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We also serve physicians associated with accountable care organizations (“ACOs”), and Federally Qualified Health Centers (“FQHCs”).
−Removed: Physicians determine which laboratory to recommend or use based on a variety of factors, but we believe that we provide the most attractive service offering in the industry, including the most comprehensive test menu, innovative test offerings, a positive customer experience, deep medical and scientific expertise, high quality, leading access and distribution, and data-powered integrated information-technology solutions.
−Removed: We believe that the growing market challenges faced by hospitals, including continued consolidation, price transparency, cost and utilization pressure, evolving healthcare payment models, capital needs, changing technology and limited resources, provide us with an opportunity to partner with them as they consider more effective ways to implement their laboratory testing strategy and drive demand for our expertise and services.
+Added: Physicians determine which laboratory to recommend or use based on a variety of factors, but we believe that we provide the most attractive service offering in the industry, including a comprehensive test menu, innovative test offerings, a positive customer experience, deep medical and scientific expertise, high quality, leading access and distribution, and data-powered integrated information-technology solutions.
+Added: Large physician practices value our ability to standardize services on a national or regional scale.
+Added: We believe that the market challenges faced by hospitals, including continued consolidation, price transparency, cost and utilization pressure, evolving healthcare payment models, capital needs, changing technology and limited resources, provide us with an opportunity to partner with them as they consider more effective ways to implement their laboratory testing strategy and drive demand for our expertise and services.
We serve approximately half the hospitals in the United States each year in many ways, including:
• Serving as a hospital lab’s laboratory.
−Removed: In 2024, we generated over $1 billion in revenue from “reference testing,” where we perform testing that hospitals do not perform in their own in-hospital labs.
+Added: In 2025, we generated approximately $1.2 billion in revenue from “reference testing,” where we perform testing that hospitals do not perform in their own in-hospital labs.
• Helping hospitals operate their labs more efficiently.
−Removed: In 2024, our Professional Laboratory Services offering generated approximately $800 million in revenues and management fees supporting hospitals in the operation of their own labs.
−Removed: Our key Professional Laboratory Services offerings include lab management outsourcing, test menu optimization and spend consolidation, supply chain management and providing, advanced data solutions.
+Added: In 2025, our Collaborative Lab Solutions (formerly known as Professional Laboratory Services) offering generated approximately $800 million in revenues and management fees supporting hospitals in the operation of their own labs.
+Added: Our key Collaborative Lab Solutions offerings include lab management outsourcing, test menu optimization and spend consolidation, supply chain management, and providing advanced data solutions.
• Acquiring outreach lab operations from hospitals.
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We also have joint venture arrangements with leading hospitals and health systems.
−Removed: These joint venture arrangements, which provide diagnostic information services for affiliated hospitals as well as for unaffiliated clinicians and other local healthcare providers, serve as our principal facilities in their service areas.
+Added: These joint venture arrangements, which provide diagnostic information services for affiliated and nonaffiliated hospitals and clinicians and other local healthcare providers, serve as our principal facilities in their service areas.
Typically, we have either a majority ownership interest in, or day-to-day management responsibilities for, our joint venture relationships.
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We continue to enhance our operations to improve the patient experience in these locations.
−Removed: For example, our "Schedule at Check In" capability encourages patients to make appointments, and our self-serve kiosks provide wait-time estimates for walk-in and standby patients and offer many language options.
+Added: For example, our "Schedule at Check In" capability encourages patients to make appointments, including through mobile appointment scheduling, and our self-serve kiosks provide wait-time estimates for walk-in and standby patients and offer many language options.
These improvements allow us to better manage demand and productivity and have reduced average wait times in the patient service centers.
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We are also integrating the patient payment process into the digital customer experience, which improves the patient experience, provides greater pricing transparency, helps our patient concession rate and reduces demands on phlebotomists.
−Removed: As people are increasingly seeking to be more directly involved in and have more control over their health outcomes, we are seeking to meet this need.
−Removed: Our QuestHealth.com platform empowers health-minded consumers to purchase testing directly from us without first having to visit their doctor.
−Removed: Consumers who want to evaluate their health or monitor certain chronic conditions, such as diabetes or hepatitis, as well as those seeking privacy can use these self-directed options to identify and more frequently monitor health issues than their health plan or other payer may be willing to reimburse.
−Removed: We are enabling a third-party physician to review and place test orders and be available to consult with the consumer via a teleconsult about their test results.
−Removed: We also launched health coaching on our QuestHealth.com platform.
−Removed: Our QuestHealth™ offering reflects our belief that by building on the foundation of our strong consumer focus we can capture the growing opportunities presented by the growth of consumer-initiated testing and demand for expanded access to basic healthcare services.
