2013


2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY

STATUS: APPEAL FILED BY LAB

THOMAS BRITTON, DIRECTOR PLANNED PARENTHOOD CHOICE 316 SECOR STREET MIDLAND, TX 79701 CLIA ID# 45D1044573



REASON: 2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT IMPROPER PROFICIENCY TESTING REFERRAL ACTIVITIES

EDGAR CORTES, DIRECTOR COASTAL CHILDREN'S CLINIC PA SOUTH PLAZA 5945 SARATOGA CORPUS CHRISTI, TX 78413 CLIA ID# 45D1052873



REASON: CANCELLATION OF MEDICARE APPROVAL SUSPENSION CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING


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YOLANDA LAWSON, MD, DIRECTOR MADEWELL OB GYN YOLANDA LAWSON, MD, PA 3310 LIVE OAK, SUITE 210 DALLAS, TX 75204 CLIA ID# 45D1085262



REASON: CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY CANCELLATION OF MEDICARE APPROVAL SUSPENSION UNSUCCESSFUL PROFICIENCY TESTING


M GAIL VANDERLEE, DIRECTOR PLANNED PARENTHOOD CHOICE 3449 NORTH 10TH ABILENE, TX 79603 CLIA ID# 45D2019250



REASON: CANCELLATION OF MEDICARE APPROVAL REVOCATION CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY IMPROPER PROFICIENCY TESTING REFERRAL ACTIVITIES


M GAIL VANDERLEE, DIRECTOR PLANNED PARENTHOOD CHOICE 2010 PECOS ST SAN ANGELO, TX 76901 CLIA ID# 45D2019253



REASON: IMPROPER PROFICIENCY TESTING REFERRAL ACTIVITIES 2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT

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EDUARDO CARRILLO MD, DIRECTOR MOLECULAR MEDICAL LABORATORY, INC 2218 WEST MILE 5 ROAD MISSION, TX 78574 CLIA ID# 45D2020075



EFFECTIVE DATE: NOVEMBER 04, 2013

DECEMBER 24, 2013 NOVEMBER 04, 2013



YILING DING, DIRECTOR AUSPICIOUS LABORATORY INC 7400 HARWIN DRIVE SUITE 258 HOUSTON, TX 77036 CLIA ID# 45D2048957


SUSPENSION OF CLIA CERTIFICATE

EFFECTIVE DATE: JULY 31, 2013 JULY 31, 2013

REASON: MEDICARE CANCELLATION/SUSPENSION

CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY


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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 ***

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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

BEN HESTER, DIRECTOR ETOWAH PEDIATRICS 170 INDEPENDENT DRIVE RAINBOW CITY, AL 35906 CLIA ID# 01D1048892

SANCTION: DIRECTED PLAN OF CORRECTION

SUSPENSION PART OF MEDICARE/MEDICAID

EFFECTIVE DATE: SEPTEMBER 10, 2013 SEPTEMBER 10, 2013



STEPHEN STURDIVANT, DIRECTOR BRADLEY COUNTY MEDICAL CENTER LAB 404 SOUTH BRADLEY STREET WARREN, AR 71671 CLIA ID# 04D0465446



REASON: CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY`


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ROBERT JAMES MD, DIRECTOR MODOC MEDICAL CENTER LAB 228 W MCDOWELL AVE ALTURAS, CA 96101 CLIA ID# 05D0618592


EFFECTIVE DATE: JUNE 03, 2013


ARON BICK MD, DIRECTOR SYNERGY HEMATOLOGY ONCOLOGY MEDICAL ASSOCIATES LABORATORY 5901 W OLYMPIC BLVD STE 420 LOS ANGELES, CA 90036 CLIA ID# 05D0724185




ZONG LANG TSAI MD, DIRECTOR DEL AMO MEDICAL LABORATORY, INC 21350 HAWTHORNE BLVD, SUITE 164 TORRANCE, CA 90503 CLIA ID# 05D0913319


DIRECTED PLAN OF CORRECTION

EFFECTIVE DATE: FEBRUARY 01, 2013 MARCH 18, 2013


CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY FAILURE TO CORRECT DEFICIENCIES


APPEAL FILED BY LAB

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EDWARD LAI MD M.D., DIRECTOR BIODATA MEDICAL LABORATORIES, INC. 5494 ARROW HWY MONTCLAIR, CA 91763 CLIA ID# 05D0938572


DIRECTED PLAN OF CORRECTION SUSPENSION PART OF MEDICARE/MEDICAID


SEPTEMBER 21, 2013 SEPTEMBER 23, 2013


CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING

ALFRED LUI, MD, DIRECTOR PATHOLOGY INC 19951 MARINER AVENUE, SUITE 150 TORRANCE, CA 90503 CLIA ID# 05D0980136

SANCTION: CIVIL MONEY PENALTY DIRECTED

PLAN OF CORRECTION

EFFECTIVE DATE: MARCH 09, 2013 MARCH 09, 2013


ALICE REIER MD, DIRECTOR ALICE REIER MD 3300 WEBSTER ST STE 900 OAKLAND, CA 94609 CLIA ID# 05D1030082

SANCTION: SUSPENSION PART OF MEDICARE/MEDICAID



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RICHY AGAJANIAN, MD, DIRECTOR ONCOLOGY INSTITUTE OF HOPE AND INNOVATION, THE DOWNEY 11480 BROOKSHIRE AVENUE, SUITE 309 DOWNEY, CA 90241 CLIA ID# 05D1076983



