Drug Testing Instructions

• Members are Required to Order Drug Tests Online in your Express Labs Account.  Only use the Paper Quest Forms for Emergencies or if you can not Order Online.  After Enrolling, Express Labs does not accept Drug Test Results from other Companies

Ordering Drug Tests Online - Step-by-Step Instructions

1. Login to your Express Labs Account .

2. Go to Order Drug Tests on the Top Left Tabs

3. Select the Reason-for-Testing (Pre-Employment, Random, Post-Accident)

4. Choose a Collection Site (Enter Zip Code)

5. Click Complete Order to Order the Drug Test

6. Check Your Email - You will receive the QPassport from Quest within 1 hour

7. Driver Instructions - Drivers must bring the QPassport (printed or on phone) to the Selected Site

8. Arrival at Collection Site - Collector Scans the QPassport Barcode upon arrival

9. Call the Collection Site - Always call the Site first to ensure they are Open before Notifying the Driver or Driving to the Site

10. Receive Results - Drug Test Results are Emailed and Posted to your Account by Express Labs MRO

Paper Quest Forms

Only use the Paper Quest Forms for Emergencies or if you can not Order Online.  Drivers must have Quest Paper Forms in case of an Accident.  Additional Forms can be ordered in your Account in "Order Drug Testing Forms" (Left Side Tabs).  After Enrolling, Express Labs does not accept Drug Test Results from other Companies.

• In-Network Site Locator: Click Here (Collection Fees Included)
• Out-of-Network Sites: Choose Any Site that Collects for Quest (Collection Fees Not Included)
• Paper Quest Forms that Express Labs provides must be used at In-Network or Out-of-Network Sites

Drug Test Results

• Results are Emailed & Posted to your Account by Express Labs MRO
• Most Negative Results are within 3 Business Days from the Date the Lab receives the Sample
• If you have not received Results within 4 Business Days contact Quest Customer Service at 800-877-7484 with your Quest Account Number (on the QPassport) or the Specimen ID (on the Paper Quest Form)

Drug Testing Fees

• Express Labs charges $80 for Drug Test Results
• Collection Fees are Included at In-Network Sites but not at Out-of-Network Sites
• Return-to-Duty & Follow-Up Drug Test Results are $125 (Observed)
• Invoices are Due Upon Receipt on the 1st of the Month for the Previous Month's Results
• Members must keep a Valid Credit Card on file for Testing Fees to keep your Company & Drivers Active

After Enrolling, Express Labs does not accept Drug Test Results from other Companies

• Members are Required to Order Drug Tests Online in your Express Labs Account.  Only use the Paper Quest Forms for Emergencies or if you can not Order Online.  Upon Enrolling you are assigned a Quest Diagnostics Sub-Account Number from Express Labs that is listed on your QPassport (online orders) and Quest Paper Forms.  This Account Number must be used for All Drug Testing.  All Results are posted on the MIS Report that All Members need for DOT Audits

Frequently Asked Questions - Click Here

What is a QPassport?

The QPassport is a Digital or Printable Authorization Pass issued by Quest Diagnostics when a Drug Test is Ordered in your Express Labs Account.  It includes a unique Barcode and "Q" Number that Identifies the Driver to the Test Order.

• The QPassport takes the place of traditional Paper Custody & Control Forms
• It can be Printed or Displayed on your Phone when at the Collection Site
• The Collector Scans the Barcode to begin the Testing Process with no additional paperwork needed
• Ordering Online using the QPassport provides Faster Results and improves Accuracy by Reducing Manual Data Entry Errors

What is the Drug Testing Process?

1. Collection Process

• The Driver reports to a DOT certified collection site
• A Trained Collector verifies identification
• The Driver washes their hands and removes unnecessary outer clothing
• A split specimen urine collection is conducted:
  • Bottle A: 30 ml (for initial testing)
  • Bottle B: 15 ml (for confirmation testing if needed)
• The Temperature of the sample is checked immediately
• The Sample is sealed and labeled in the presence of the Driver
• The Federal Drug Testing Custody and Control Form (CCF) is completed
• The Sample is shipped to Quest Diagnostics Laboratory for Testing

2. Laboratory Testing (Quest Diagnostics Laboratory)

• Initial Screening Test (Immunoassay)
  • If Negative, the result is reported as Negative
  • If Positive, the sample moves to Confirmation Testing
• Confirmation Test (Gas Chromatography/Mass Spectrometry) Confirms Specific Drug Presence for:
  • Marijuana (THC)
  • Cocaine
  • Opiates (Codeine, Morphine, Heroin)
  • Amphetamines (Methamphetamine, MDMA, etc.)
  • Phencyclidine (PCP)
• Results are sent to the Medical Review Officer (MRO) for Review

3. Medical Review Officer (MRO) Reviews & Reports Results

• The MRO, A Licensed Physician trained in Substance Abuse, Reviews Results to determine if the Results are Negative, Positive, Invalid or require further investigation
• Drug Test Results are Emailed & Posted to your Account by Express Labs MRO
• To ensure you receive Results from the MRO, add email@drsmro.com to your email whitelist in your Email Settings

What is the MRO Review Process?