−Removed: In 2024, we launched a new service that offers patients experiencing symptoms of several common genital tract infections the option to self-collect a swab specimen, aimed at increasing privacy, convenience and speed of testing.
+Added: As consumers increasingly seek more involvement and control over their health and wellness, we aim to meet them where they are.
+Added: Our QuestHealth.com platform empowers health- and wellness-minded consumers to purchase tests and panels without the need to schedule an appointment and visit a doctor’s office.
+Added: Through this platform, we enable access to third-party physician review to place test orders and be available to consult with the consumer via a teleconsult about their test results.
+Added: We offer over 150 tests, including comprehensive wellness panels with up to 85 key health indicators, tests to monitor certain chronic conditions, and tests for students and workers in healthcare, education and other occupations that require them.
+Added: Our cash pay price for consumers is convenient for those who wish to establish their baseline wellness status, monitor themselves for chronic medical conditions, and are interested in their wellness throughout relevant time periods, such as athletes preparing for events.
+Added: We are also powering the testing offered by leading health, wellness, and wearable brands, where we provide the underlying testing services for their consumer health service offerings.
+Added: Our multi-channel consumer offerings reflect our belief that our consumer focus positions us to capture expanding opportunities presented by the growth of consumer-initiated testing and of the demand for expanded access to health and wellness services.
+Added: We continually evaluate technologies with the potential to improve choice and convenience for patients and consumers.
+Added: We offer patients and consumers experiencing symptoms of several common genital tract infections, including sexually transmitted infections, the option to self-collect a swab specimen, aimed at increasing privacy, convenience and speed of testing.
+Added: In 2025, we introduced specimen self-collection in clinical settings for human papillomavirus (HPV) screening to help identify women at risk for developing cervical cancer, broadening access to a vital preventative care test.
We also provide opportunities for companies with telehealth and retail business models to rebrand our testing and utilize our patient service centers to provide access.
Other Customer Channels
−Removed: Our other customer channels include health plans, employers, emerging retail healthcare providers, government agencies, pharmaceutical companies and other commercial clinical laboratories, which are described in more detail under “ – Customer Channels”.
−Removed: While we principally focus on the U.S.
+Added: Our other customer channels include health plans, employers, new and emerging retail healthcare providers, government agencies, pharmaceutical companies and other commercial clinical laboratories, which are described in more detail under “ – Customer Channels.” While we principally focus on the U.S.
market, we serve customers globally and have a growing business that provides advanced reference testing to laboratory providers in other countries.
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Clinical laboratory testing can be characterized as routine, non-routine or advanced.
−Removed: Non-routine tests are tests that may require professional “hands-on” attention from highly-skilled technical personnel, generally require more sophisticated data analysis, technology, equipment or materials, may be performed less frequently than routine tests and may be reimbursed at higher levels than routine tests.
−Removed: Some non-routine tests are advanced (“Advanced Diagnostics™”).
−Removed: Advanced Diagnostics™ includes certain procedures in the areas of molecular diagnostics (including next-generation sequencing), oncology, neurology, companion diagnostics and non-invasive pre-natal and other germline genetic testing.
−Removed: We are a leading provider of Advanced Diagnostics™ and provide an array of offerings across the spectrum, including in high growth areas such as Molecular Genomics and Oncology.
−Removed: We have a portfolio of oncology tests that includes traditional oncology screening and anatomic pathology, such as cervical cancer and skin cancer screening and diagnosis.
−Removed: are also well positioned to take advantage of advances in next generation sequencing to grow our business in cancer and other disease state testing.
−Removed: This includes inherited genetics, newborn screening, and rare disease diagnosis, and solid tumor sequencing, such as to aid treatment selection and monitoring.
+Added: Non-routine tests (commonly referred to as esoteric) are tests that may require professional “hands-on” attention from highly-skilled technical personnel, generally require more sophisticated data analysis, technology, equipment or materials, may be performed less frequently than routine tests and may be reimbursed at higher levels than routine tests.
+Added: We refer to certain non-routine, highly innovative and specialized tests that we offer as Advanced Diagnostics™.
+Added: We are a leading provider of Advanced Diagnostics™ and provide an array of offerings, including certain procedures in the areas of molecular diagnostics (including next-generation sequencing), oncology, neurology, companion diagnostics and non-invasive pre-natal and other germline genetic testing.
+Added: In 2025, certain Advanced Diagnostics™ test offerings within five clinical areas – oncology, cardiometabolic and endocrine, brain health, autoimmune, women’s health and genetics – generated over $1 billion in revenues on double-digit revenue growth.