EFFECTIVE DATE: MAY 01, 2013 MAY 01, 2013


FAILURE TO CORRECT DEFICIENCIES FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION

JAMES DIBDIN MD, DIRECTOR KESTER DIAGNOSTIC LABORATORY INC 6817 KESTER AVE VAN NUYS, CA 91405 CLIA ID# 05D2025446





CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING

RICHARD BRUNELLE M.D., DIRECTOR RICHARD R BRUNELLE MD PA 508 S HABANA AVE STE 370 TAMPA, FL 33609 CLIA ID# 10D0290320





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GERMAN LEPARC, DIRECTOR ONEBLOOD INC 10100 DR MARTIN LUTHER KING JR ST N SAINT PETERSBURG, FL 33716 CLIA ID# 10D0665918


PLAN OF CORRECTION

EFFECTIVE DATE: JANUARY 24, 2013 JANUARY 24, 2013

REASON: IMPROPER PROFICIENCY TESTING REFERRAL ACTIVITIES

STATUS: APPEAL FILED BY LAB COMPLIANCE ACHIEVED

GRAHAM MATTHEWS MD, DIRECTOR PERIMETER NORTH FAMILY MEDICINE 900 TOWNE LAKE PARKWAY SUITE 210 WOODSTOCK, GA 30189 CLIA ID# 11D0917331





STATUS: LAB VOLUNTARILY CEASED TESTING COMPLIANCE ACHIEVED

MANDY GITTLER M D, DIRECTOR ALL WOMENS HEALTH 2000 W ARMITAGE AVE, 2ND FL CHICAGO, IL 60647 CLIA ID# 14D1073128



EFFECTIVE DATE: JULY 26, 2013 JULY 26, 2013



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KAMLESH DAVE, DIRECTOR FIRST STOP URGENT CARE MADISON 311 E CLIFTY DR MADISON, IN 47250 CLIA ID# 15D2012150



EFFECTIVE DATE: OCTOBER 01, 2013 OCTOBER 01, 2013


STATUS: SUSPENSION AND LIMITATION LIFTED COMPLIANCE ACHIEVED 12/03/2013

DANIEL GRALNEK, DIRECTOR UROLOGIC ASSOCIATES OF IOWA CITY PC 2943 NORTHGATE DRIVE IOWA CITY, IA 52245 CLIA ID# 16D0386507




MAGGIE TRAN, DIRECTOR VIP DBA PEDIATRIC ASSOCIATES 1717 HIGH STREET SUITE 3A HOPKINSVILLE, KY 42240 CLIA ID# 18D0326113





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QUANG VU M.D., DIRECTOR HARVEY MEDCARE 3709 WESTBK EXPY 1-B HARVEY, LA 70058 CLIA ID# 19D0457620





JAMES LIPSTATE M.D., DIRECTOR LAFAYETTE ARTHRITIS & ENDOCRINE CLINIC 401 AUDUBON BLVD SUITE 102B LAFAYETTE, LA 70506 CLIA ID# 19D0460899


EFFECTIVE DATE: AUGUST 23, 2013



TROY MARTIN, DIRECTOR ACADIANA FAMILY PHYSICIANS 427 HEYMANN BLVD LAFAYETTE, LA 70503 CLIA ID# 19D0461003



REASON: FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION


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ALBERT RICHERT SR, DIRECTOR PEDIATRIC CENTER OF SOUTHWEST LOUISIANA, THE 600 CYPRESS STREET SULPHUR, LA 70663 CLIA ID# 19D0462025





ALBERT RICHERT SR M.D., DIRECTOR PEDIATRIC CENTER OF SOUTHWEST LOUISIANA, THE 2640 COUNTRY CLUB ROAD, SUITE 100 LAKE CHARLES, LA 70605 CLIA ID# 19D1102217





PAUL BRACEY M.D., DIRECTOR URGENT CARE OF LOUISIANA, LLC 6901 FERN AVENUE, SUITE 100 SHREVEPORT, LA 71105 CLIA ID# 19D2023482





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KHALED RABIE, DIRECTOR RABIE CLINIC FOR WOMEN 404 6TH ST ALEXANDRIA, LA 71301 CLIA ID# 19D2029503



REASON: CONDITION LEVEL NONCOMPLIANCE FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION


JILL WILKENS, DIRECTOR PROGRESSIVE RADIOLOGY 7701 GREENBELT RD STE 102 GREENBELT, MD 20770 CLIA ID# 21D2014997

SANCTION: STATE ONSITE MONITORING




FAILURE TO CORRECT DEFICIENCIES


MILENKO TANASIJEVIC, DIRECTOR BWH CLINICAL LABORATORIES 75 FRANCIS ST AMORY 2 RM 215 BOSTON, MA 02115 CLIA ID# 22D0666524



REASON: IMPROPER PROFICIENCY TESTING REFERRAL ACTIVITIES


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BENJAMIN RIVNAY PH.D., DIRECTOR SCHREIBER ENDOCRINE LAB 675 MAIN STREET MELROSE, MA 02176 CLIA ID# 22D2003807



EFFECTIVE DATE: FEBRUARY 11, 2013 FEBRUARY 11, 2013


2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT MEDICARE CANCELLATION/SUSPENSION

