Drug Testing Instructions

Members are Required to order Drug Testing Online or by using Paper Quest Forms.  After Enrolling, Express Labs does not accept Drug Test Results from other Companies.

• Option 1: Order Drug Tests Online (QPassports) in your Express Labs Account
• Option 2: If you cannot order online, use the Paper Quest Forms provided by Express Labs

Option 1: Ordering Drug Tests Online (Collection Fees Included)

1. Login to your Express Labs Account.
2. Click "Order Drug Tests" in the Top Left Tabs
3. Select the Reason for Testing (Pre-Employment, Random, Post-Accident)
4. Choose a Collection Site by entering the ZIP Code
5. Click "Complete Order"
6. Check your Email for the QPassport - Emailed from Quest within 1 Hour (noreply@questdiagnostics.com)

• Call the Collection Site to confirm they are open and performing DOT Drug Testing before Notifying Drivers or Driving to the Site
• Drivers must bring the QPassport (printed or on phone) to the Site Selected for the Collector to Scan the QPassport Barcode
• Drug Test Results are Emailed from Express Labs MRO (Medical Review Officer) and uploaded into your Express Labs Account
• Collection Sites may not begin a DOT Drug Test Collection within 3 Hours of Closing (Drivers have up to 3 hours to provide sample)

Option 2: Paper Quest Diagnostics Forms (If you can not order online)

If you cannot order online, use the Paper Quest Forms provided by Express Labs for any Site that Collects for Quest Diagnostics.

In-Network Collection Sites (Collection Fees Included)

• In-Network Collection Site Locator - Click Here

Out-of-Network Collection Sites: (Collection Fees Not Included)

• Google "DOT Drug Testing Sites Near Me"
• Out-of-Network Collection Sites Include: Concentra, Urgent Cares and most Hospitals

Drug Test Results

• All Drug Test Results are Emailed Directly from the Express Labs Medical Review Officer (MRO) and Uploaded into your Express Labs Account
• Most Negative Results are Reported within 3 Business Days from the Date the Lab Receives the Sample
• If you have not Received Results within 4 Business Days, you may contact Quest Customer Service at 800-877-7484
• Provide either your Quest Account Number (Listed on the QPassport) or the Specimen ID (Listed on the Paper Quest Form) to assist in Locating your Results

Express Labs Testing Fees

• DOT & Non-DOT Drug Test Results (In-Network Collection Sites): $80
• Collection Fees are Included at In-Network Sites but not at Out-of-Network Sites
• Return-to-Duty & Follow-Up Drug Tests (Observed): $125
• Breath Alcohol Test Results (Online Orders): $80
• Billing & Payment: Invoices are Due Upon Receipt - Members must keep a Valid Credit Card on File to Maintain Active Status for both the Company and Drivers

Drug Testing Requirements

Members are Required to Order Drug Tests Online (QPassports) in their Express Labs Account or by using the Paper Quest Forms provided by Express Labs if they cannot Order Online.  Upon Enrolling, Members are assigned a Quest Diagnostics Sub-Account Number, which must be used for All DOT Drug Testing

• After Enrolling, Express Labs does not accept Drug Test Results from other Companies
• Adding Drivers: Drivers can not be Added with Pre-Employment Drug Test Results from another Company
• Random Drug Tests: Random Drug Tests can not be marked Complete with Random Drug Test Results from another Company
• Drug Test Results: Express Labs and the Employer’s Company Name must be Listed on All DOT Drug Test Results
• MIS Report: DOT Requires All DOT Drug Test Results to be on the MIS Report that All Members need for DOT Audits
• 2024 MIS Report - Click Here

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 are the Paper Quest Diagnostics Forms?

• DOT Requires Drivers to carry Quest Paper Forms in case of an Accident or can not Order Online
• Additional Forms can be ordered in your Account in "Order Drug Testing Forms" (Left Side Tabs)
• Quest Paper Forms are Printed on 5-Part NCR Paper and can not be Faxed or Emailed

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
• Prescription Medications: Only the Medical Review Officer (MRO) Is Authorized to Discuss Prescription Medications with DOT Drivers for a DOT Drug Test.

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
• No Re-Test is Required

Collector Error (Pre-Employment)

• DOT Requires the Driver to be sent for a New Pre-Employment Drug Test
• DOT Requires a Re-Test

Abnormal pH

• Urine pH in a DOT Drug Test should be 4.5–8. Levels outside this Range may show Tampering, Dilution, or Substitution
• DOT Requires a Retest under Direct Observation

Immunoassay Interference

• Interference with Creatinine Levels from Medications, Metabolites, or Abnormal Values may cause False Positives or Negatives
• DOT Requires a Retest under Direct Observation

Invalid Creatinine

• Creatinine confirms if a Urine Sample is Genuine. Very Low or Abnormal Levels may indicate Dilution or Substitution
• DOT Requires a Retest under Direct Observation

Bottle A & Bottle B – Different Appearance

• DOT Tests split Urine into Bottle A (Primary) and Bottle B (Split). If the Bottles look different, it may signal Tampering or Contamination
• DOT Requires a Retest under Direct Observation

Temperature-Out-of-Range

• Urine must be 90°F–100°F at Collection. Readings outside this Range suggest Tampering or Substitution
• .DOT Requires a Retest under Direct Observation

Specific Gravity

• Specific Gravity checks Urine Concentration. Out-of-Range results may indicate Dilution or Adulteration
• DOT Requires a Retest under Direct Observation