Our investments in our Advanced Diagnostics™ offerings enhance our innovation capabilities and strengthen our service offering, making our Advanced Diagnostics™ offerings more attractive and accessible to physicians and hospitals.
−Removed: We are also seeking to apply the capabilities gained by these efforts to support other areas where we can make a meaningful difference in healthcare, including offerings to pharmaceutical companies and consumers.
+Added: We are also applying the capabilities gained by these efforts to support other areas where we can make a meaningful difference in healthcare, including offerings to pharmaceutical companies and consumers.
We are also particularly focused on the rapidly growing areas of monitoring recurrence and therapy effectiveness.
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Since the acquisition, several organizations have used the Haystack Oncology MRD test in research, including for clinical trials.
−Removed: During 2024, we also developed the test as a clinical offering in anticipation of making it available to oncologists.
−Removed: In 2023, we also launched our QUEST AD-DETECT® test portfolio for assessing Alzheimer's disease risk using blood specimens, as opposed to testing by more costly or invasive methods, such as testing of cerebral spinal fluid by lumbar puncture.
+Added: In 2025, we received a breakthrough device designation from the U.S.
+Added: Food and Drug Administration (“FDA”) for our Haystack Oncology MRD test for patients with an early stage colorectal cancer diagnosis.
+Added: This milestone reinforces the high caliber of our cancer monitoring innovation by validating the use of the Haystack Oncology MRD test and opens avenues for developing companion diagnostics.
+Added: We continue to make progress towards commercialization by expanding access.
+Added: In 2025, we commenced separate trials with Mass General Brigham and Rutgers Cancer Institute to further research Haystack Oncology MRD test's clinical utility as a guide in making post-operative therapy decisions.
+Added: We also continue to focus on neurology.
+Added: In 2023, we launched our QUEST AD-Detect ® test portfolio for assessing Alzheimer's disease risk using blood specimens, as opposed to testing by more costly or invasive methods, such as testing of cerebral spinal fluid by lumbar puncture.
+Added: We continue to publish evidence on our AD-Detect test, including a study in a publication of the American Academy of Neurology that found two of our innovative panels provide confirmatory accuracy for aiding Alzheimer's diagnosis.
We continue to add new testing to this suite of services for assessing the risk of Alzheimer's Disease, including isoform and plasma testing for patients with cognitive impairment.
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We will continue to invest in our business in a disciplined manner, including focusing on enhancing our solid foundation of strategic assets and capabilities.
−Removed: During 2024, we completed acquisitions for an aggregate purchase price of $2.2 billion.
−Removed: We acquired select assets of the outreach laboratory services business of Allina Health, which serves providers and patients in Minnesota and Wisconsin, as well as select assets of the outreach laboratory services business of OhioHealth and the outreach laboratory services business of University Hospitals, which each serve providers and patients in Ohio.
−Removed: In August 2024, we also acquired all of the issued and outstanding common shares of LifeLabs Inc.
−Removed: and all of the partnership interests of BPC Lab Finance LP (collectively, "LifeLabs"), which provides laboratory diagnostic information and digital health connectivity systems in Canada.
−Removed: During the full year of 2024, LifeLabs performed approximately 140 million laboratory tests to help diagnose, treat, monitor and prevent diseases for millions of Canadians.
−Removed: LifeLabs operates approximately 15 laboratories, over 350 collection centers in British Columbia, Ontario and Saskatchewan, and an extensive network of couriers and mobile phlebotomists.
−Removed: LifeLabs also partners with governments and companies to develop technologies and customized services.
+Added: In 2025, we acquired select clinical testing and dialysis-related water testing assets of Fresenius Medical Care's wholly-owned Spectra Laboratories, a leading provider of renal-specific laboratory testing services in the United States.
+Added: We also entered into a joint venture with Corewell Health, a leading health system in Michigan, which will perform laboratory testing in the state of Michigan via a new laboratory facility.
+Added: Equity ownership of the joint venture is shared 51% by Quest and 49% by Corewell Health.
+Added: In addition, we provide the full complement of our Collaborative Lab Solutions offering for Corewell Health.
Our significant acquisitions in each of the last three years are further discussed in Note 6 to the audited consolidated financial statements (Part II, Item 8 of this Report).
Acquisitions are part of our disciplined capital deployment framework, which also includes investment in our business, dividends and share repurchases and is grounded in maintaining an investment grade credit rating.
−Removed: We expect to return a majority of our free cash flow to stockholders through a combination of dividends and share repurchases.
−Removed: Consistent with that expectation, in January 2025, we announced that we increased our quarterly common stock cash dividend by approximately 6.7%, from $0.75 per common share to $0.80 per common share.