ROBERT IRELAND, DIRECTOR ALFREDO R CHAN MD PC 105 WEBSTER ST UNIT 6 HANOVER, MA 02339 CLIA ID# 22D2016010





2 YEAR PROHIBIT FROM OWN, OPERATE, OR DIRECT

SUNHIE LEE, DIRECTOR PARK AVENUE FAMILY PRACTICE 2707 NICOLLET AVE MINNEAPOLIS, MN 55408 CLIA ID# 24D0401673

SANCTION: CIVIL MONEY PENALTY OF -$5,000 PER DAY


EFFECTIVE DATE: JANUARY 15, 2013 JANUARY 15, 2013



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DENNIS DIETZEN, DIRECTOR STOVER MEDICAL SUPPORT SERVICES 206 SOUTH MAIN STREET O FALLON, MO 63366 CLIA ID# 26D0691515




ESTELA CHAN, DIRECTOR WEBSTER COUNTY COMMUNITY HOSPITAL SIXTH AVENUE & FRANKLIN STREET RED CLOUD, NE 68970 CLIA ID# 28D0679420




EUGENE SOMPHONE MD, DIRECTOR SOUTHWEST MEDICAL ASSOCIATES-RANCHO 888 S RANCHO DR LAS VEGAS, NV 89106 CLIA ID# 29D0904176




STATUS: CERTIFICATE REINSTATED

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JACK TROPER, DIRECTOR BORO PARK OBSTETRICS AND GYNECOLOGY PC 5925 15TH AVENUE BROOKLYN, NY 11219 CLIA ID# 33D1019019


PLAN OF CORRECTION SUSPENSION PART OF MEDICARE/MEDICAID


MARCH 28, 2013 APRIL 18, 2013

REASON: FAILURE TO CORRECT DEFICIENCIES

MEDICARE CANCELLATION/SUSPENSION

SARAH FROMAN MD DIRECTOR, DIRECTOR OB/GYN ASSOC OF LANCASTER INC MEDICAL OFFICE PAVILION STE 201 135 NORTH EWING STREET LANCASTER, OH 43130 CLIA ID# 36D0328385

SANCTION: CIVIL MONEY PENALTY OF $200 PER DAY





DELIA SLAGA M.D., DIRECTOR PEDIATRIC AND FAMLY MEDICINE HEALTHCARE INC 2400 WALES AVE NW STE C MASSILLON, OH 44646 CLIA ID# 36D0342872





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DAVID GROSSMAN MD M.D., DIRECTOR LUCAS COUNTY REGIONAL HEALTH DISTRICT 635 NORTH ERIE STREET TOLEDO, OH 43624 CLIA ID# 36D0674771



EFFECTIVE DATE: DECEMBER 11, 2013 DECEMBER 11, 2013



EVELYN JOSEPH MD, DIRECTOR DRS JOSEPH BROWN BAGAMERY ARAR GARVIN 3666 PAXTON AVENUE CINCINNATI, OH 45208 CLIA ID# 36D0677986

SANCTION: CIVIL MONEY PENALTY OF $1,000 PER DAY DIRECTED PLAN OF CORRECTION


DECEMBER 02, 2013



JOHN KAVLICH MD, DIRECTOR PATIENT FIRST DBA JOHN J KAVLICH MD 276 WEST BAGLEY ROAD BEREA, OH 44017 CLIA ID# 36D0909600

SANCTION: CIVIL MONEY PENALTY OF $500 PER DAY


EFFECTIVE DATE: DECEMBER 17, 2013 DECEMBER 17, 2013



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CHANDRE GOWDA MD DIRECTOR, DIRECTOR MAIN STREET FAMILY MEDICINE 881 EAST MAIN STREET COLUMBUS, OH 43205 CLIA ID# 36D1062944





JOHN KAMAU, DIRECTOR BEDFORD COMMUNITY EMERGENCY ROOM 22750 ROCKSIDE ROAD BEDFORD, OH 44146 CLIA ID# 36D2044024






JAMES SCIBILIA, DIRECTOR TRI-STATE PEDIATRICS 15700 STATE RT 170 SUITES C & D CALCUTTA, OH 43920 CLIA ID# 36D2055880





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MICHELLE POWERS MD, DIRECTOR MERCY HOSPITAL KINGFISHER, INC 1000 KINGFISHER REGIONAL HOSPITAL DRIVE KINGFISHER, OK 73750 CLIA ID# 37D0472688





FRANK HUBBARD, DIRECTOR CLEVELAND AREA HOSPITAL 1401 W PAWNEE STREET CLEVELAND, OK 74020 CLIA ID# 37D0473165





STEVE ROSE, DIRECTOR OKMULGEE MEMORIAL HOSPITAL 1401 MORRIS DRIVE OKMULGEE, OK 74447 CLIA ID# 37D0475237





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KAMIL NEMRI, DIRECTOR LINDSAY MUNICIPAL HOSPITAL HIGHWAY 19 WEST LINDSAY, OK 73052 CLIA ID# 37D0995219





FORREST BROWN MD, DIRECTOR CONSULTING DERMATOLOGIC SPECIALISTS 7777 FOREST LANE BLDG C SUITE 828 DALLAS, TX 75230 CLIA ID# 45D0480177

SANCTION: CIVIL MONEY PENALTY (CMP)



STATUS: LABORATORY CLOSED

PAUL NOURSE, DIRECTOR LAKE WHITNEY MEMORIAL HOSPITAL/LAB LAKE WHITNEY MEDICAL CENTER 200 N SAN JACINTO ST WHITNEY, TX 76692 CLIA ID# 45D0488454