When a DOT Drug Test is under MRO Review (Medical Review Officer), it means that the Drug Test has returned a Non-Negative or questionable result and requires further examination before a final determination is made.  The MRO will attempt to contact the Driver for further clarification.  If the Driver provides a legitimate medical reason (such as a valid prescription), the result may be reported as Negative.  If no valid reason is given, the result may be confirmed as Positive.

• Positive Test Result: If the test detects a controlled substance, the MRO must confirm the result and give the Driver an opportunity to provide a valid medical explanation (prescription medication)
• Medical Explanation Required: If a prescribed medication could have caused the result, the MRO may verify the legitimacy of the prescription

What can cause Results to be Delayed?

1 - MRO Requires Custody & Control Form to Report Results

The Medical Review Officer needs a Clearer Copy of the Custody & Control Form (CCF) the Driver Signed during the Collection to Report the Results.

• MRO: Requests a clearer copy from the Collector, Employer & Express Labs to obtain a more legible version of the CCF.
• Express Labs: Contacts the Collector to get a copy of the Custody & Control Form (CCF)
• Employer: Send the Custody & Control Form (CCF) to Results@ExpressLabs.com
• Driver: Receives the Custody and Control Form (CCF) during the Collection
• Potential Delays: If a legible copy is not received promptly, it could delay the verification and reporting of test results.
• Regulatory Compliance: Under DOT (Department of Transportation) regulations, the process must comply with 49 CFR Part 40, ensuring all necessary information is available for verification

2 - Results are in "Further Testing" at the Lab

"Further Testing" for a DOT Drug Test at the Laboratory typically means that the initial screening test returned a Non-Negative result, and additional Confirmatory Testing is required.  If a test goes to "Further Testing," it does not automatically mean a failed test.  The confirmatory process ensures accuracy before reporting a final result.  This could be due to several reasons, including:

• Presence of a Substance: The initial immunoassay screen detected a substance that requires confirmation using a more specific test, like Gas Chromatography-Mass Spectrometry (GC-MS)
• Invalid or Adulterated Sample: The sample showed signs of tampering, dilution, or substitution, requiring further analysis to determine if it is a valid specimen
• Specimen Validity Testing (SVT) Issues: The pH, creatinine levels, or specific gravity of the sample were outside expected ranges, prompting further investigation

3 - The Laboratory Requires Additional Documentation

Quest Diagnostics requires Documentation from the Collector to Test the Sample and will contact the Collector to send the Documentation (Called a "Wet Signature") as required to Test the Sample.  If Quest does not receive the Documentation within 10 Business Days, they will Cancel the Test, due to Collector Error.

• A "Wet Signature" means the Documentation must be sent from the Collection site via Mail (Quest Courier or FedEx) with the Wet Ink Signature printed in pen.  It cannot be accepted via Email or Fax

Why a Drug Test may be Cancelled?

• Collector Error (Random): The Random Selection is Marked Complete and No Re-Test is Required.
• Collector Error (Pre-Employment): DOT Requires the Driver to be sent for a New Pre-Employment Drug Test.
• Abnormal PH: In a DOT Drug Test, an Abnormal PH Level in a Urine Sample could indicate that the Sample has been Adulterated or Substituted with another Substance.
• Immunoassay Interference: Immunoassays are commonly used in Drug Testing to detect the Presence of Specific Drugs or their Metabolites.
• Invalid Creatinine: Invalid Creatinine means the Creatinine Level in the Urine Sample is Unusual or Out-of-Range. Creatinine is a Waste Product from Muscles and helps verify if the Urine Sample is Legitimate.
• Temperature-out-of-Range: The Acceptable Temperature Range for a Urine Sample is between 90°F to 100°F (32°C to 38°C) at the time of Collection.  This Temperature Range is considered Normal Body Temperature and is necessary to indicate that the Sample is Fresh and hasn't been Tampered with or Substituted.
• Specific Gravity: Specific Gravity measures the Concentration of Substances Dissolved in the Urine.  It indicates the Sample's Density compared to pure water and helps assess whether the Sample has been Diluted or Tampered with.