+Added: We expect to return a majority of our free cash flow to stockholders through a combination of dividends and share repurchases over time.
+Added: Consistent with that expectation, in February 2026, we announced that we increased our quarterly common stock cash dividend by approximately 7.5%, from $0.80 per common share to $0.86 per common share.
This represents our 15 th increase in the dividend since the beginning of 2012.
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We strive to accomplish that through rigorous processes that we measure and seek to improve, and by using the Quest Management System, which provides best-in-class business performance tools to create and implement effective and sustainable quality processes.
+Added: Our Quality and Regulatory Affairs organization continues to advance our commitment to operational excellence, regulatory integrity, and a culture of quality.
Our Quality Program includes policies and procedures to document, measure and monitor the effectiveness of our laboratory operations in providing and improving quality and meeting applicable regulatory requirements.
The Quality Program is designed so that the quality of laboratory services is monitored objectively and evaluated systematically to deliver superior quality care, identify opportunities to improve patient care and resolve identified problems.
−Removed: To help achieve our goal of becoming recognized as the undisputed quality leader in the diagnostics information services industry, we have implemented our Quality System Framework, which serves as a reference guide for our employees and describes our Quality System Elements to provide the structure for each laboratory to achieve and maintain quality processes.
−Removed: We also have a robust Supplier Quality Program designed to help us ensure we have a high-quality supplier network and to raise the bar of quality expectations across that network.
+Added: Recently, we enhanced enterprise engagement through a unified Quality Policy and advanced our quality foundation by refining global processes, updating our Quality Framework, and deepening our cross-site collaboration.
+Added: Additionally, we have a robust Supplier Quality Program designed to help us ensure we have a high-quality supplier network and to raise the bar of quality expectations across that network.
Operating Efficiency
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Improving our operations through standardization, optimization, digitization and automation can yield many benefits, including improving our quality and competitiveness, strengthening our foundation for growth, supporting our growth strategy, and increasing employee engagement, customer service and shareholder value.
−Removed: We are guided by a service dashboard that focuses throughout our operations on quality for consumers, healthcare providers and employees, including medical quality, on-time delivery, competitive costs and employee safety.
+Added: We are guided by a service dashboard that focuses throughout our operations on quality for consumers, healthcare providers and employees, including medical quality, on-time delivery, and employee safety.
Our cost excellence program, Invigorate, includes structured plans to drive savings and improve productivity across the value chain, including in such areas as patient services, logistics and laboratory operations, revenue services, information technology ("IT") and procurement.
−Removed: Our Invigorate program has consistently delivered 3% of annual cost savings and productivity improvements, which partly offset pressures from the current inflationary environment, including labor and benefit cost increases, and reimbursement pressures.
−Removed: We are leveraging automation and AI to improve productivity and improve quality across our entire value chain, not just in the laboratory.
−Removed: For example, in 2024, we advanced our use of automation in front-end specimen processing to include five of our labs, freeing more of our processors to focus on higher-order work.
−Removed: Other areas of focus include reducing denials and patient concessions, enhancing the digital experience, and selecting and retaining talent.
+Added: Our Invigorate program has consistently delivered 3% of annual cost savings and productivity improvements, which partly offset pressures from an inflationary environment, including labor and benefit cost increases, and reimbursement pressures.
+Added: We are leveraging automation and AI to improve quality and productivity across our entire value chain, not just in the labo ratory.
+Added: For example, we advanced our use of automation in front-end specimen processing and labeling in six of our labs, freeing more of our processors to focus on higher-order work.
+Added: We also completed a successful pilot of our automated specimen processing and labeling platform at our Clifton, NJ lab.
+Added: In 2025, we initiated or expanded our use of AI and automation in several areas, ranging from digital cytology, microbiology, parasitology and digital pathology.
+Added: Other areas of focus include reducing denials and patient concessions, logistics route optimization to speed specimen transport, and enhancing the digital experience.
+Added: In February 2025, we committed to a multi-year project ("Project Nova") to modernize our "Order to Cash" business processes, which includes the related information technology infrastructure and underlying enabling technologies.
+Added: We are partnering with Epic, a third-party licensor, to assist in the implementation of Project Nova.
+Added: We expect to deliver value throughout the implementation of Project Nova, which is expected to be completed in 2031 to 2032, as it unlocks a variety of streamlined operational benefits, reduced technology-related operating costs, accelerated revenue opportunities, and improvements to the customer and patient experience.