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ORDAN SEAN HEALEY, DIRECTOR HEALEY UROLOGY CLINIC PA 3180 CENTRAL MALL DRIVE PORT ARTHUR, TX 77642 CLIA ID# 45D0497725



REASON: CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY FAILURE TO SUBMIT ACCEPTABLE PLAN OF CORRECTION FAILURE TO CORRECT DEFICIENCIES


LEONARD GIETZ, DIRECTOR REGIONAL MEDICAL LABORATORY 2110 NORTH NAVARRO VICTORIA, TX 77901 CLIA ID# 45D0498740

SANCTION: DIRECTED PLAN OF CORRECTION EFFECTIVE DATE: OCTOBER 31, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE WITH IJ

FAILURE TO CORRECT DEFICIENCIES

STATUS: COMPLIANCE ACHIEVED CAROLINE VALDES MD, DIRECTOR CUERO COMMUNITY HOSPITAL LABORATORY 2550 N ESPLANADE CUERO, TX 77954 CLIA ID# 45D0498840

SANCTION: CIVIL MONEY PENALTY


REASON: FAILURE TO CORRECT DEFICIENCIES CONDITION LEVEL NONCOMPLIANCE


35

RONNIE DEAL, DIRECTOR NORTH RUNNELS HOSPITAL LABORATORY 187 EAST HWY 153 WINTERS, TX 79567 CLIA ID# 45D0508239




FAILURE TO SUBMIT ACCEPTABLE POC or

AOC


JAY JONES MD, DIRECTOR THIRD FLOOR LABORATORY 8210 WALNUT HILL LANE STE 304 DALLAS, TX 75231 CLIA ID# 45D0666917



REASON: CONDITION LEVEL NONCOMPLIANCE FAILURE TO CORRECT DEFICIENCIES


DONNA SIRBASKU, DIRECTOR NORTH DFW UROLOGY 1601 LANCASTER #170 GRAPEVINE, TX 76051 CLIA ID# 45D0863263



REASON: CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARDY FAILURE TO CORRECT DEFICIENCIES


COMPLIANCE ACHIEVED

36

STEPHEN JACKSON, DIRECTOR URGENT CARE INSTITUTE OF ABILENE, LLC 3802 CATCLAW DRIVE ABILENE, TX 79606 CLIA ID# 45D1036363



REASON: CONDITION LEVEL NONCOMPLIANCE FAILURE TO CORRECT DEFICIENCIES


OSCAR MANGINI, MD, DIRECTOR MEDICAL CENTER LABORATORY II 2525 WEST BELFORT, SUITE 197 HOUSTON, TX 78413 CLIA ID# 45D1052675

SANCTION: DIRECTED PLAN OF CORRECTION EFFECTIVE

DATE: JANUARY 21, 2013

REASON: CONDITION LEVEL NONCOMPLIANCE WITH IJ UNSUCCESSFUL PT FAILURE TO CORRECT DEFICIENCIES FAILURE TO SUBMIT ACCEPTABLE POC or AOC


EDGAR CORTES, DIRECTOR COASTAL CHILDREN'S CLINIC PA SOUTH PLAZA 5945 SARATOGA CORPUS CHRISTI, TX 78413 CLIA ID# 45D1052873



REASON: CANCELLATION OF MEDICARE APPROVAL SUSPENSION CONDITION LEVEL NONCOMPLIANCE UNSUCCESSFUL PROFICIENCY TESTING


37

YOLANDA LAWSON, MD, DIRECTOR MADEWELL OB GYN YOLANDA LAWSON, MD, PA 3310 LIVE OAK, SUITE 210 DALLAS, TX 75204 CLIA ID# 45D1085262





WITH IMMEDIATE JEOPARDY CANCELLATION OF MEDICARE APPROVAL SUSPENSION UNSUCCESSFUL PROFICIENCY TESTING


ARTURO MENDIETTA, DIRECTOR TEXAS INTERNAL MEDICINE AND DIAGNOSTIC CENTER 4502 N LAURENT ST VICTORIA, TX 77901 CLIA ID# 45D2000387



REASON: CONDITION LEVEL NONCOMPLIANCE WITH IJ


ALICE GILMAN-SACHS, DIRECTOR RHEUMATIC DISEASE CLINIC 4825 ALMEDA ROAD HOUSTON, TX 77004 CLIA ID# 45D2004950





38

FE IMUS MT AMT, DIRECTOR ACCURATE LAB SERVICES, LLC 7155 COLLEYVILLE BLVD, SUITE 102 COLLEYVILLE, TX 76034 CLIA ID# 45D2017092





MICHAEL ROBLES, DIRECTOR GASTROENTEROLOGY & LIVER ASSOCIATES, PLLC 3030 S GESSNER RD, SUITE 290 HOUSTON, TX 77063 CLIA ID# 45D2020900





39

HERIBERTO SALINAS, DIRECTOR TOP CARE MEDICAL D/B/A MI DOCTOR 22 1900 HENDERSON CLEBURNE, TX 76031 CLIA ID# 45D2021133



REASON: CONDITION LEVEL NONCOMPLIANCE WITH IMMEDIATE JEOPARY


GERALD SMITH M.D., DIRECTOR AURORA HEALTH CARE METRO INC AURORA SINAI MEDICAL CENTER 945 NORTH 12TH ST MILWAUKEE, WI 53233 CLIA ID# 52D0392249