Organized to Drive Growth and Value
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Range of Testing ● Industry-leading test menu across clinical and pathology sub-specialty areas and diagnostic technologies
−Removed: Patents ● Own or control approximately 1,200 issued and nearly 400 pending patents worldwide in 2024
+Added: Patents ● Own or control approximately 1,200 issued and approximately 400 pending patents worldwide in 2025
Strong Relationships with Health Plans and Other Payers
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For over 30 years, the Company has published the Quest Diagnostics ® Drug Testing Index, TM a series of reports on national workplace drug positivity trends based on the Company's employer workplace drug testing data, that is widely cited by employers, the federal government and the media to help identify and quantify drug abuse among the nation's workforce.
−Removed: The Company also publishes Quest Diagnostics ® Health Trends, ® a series of scientific reports that provide insights into health topics, based on analysis of objective clinical laboratory data, to empower better patient care, population health management and public health policy.
−Removed: In 2024, we published a Health Trends ® report with the University of Alabama that suggests adherence to guideline-based laboratory testing and treatment of pregnant women for two of the most prevalent sexually transmitted infections is suboptimal in the United States, with potentially dire effects on maternal and newborn health.
+Added: The Company also publishes Quest Diagnostics ® Health Trends, ® scientific reports that provide insights into health topics, based on analysis of objective clinical laboratory data, to empower better patient care, population health management and public health policy.
+Added: In 2025, we published a Health Trends ® report showing that many oncologists feel they are seeing more patients with advanced cancers due to screening barriers, such as
+Added: missed or delayed follow-up care or monitoring, and that imaging tests may not detect cancer recurrence early enough.
+Added: Many of these oncologists believe that ctDNA MRD testing could reduce diagnosis delays in cancer recurrence.
We are a founding member, with other leading diagnostic laboratories outside the United States, of the Global Diagnostics Network TM , a strategic working group of diagnostic laboratories committed to unleashing and sharing local innovation to increase global access to diagnostic science, information and services and generating enhanced diagnostic insights to improve the delivery of global healthcare.
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Our capabilities include discovery, technology development and clinical validation of diagnostic tests.
−Removed: We also partner with other developers of new technologies, services and tests to transfer their innovations to the marketplace, using our in-house expertise (e.g., strength in new service development and commercialization of testing services).
+Added: We also partner with other developers of new technologies, services and tests to transfer their innovations to the marketplace, using our in-house expertise ( e.g.
+Added: , strength in new service development and commercialization of testing services).
These developers include large commercial manufacturers, the academic community, pharmaceutical and biotechnology firms, emerging medical technology companies, other laboratory companies and others that develop and commercialize novel diagnostics, pharmaceutical and device technologies.
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Our innovation strategy focuses on new services and solutions for unmet clinical needs that will improve patient care and outcomes as well as economic value for patients, health plans and other payers.
−Removed: Our research and development team includes leaders in a number of fields, including in genomics, genetics and bioinformatics, as well as in disease states, such as oncology, neurology, cardiometabolic disease and other disorders.
+Added: In 2023 and 2025, certain diagnostic programs received FDA Breakthrough Device Designation, designed to address identified limitations in current diagnostic methodologies and unmet clinical needs.
+Added: Our research and development team includes leaders in a number of fields, including genomics, genetics and bioinformatics, as well as in disease states, such as oncology, neurology, cardiometabolic disease and other disorders.
+Added: We are also well positioned to take advantage of advances in next generation sequencing to grow our business in cancer and other disease state testing.
+Added: This includes inherited genetics, newborn screening, rare disease diagnosis, and solid tumor sequencing, such as to aid treatment selection and monitoring.
We also maintain relationships with advisers and consultants who are leaders in key fields of science and medicine who advise us with our internal team of experts, complementing our expertise.
−Removed: We endeavor to improve test processes, including through increased automation.
+Added: We endeavor to improve test processes, including through increased automation and AI.
+Added: For example, we provide automated next generation genetic sequencing, which will enable genetic screening that is more precise, faster and at lower cost.
In addition, we aim to develop holistic solutions responsive to challenges that healthcare providers and patients face, by developing solutions of tests, information and services focused on specific clinical challenges.
−Removed: We look to offer solutions from our large dataset and data analytics capabilities to help providers and health plans identify opportunities to optimize appropriate laboratory utilization, align clinical practice to medical guidelines, and inform patient-care decisions.
+Added: We look to offer solutions from our large dataset and data analytics capabilities to help providers and health plans identify opportunities to optimize appropriate
+Added: laboratory utilization, align clinical practice to medical guidelines, and inform patient-care decisions.
We also look for innovations and solutions that are more convenient, less invasive and more cost effective than currently available options.
−Removed: We seek innovation in the ways we bring solutions to customers, and in the customer experience, including enhanced services and end-to-end solutions for convenience and support.
+Added: We seek innovation in the ways we bring solutions directly to customers to allow them to be more involved in and have more control over their health outcomes, and to improve the customer experience, including enhanced services and end-to-end solutions for convenience and support.
Artificial Intelligence
−Removed: We have a long history of using advanced technologies to automate processes, improve customer service, generate insights from lab and other data, improve the customer experience, and stimulate innovation.
−Removed: We use AI to help drive innovation and operational efficiency at Quest Diagnostics.
−Removed: AI helps improve the quality of our screening and diagnostic capabilities.
−Removed: For instance, in 2024, we extended our AI capabilities in microbiology to include the ability to segregate out specimens with no evidence of microbial growth so our medical scientists can concentrate on reviewing those with the greatest likelihood of disease.
−Removed: AI also helps improve our operating efficiency.
−Removed: We continue to broaden our use of AI in customer service to help our representatives access answers more quickly, improving their effectiveness and service quality.
+Added: We have a long history of using advanced technologies to automate processes, improve customer service and productivity, generate insights from lab and other data, improve the customer experience, and stimulate innovation.
+Added: Other areas of focus include reducing denials and patient concessions, and logistics route optimization to speed specimen transport.
+Added: We use AI to help drive innovation and operational efficiency through improving the quality of our screening and diagnostic capabilities.
+Added: We also continue to broaden our use of AI in customer service to help our representatives access answers more quickly, improving their effectiveness and service quality.
+Added: In 2025, we announced a collaboration with Google to use Google Cloud's data analytics and generative AI to help us streamline our data management, improve data analytics, and personalize the experiences we deliver to patients, providers, and other customers.
We are committed to using AI in an ethical, responsible and compliant way.
We have implemented a formal AI governance oversight committee and established multiple AI safeguards to minimize risks associated with AI, including, but not limited to, expanded security and privacy measures, increased user access controls, employee and other end user training and certification, and standard operating procedures.
−Removed: Our AI program has been designed to comply with applicable laws, regulations and AI frameworks, and we strategically partner with external AI experts as needed to ensure we remain informed about the latest technological advancements in the industry.
−Removed: Over time, we believe generative AI will help us innovate and grow in a responsible manner while also enhancing customer and employee experiences and bring cost efficiencies.
−Removed: We intend to be at the forefront of the innovative, responsible and secure use of AI, including generative AI, in diagnostic information solutions.
−Removed: A Commitment to Helping the Underserved
−Removed: As part of our commitment to create a healthier world, we, along with our Quest Diagnostics Foundation, launched an initiative to reduce health disparities in underserved communities in the United States through a combination of testing services, education programs, alliances and financial support.
−Removed: Since its inception, we have committed approximately $46 million to more than 80 programs launched across the United States and Puerto Rico, including supporting community workforce development, COVID-19 testing and vaccination events, wellness events, educating young students on healthy nutrition choices and expanding research and mentorship opportunities.
−Removed: Numerous undertakings demonstrate our commitment to FQHCs and the people they serve, including by providing free lab testing services.
−Removed: We are also looking at ways we can assist in addressing social determinants of health that can create barriers to healthcare for marginalized communities in the healthcare system.
+Added: Our AI program has been designed to comply with applicable laws, regulations and AI frameworks, and we strategically partner with external AI experts as needed to ensure we remain informed about the latest technological advancements and best practices in the industry.
+Added: Over time, we believe AI, including generative AI, will help us innovate and grow in a responsible manner while also enhancing customer and employee experiences and bring operating and cost efficiencies.
+Added: We intend to be at the forefront of the innovative, responsible and secure use of AI in diagnostic information solutions.
+Added: A Commitment to Improving Health and Well-Being in the Communities We Serve
+Added: As part of our commitment to creating a healthier world, we work alongside the Quest Diagnostics Foundation to support community-led solutions that seek to improve health and well-being in the communities we serve.
+Added: Our approach leverages donated diagnostic testing by Quest and emphasizes investments in nonprofit healthcare systems, safety net providers, and community-based organizations addressing social drivers of health that create barriers to care.
+Added: We have invested approximately $53 million to community initiatives across the United States and Puerto Rico.
+Added: These investments span a broad range of evidence-based strategies, including community workforce development, community health worker care coordination models, expanded access to diagnostic testing, wellness and screening events, and education programs that promote long-term health and prevention.
+Added: As we look ahead, we will continue to invest in evidence-based, scalable practices that improve health in the communities we serve.