MATTHEW SNYDER, DIRECTOR AURORA HEALTHCARE METRO INC - GRAFTON CANCER CARE 975 PORT WASHINGTON RD GRAFTON, WI 53024 CLIA ID# 52D2038178





40

MA IVY CLEMENTE MD, DIRECTOR LBJ TROPICAL MEDICAL CENTER CLINICAL LABORATORY PO BOX LBJ PAGO PAGO, AS 96799 CLIA ID# 64D0724937





41

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)

TRAVIS KIDD JR MD, DIRECTOR CLANTON HOSP/CHILTON MED CTR LAB 1010 LAY DAM ROAD CLANTON, AL 35045 CLIA ID# 01D0300055 TJC

SANCTION: DENIAL OF ACCREDITATION


REASON: NON-COMPLIANCE

MEHRA SHVETA, DIRECTOR ARIZONA REGIONAL MEDICAL CENTER 515 N MESA DR MESA, AZ 85201 CLIA ID# 03D1084639 TJC




ROBERT STROTH, DIRECTOR BANNER GOLDFIELD MEDICAL CENTER 2050 WEST SOUTHERN AVENUE APACHE JUNCTION, AZ 85120 CLIA ID# 03D2001924 TJC




42

REGINA VAN BUREN, DIRECTOR WEST VALLEY EMERGENCY CENTER 525 S WATSON RD BUCKEYE, AZ 85326 CLIA ID# 03D2024629 CAP

SANCTION: CEASE TESTING FIBRINOGEN


REASON: REGULATED ANALYTE REPORTED CRITICAL

ERWIN GABOR MD, DIRECTOR E PETER GABOR MD 9735 WILSHIRE BLVD #400 BEVERLY HILLS, CA 90212 CLIA ID# 05D0546844 COLA



REASON: FAILURE TO ADHERE TO COLA IMPOSED REQUIRED IMPROVEMENTS

JAMES FRENCH MD, DIRECTOR COR HEALTHCARE MEDICAL ASSOCIATES 1360 W 6TH 200 SAN PEDRO, CA 90732 CLIA ID# 05D0553670 COLA

SANCTION: CEASE TESTING FOR CHLORIDE


REASON: NONCOMPLIANCE DUE TO UNSUCCESSFUL PARTICIPATION IN PROFICIENCY TESTING

RONALD CHOCHINOV, DIRECTOR RONALD H CHOCHINOV MD 168 N BRENT ST, STE 405 VENTURA, CA 93003 CLIA ID# 05D0583029 COLA




43

MANUEL BACULI, MD, DIRECTOR MEDICAL CLINICAL LABORATORIES 2216 SANTA MONICA BLVD. #101 SANTA MONICA, CA 90404 CLIA ID# 05D0704107 COLA




LINDA COWAN MD DIRECTOR, DIRECTOR PRO GENETIC LABORATORY INC DBA UNIVERSITY CHILDRENS GENETICS LABORATORY 431 S RAYMOND AVE UNIT 101 ALHAMBRA, CA 91803 CLIA ID# 05D0943445 CAP

SANCTION: ACCREDITATION REVOKED


REASON: LABORATORY PERFORMANCE DOES NOT MEET CAP STANDARDS OF ACCREDITATION

RUBEN GAMEZ M.D., DIRECTOR ASCEND GENOMICS, LLC 320 HATCH DRIVE FOSTER CITY, CA 94404 CLIA ID# 05D2006211 CAP

SANCTION: PROBATION


REASON: QUALITY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT ENOUGH TO QUESTION ABILITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPORT IMPLEMENTATION & PREVENTION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

44

THOMAS TINGHITELLA, PHD, DIRECTOR GRAHAM-MASSEY ANALYTICAL LAB 60 TODD ROAD SHELTON, CT 06484 CLIA ID# 07D0686807 CAP

SANCTION: PROBATION



IMMUNO LABORATORIES INC 6801 POWERLINE RD FORT LAUDERDALE, FL 33309-2155 CLIA ID# 10D0284781 CAP



REASON: LABPORATORY PERFORMANCE DOES NOT MEET CAP STANDARDS

PAUL GAREN, DIRECTOR JUPITER MEDICAL CENTER CLINICAL LABORATORY 1210 S OLD DIXIE HWY JUPITER, FL 33458 CLIA ID# 10D0288212 CAP

SANCTION: CEASE TESTING LITHIUM


REASON: REGULATED ANALYTE CRITICAL

STATUS: RESUMED TESTING AUGUST 21, 2013

45

JOSE ROSADA, DIRECTOR FLORIDA HEART & VASCULAR MULTISPECIALTY GROUP PA 802 E DIXIE AVE LEESBURG, FL 34748 CLIA ID# 10D0680120 COLA

SANCTION: CEASE TESTING FOR BUN


REASON: NON-COMPLIANCE DUE TO UNSUCCESSFUL PARTICIPATION IN PROFICIENCY TESTING

EDWIN SIA, DIRECTOR STAGES OF LIFE MEDICAL INSTITUTE 1917 BOOTHE CIR LONGWOOD, FL 32750 CLIA ID# 10D2001025 COLA

SANCTION: CEASE TESTING



ANDREW YOUNG M.D., DIRECTOR GRADY HEALTH SYSTEM 80 JESSE HILL JUNIOR DRIVE SOUTH EAST ATLANTA, GA 30303 CLIA ID# 11D0021076 CAP