BUSINESS OPERATIONS
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We see opportunities to bring our experience and expertise in diagnostic information services to markets outside the United States, including leveraging existing facilities to serve new markets.
−Removed: In August 2024, we acquired LifeLabs, which provides laboratory diagnostic information and digital health connectivity systems in Canada.
Diagnostic Information Services
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Commonly ordered routine tests include blood chemistries, urinalysis, allergy tests and complete blood cell counts.
−Removed: Non-routine tests may require professional “hands-on” attention from highly-skilled technical personnel, generally require more sophisticated data analysis, technology, equipment or materials, may be performed less frequently than routine tests and may be reimbursed at higher levels than routine tests.
+Added: We also have a portfolio of oncology tests that includes traditional oncology screening and anatomic pathology, such as cervical cancer and skin cancer screening and diagnosis.
+Added: Non-routine tests (commonly referred to as esoteric) may require professional “hands-on” attention from highly-skilled technical personnel, generally require more sophisticated data analysis, technology, equipment or materials, may be performed less frequently than routine tests and may be reimbursed at higher levels than routine tests.
It may not be practical, from a cost-effectiveness or infrastructure perspective, for many hospitals, ACOs, commercial laboratories or physician office laboratories to develop and perform a broad menu of non-routine tests or to perform low-volume non-routine testing in-house.
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Our services.
−Removed: We provide information and insights based on an industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services.
+Added: We primarily provide information and insights based on an industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services.
We have strong testing capabilities, including services for the predisposition, diagnosis, treatment and monitoring of cancers and other diseases, and offer advanced tests in many fields, including endocrinology, immunology, neurology and oncology.
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Our solutions enable employers to leverage screening insights to identify chronic disease risks, guide employees to needed in-network care, and improve employee health with intervention services.
−Removed: Our offerings include connecting participants to the right care at the right time, such as (i) a program designed to prevent diabetes and other chronic conditions, (ii) a program that enables participants to engage with a board-certified physician about their results and be guided to the right next action based on those results, (iii) a health coaching program to help individuals adopt healthier behaviors to improve health outcomes and (iv) a program to facilitate virtual telehealth access to clinical services for participants and adult dependents, with emphasis on reducing risks related to preventable chronic diseases.
+Added: Our offerings emphasize the importance of identifying and reducing health risks, including (i) a program designed to prevent diabetes and other chronic conditions, (ii) early screenings for treatable cancers, such as prostate and colorectal, and (iii) engaging with partner-provided health coaching programs to help individuals adopt healthier behaviors to improve health outcomes.
These services are sold directly to employers, through resellers and health plan partners.
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Our services build on the power of our information assets and data capabilities and help our customers deliver better care to their patient populations by identifying gaps in care in a population, providing clinical solutions to close the gaps and fostering consumer engagement with a solution.
−Removed: For example, Quest ® Lab Stewardship TM employs machine learning to help clinicians optimize medically-appropriate laboratory test utilization.
+Added: To help support hospitals in the operation of their own labs, our key Collaborative Lab Solutions offerings include lab management outsourcing, test menu optimization and spend consolidation, supply chain management, and providing advanced data solutions.
+Added: For clinicians, Quest ® Lab Stewardship TM employs machine learning to help optimize medically-appropriate laboratory test utilization.
Our extended care services ( e.g ., home collection kits for lab testing) help deliver better care to patient populations by identifying and filling gaps in care for patient populations and by enabling delivery of the most effective healthcare to the right populations and individuals.
These services leverage the power of our assets ( e.g.
−Removed: , our extensive clinical data and data analytics services) and capabilities ( e.g ., call centers, patient service centers, mobile workforce) and focus on extending the reach of clinician offices beyond their traditional four walls to assess the health of their populations, and doing so when it is convenient for consumers.
−Removed: Once gaps are identified, we engage patients in our retail sites, in home or by telephone, including through our call centers and our mobile capabilities, including highly trained healthcare professionals.
+Added: , our extensive clinical data and data analytics services) and capabilities ( e.g ., call centers, patient service centers, mobile phlebotomists) and focus on extending the reach of clinician offices beyond their traditional four walls to assess the health of their populations, and doing so when it is convenient for consumers.
+Added: Once gaps are identified, we engage patients in our retail sites, in home or by telephone, including through our call centers and our mobile phlebotomists.
We offer services to pharmaceutical companies, including clinical trials laboratory testing, population analytics and patient engagement services.
−Removed: We also develop laboratory tests for U.S.
−Removed: Food and Drug Administration (“FDA”) submissions as companion diagnostics and laboratory developed tests (“LDTs”) for complementary diagnostics, and offer an array of assets and services to support the development of companion diagnostics, including our robust data set and patient services network.