SANCTION: CEASE TESTING PHENOBARBITAL



46

CESAR ANGELETTI M.D., DIRECTOR WELLSTAR DOUGLAS HOSPITAL LABORATORY 8954 HOSPITAL DR DOUGLASVILLE, GA 30134 CLIA ID# 11D0256511 CAP

SANCTION: CEASE TESTING FIBRINOGEN


REASON: REGULATED ANALYTE REPORTEDCRITICAL

JOHN BLEICHNER, DIRECTOR LOWER OCONEE COMMUNITY HOSPITAL 111 N 3RD ST GLENWOOD, GA 30428 CLIA ID# 11D0260995 TJC


EFFECTIVE DATE: SEPTEMBER 9, 2013 REASON:

NON-COMPLIANCE

WILLIAM CHECK, DIRECTOR MEMORAIL HEALTH UNIVERSITY MEDICAL CENTER LAB 4700 WATERS AVENUE SAVANNAH, GA 31404 CLIA ID# 11D0264614 CAP

SANCTION: CEASE TESTING ASO, QUANT



STATUS: RESUMED TESTING 2/2/2013

47

FRANKLIN CONNER, DIRECTOR ALLERGY & ASTHMA CLINIC OF SE GEORGIA 1608 MEADOW LANE, SUITE 1 VIDALIA, GA 30474 CLIA ID# 11D0885214 COLA

SANCTION: CEASE TESTING SODIUM


REASON: NON-COMPL DUE TO UNSUCCESSFUL PARTICIPATION IN PROFICIENCY TESTING

HIU LUI LAU MD PHD, DIRECTOR SWEDISH AMERICAN MEDICAL CENTER-BELVIDERE 1625 S STATE ST BELVIDERE, IL 61008 CLIA ID# 14D0043993 CAP

SANCTION: CEASE TESTING PO2




FRED BUSSE M.D., DIRECTOR LOGANSPORT MEMORIAL HOSPITAL LABORATORY 1101 MICHIGAN AVE LOGANSPORT, IN 46947 CLIA ID# 15D0035155 CAP

SANCTION: CEASE TESTING THYROXINE



48

ASKHOK PRADHAN M.D., DIRECTOR MAHASKA COUNTY HOSPITAL DBA MAHASKA HEALTH PARTNERSHIP 1229 C AVENUE EAST OSKALOOSA, IA 52577 CLIA ID# 16D0669914 CAP

SANCTION: CEASE TESTING COMPATIBILITY



STATUS: REINSTATEMENT OF TESTING PENDING

JAMES WELCH MD, DIRECTOR LABETTE COUNTY MEDICAL CENTER LABORATORY PO BOX 956 SOUTH 59 HIGHWAY PARSONS, KS 67357 CLIA ID# 17D0452248 CAP

SANCTION: CEASE TESTING TOBRAMYCIN



SALVATORE CILIBERTI MD, DIRECTOR CILIBERTI & WIJANGCO 250 E LIBERTY ST 410 LOUISVILLE, KY 40202 CLIA ID# 18D0320824 COLA

SANCTION: CEASE TESTING FOR CHOLESTEROL



49

JAMES BODNAR DIRECTOR, DIRECTOR FLEMING COUNTY HOSPITAL 55 FOUNDATION DRIVE FLEMINGSBURG, KY 41041 CLIA ID# 18D0324312 CAP

SANCTION: CEASE TESTING TSH


REASON: REGULATED ANALYTE REPORTED CRITICAL STATUS: RESUMED TESTING 1/18/2013

RICHARD T.C. WAN, MD, DIRECTOR WAN’S MEDICAL CLINIC 101 WEST ROBERTS STREET MORGANTOWN, KY 42261 CLIA ID# 18D0326142 COLA




BATON ROUGE GENERAL MEDICAL CENTER-MID CITY LABORATORY 3600 FLORIDA BLVD. BATON ROUGH, LA 70806-3842 CLIA ID# 19D000346 CAP

SANCTION: CEASE TESTING THYROXINE, TOTAL


REASON: REGULATED ANALYTE REPORTED CRITIAL


50

SREEDEREVI KURELLA, DIRECTOR FORT WASHINGTON HOSPITAL 11711 LIVINGSTON RD FORT WASHINGTON, MD 20744 CLIA ID# 21D0210504 CAP

SANCTION: PROBATION


REASON: QUALITY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT ENOUGH TO QUESTION ABILITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPORT IMLEMENTATION & PREVENTION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PENDING

NICHOLAS HRUBY, DIRECTOR WEST BRANCH REGIONAL MEDICAL CENTER 2463 SOUTH M 30 WEST BRANCH, MI 48661 CLIA ID# 23D0037171 CAP

SANCTION: PROBATION



STATUS: PROBATION REMOVED 9/10/2013

JULIETA TABLANTE-BLANCO, DIRECTOR SPECTRUM HEALTH BLODGETT IMMEDIATE RESPONSE LAB 1840 WEALTHY SE GRAND RAPIDS, MI 49506 CLIA ID# 23D0037884 CAP

SANCTION: CEASE TESTING BACTERIOLOGY GRAM STAIN




51

JAYANT SHAH, DIRECTOR DETROIT BIO MEDICAL LABS 23955 FREEWAY PARK DRIVE FARMINGTON HILLS, MI 48335 CLIA ID# 23D0363260 CAP

SANCTION: PROBATION EFFECTIVE

DATE: SEPTEMBER 24, 2013


STATUS: PENDING

NEELAM KUMAR, DIRECTOR DOCTORS HOSPITAL OF MICHIGAN 461 WEST HURON PONTIAC, MI 48341 CLIA ID# 23D0685754 CAP

SANCTION: PROBATION


REASON: QUALITY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT ENOUGH TO QUESTION ABILITY TO SUSTAIN CORRECTION; CORRECTIVE ACTION FAILS TO SUPPORT IMPLEMENTATION & PREVENTION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PENDING

BARBARA OMALLEY M.D., DIRECTOR D M C SURGERY HOSPITAL 30671 STEPHENSON HIGHWAY DMC UNIVERSITY LABORATORIES MADISON HEIGHTS MADISON HEIGHTS, MI 48071 CLIA ID# 23D0963695 CAP

SANCTION: CEASE TESING COMPATIBILITY



52

MICHAEL TODD MD, DIRECTOR MAGNOLIA REGIONAL HEALTH CENTER LAB 611 ALCORN DRIVE CORINTH, MS 38834 CLIA ID# 25D0029572 CAP

SANCTION: CEASE TESTING PARASITOLOGY



STATUS: PENDING

CHARLES SLONAKER III MD, DIRECTOR GARDEN PARK MEDICAL CENTER LAB 15200 COMMUNITY ROAD PO BOX 1240 GULFPORT, MS 39503 CLIA ID# 25D0651952 CAP

SANCTION: PROBATION


REASON: QUALITY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT ENOUGH TO QUESTION ABILITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPORT IMPLEMENTATION & PREVENTION OF RECURRECE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PENDING

DWIGHT JOHNSON, DIRECTOR DWIGHT A JOHNSON MD 609 W CHURCH ST BOONEVILLE, MS 38829 CLIA ID# 25D0694397 COLA

SANCTION: CEASE TESTING FOR SODIUM



53

EDWARD KALMAR, JR., MD, DIRECTOR INTERNET MEDICAL GROUP, PC 181 FRANKLIN AVENUE NUTLEY, NJ 07110 CLIA ID# 31D1018495 COLA



REASON: FAILURE TO COMPLY WITH REASONABLE REQUESTS OF COLA

MERVIN SAKOWITZ, MD DIRECTOR LONG ISLAND PULMONARY ASSOCIATES 2000 NORTH VILLAGE AVENUE STE.301 ROCKVILLE CENTER, NY 11570 CLIA ID# 33D0689665 COLA



REASON: FAILURE TO PERMIT A COLA ON-SITE SURVEY

CHANA GELBFISH, MD, DIRECTOR CHANA E. GELBFISH, MD 2502 AVENUE I BROOKLYN, NY 11210 CLIA ID# 33D0871188 COLA



REASON: FAILURE TO COMPLY WITH REASONABLE REQUEST OF COLA

54

NY ARTHRITS CLINIC, PC 1664 EAST 14TH STREET, SUITE 401 BROOKLYN, NY 11229 CLIA ID# 33D1027538 COLA




CATHERINE PALMER M.D., DIRECTOR GRANVILLE HEALTH SYSTEM LABORATORY 1010 COLLEGE ST OXFORD, NC 27656 CLIA ID# 34D0240109 CAP

SANCTION: CEASE TESTING PHENYTON

EFFFECTIVE DATE: JULY 23, 2013



ELENA MCNEILL, DIRECTOR VIDANT CHOWAN HOSPITAL 211 VIRGINIA RD EDENTON, NC 27932 CLIA ID# 34D0242544 CAP

SANCTION: CEASE TESTING COMPATIBILITY




55

WILSON E. TABE, MD, DIRECTOR 1402 WAYNE MEMORIAL DRIVE GOLDSBORO, NC 27534 CLIA ID# 34D0991846 COLA


EFFECTIVE DATE: FEBRURAY 20, 2013


JOHN POWDERLY, DIRECTOR CAROLINA BIO ONCOLOGY INSTITUTE PLLC 9801 W KINCEY AVE STE 145 HUNTERSVILLE, NC 28078 CLIA ID# 34D1044817 CAP

SANCTION: PROBATION EFFECTIVE

DATE: SEPTEMBER 24, 2013

REASON: QUALITY AND SEVERITY OF DEFICIENCEIS IS SIGNIFICANT TO QUESTION THE ABILITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPORT IMPLEMENTATION & PERVENTION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PENDING

PPD GLOBAL CENTER LABS LLC-RESEARCH LABORATORY II TESSENEER DR. HIGHLAND HEIGHTS, KY 41076-9167 CLIA ID# 36D0346528 CAP

SANCTION: CEASE TESTING PARASITOLOGY



56

NAVA NAWAZ, DIRECTOR PERLL DIAGNOSTICS INC 5010 RITTER ROAD SUITE 104 MECHANICSBURG, PA 17055 CLIA ID# 39D2021686 CAP



REASON: LABORATORY PERFORMANCE DOES NOT MEET CAP STANDARDS

CRAIG HART, DIRECTOR CHESTER REGIONAL MEDICAL CENTER 1 MEDICAL PARK DRIVE CHESTER, SC 29706 CLIA ID# 42D0253342 CAP

SANCTION: PROBATION


REASON: QUALITIY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT ENOUGH TO QUESTION ABILITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPORT IMPLEMENTATION & PREVENTION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PENDING

STEPHEN INTEMANN M.D., DIRECTOR MCLEOD MEDICAL CENTER - DARLINGTON 701 CASHUA FERRY RD DARLINGTON, SC 29532 CLIA ID# 42D0658732 TJC

SANCTION: LIMTATION OF CLIA CERTIFICATE



STATUS: CURRENT

57

AMY BARUCH, DIRECTOR WALLACE THOMSON HOSP CLINICAL LAB 322 W SOUTH STREET UNION SC 29 UNION, SC 29379 CLIA ID# 42D0685774 CAP

SANCTION: PROBATION


REASON: QUALITY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT ENOUGH TO QUESTION ABLIITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPORT IMPLEMENTATION & PREVENTION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PROBATION REMOVED 1/14/2014

HOWARD MARTIN III, DIRECTOR POPLAR HEALTHCARE PLLC 3495 HACKS CROSS RD MEMPHIS, TN 38125 CLIA ID# 44D0915029 CAP

SANCTION: PROBATION


REASON: QUALITY AND SEVERITY OF DEFICIENCIES IS SIGNIFICANT EOUGH TO

QUESTION ABILITY TO SUSTAIN CORRECTIONS; CORRECTIVE ACTION FAILS TO SUPPPORT IMPLEMENTATION OF RECURRENCE IN ONE OR MORE AREAS OF THE LABORATORY

STATUS: PENDING

ROBERT WELLS, DIRECTOR UTHCT - PATHOLOGY 11937 US HIGHWAY 271 TYLER, TX 75708 CLIA ID# 45D0483716 CAP

SANCTION: CEASE TESTING TRIIDOOTHYORNINE



STATUS: PERMANENTLY CEASE TESTING 9/10/2013

58

ALLAN SPENCE MD, DIRECTOR SPENCE CLINIC 336 SOUTH 8TH STREET RAYMONDVILLE, TX 78580 CLIA ID# 45D0704215 COLA




FRED NORA, DIRECTOR TEXOMA MEDICAL CENTER 5016 S US HWY 75 DENISON, TX 75020 CLIA ID# 45D0707052 CAP

SANCTION: CEASE TESTING DIGOXIN




DAVID PRIER, DIRECTOR HUNTSVILLE PEDIATRIC & ADULT MEDICINE ASSOC 100 MEDICAL CENTER PARKWAY SUITE 1000 HUNTSVILLE, TX 77340 CLIA ID# 45D0721321 COLA

SANCTION: CEASE TESTING FOR HCT



59

JEFFREY RETTIG DO, DIRECTOR RETTIG FAMILY HEALTHCARE 204 WEST TRINITY STREET GROESBECK, TX 76642 CLIA ID# 45D0913128 COLA

SANCTION: CEASE TESTING FOR BUN



NORMA IGLESIAS, DIRECTOR NORMA A IGLESIAS MD PA AND ASSOCIATES 1205 NORTH RAUL LONGORIA SUITE H SAN JUAN, TX 78589 CLIA ID# 45D0957497 COLA

SANCTION: CEASE TESTING FOR TSH



LEONEL ACEVEDO, DIRECTOR BROWNSVILLE DOCTORS HOSPITAL LLC ATTN MELISSA MENDOZA 4750 N EXPRESSWAY 77 BROWNSVILLE, TX 78521 CLIA ID# 45D0979612 TJC




60

THOMAS BARKLOW M.D., DIRECTOR NORTON COMMUNITY HOSPITAL BLOOD GAS LAB 100 15TH ST NW NORTON, VA 24273 CLIA ID# 49D0232319 CAP

SANCTION: CEASE TESTING HEMOGLOBIN




A WRIGHT M.D., DIRECTOR WHITMAN HOSPITAL AND MEDICAL CENTER 1200 W FAIRVIEW COLFAX, WA 99111 CLIA ID# 50D0638772 CAP

SANCTION: CEASE TESTING COMPATIBILTY




ROBERT MCCOY MD, DIRECTOR FAIRMONT GENERAL HOSP DEPT OF LAB MED 1325 LOCUST AVE FAIRMONT, WV 26554 CLIA ID# 51D0236806 CAP

SANCTION: CEASE TESTING T3 UPTAKE/RELATED TESTS




61

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

SEE ABOVE LINK

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

62

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 ***

63

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

NONE

64

9. CORRECTION OF ANY ERRONEOUS STATEMENTS OF INFORMATION THAT APPEARED IN THE 2012 REGISTRY.

CRAIG S. GUSTAFSON, DIRECTOR CRAIG S. GUSTAFSON MD LLC 233 AYER ROAD HARVARD, MA 01451 CLIA #ID 22D0914368

SANCTION: REVOCATION OF CLIA CERTICATE


CONDITION: LEVEL NON-COMPLIANCE WITH IMMEDIATE JEOPARDY

65

10. OTHER ACTIONS. THIS SECTION INCLUDES OTHER SPECIFIC INFORMATION THAT MAY BE USEFUL IN EVALUATING THE PERFORMANCE OF LABORATORIES AS SPECIFIED IN 493 CFR 1850(A).IT ALSO INCLUDES INFORMATION PROVIDED BY CLIA EXEMPT STATES.

NONE

2013 laboratory registry

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