+Added: We also develop in vitro diagnostic tests for FDA submissions as companion diagnostics, laboratory developed testing services (“LDTs”) for complementary diagnostics, and offer an array of assets and services to support the development of diagnostic insights, including our robust data set and patient services network.
In addition, we offer Quest Clinical Trials Connect™ to help accelerate clinical trials (and thus the speed of drugs to market) through better patient recruitment, involvement and management, and improved physician outreach.
+Added: In 2024, we acquired LifeLabs, a company that provides laboratory diagnostic information and digital health connectivity systems in Canada.
+Added: During the full year of 2025, LifeLabs performed approximately 23 million test requisitions to help diagnose, treat, monitor and prevent diseases for millions of Canadians.
+Added: LifeLabs operates approximately 15 laboratories, over 350 collection centers in British Columbia, Ontario and Saskatchewan, and an extensive network of couriers and mobile phlebotomists.
+Added: LifeLabs also partners with governments and companies to develop technologies and customized services.
Diagnostic Solutions
−Removed: Our risk assessment service, ExamOne ® is the largest provider of risk assessment services to the life insurance industry in North America and comprises underwriting support services, including data gathering, paramedical examinations and clinical laboratory testing and analytics, designed to assist life insurance companies objectively to evaluate the mortality risks of applicants.
+Added: Our risk assessment service, ExamOne ® , is the largest provider of risk assessment services to the life insurance industry in North America and comprises underwriting support services, including data gathering, paramedical examinations and clinical laboratory testing and analytics, designed to assist life insurance companies objectively to evaluate the mortality
+Added: risks of applicants.
Most specimen collections and paramedical examinations are performed by our network of paramedical examiners at the applicant's home or workplace, but they also are offered at hundreds of our patient service centers and many additional locations.
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Reimbursement pressure driven by The Protecting Access to Medicare Act of 2014 (“PAMA”) Pursuant to PAMA, reimbursement rates for many clinical laboratory tests provided under Medicare were reduced during 2018 - 2020.
−Removed: Unfortunately, as a result of a flawed implementation of PAMA, the data collected did not accurately represent the laboratory market as required under PAMA.
−Removed: Independent laboratories were overrepresented, and hospitals and physician office laboratories were underrepresented, making the first round of PAMA cuts too extreme.
−Removed: The three years of cuts exceeded the original 10-year savings projections.
−Removed: PAMA calls for further revision of the Medicare Clinical Laboratory Fee Schedule (“CLFS”) for years after 2020, based on future surveys of market rates.
−Removed: Congress has delayed cuts five times (2021 - 2025) and delayed 2019 data reporting six times (2020 - 2025).
−Removed: Reimbursement rate reduction from 2026-28 is capped by PAMA at 15% annually.
−Removed: Congress reintroduced federal legislation in 2023 (the Saving Access to Laboratory Services Act), which would reform PAMA and create a true market-based CLFS.
+Added: Unfortunately, by relying on laboratory reported data alone in 2017, CMS did not receive comprehensive and representative data needed to set Medicare rates that reflected the commercial market, as required under PAMA.
+Added: Independent laboratories were overrepresented, and hospitals and physician office laboratories were underrepresented, making the first round of PAMA cuts excessive.
+Added: The first three years of cuts greatly exceeded the original 10-year savings projections.
+Added: Starting in 2020, Congress has repeatedly acted to delay PAMA implementation by delaying the next round of data reporting (2020-2026) and Medicare cuts (2021-2026).
+Added: However, the structural flaws of PAMA still need to be addressed to mitigate future excessive cuts.
+Added: Congress introduced legislation in 2025, the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act (the "Results Act"), which would reform PAMA and create a true market-based Clinical Lab Fee Schedule ("CLFS").
Health plans driving value in lab spending Some hospitals provide outreach testing and may encourage clinicians to send their outreach testing volume to the hospital's laboratory.
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Consumers increasingly are demanding convenience and a superior and personalized experience relevant to their needs.
−Removed: During the COVID-19 pandemic, we saw consumers increase their use of telemedicine capabilities, increase their responsibility for their own healthcare ( e.g.
+Added: In recent years, we saw consumers increase their use of telemedicine capabilities, increase their responsibility for their own healthcare ( e.g.
, increased consumer-initiated testing;
−Removed: increased specimen self-collection) and increase their openness to new delivery channels ( e.g.
−Removed: convenient "pop-up" test centers).
+Added: increased specimen self-collection) and increase their openness to new delivery channels.
In addition, consumers are seeking prompt, direct access to their test results.
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Prevention and wellness We believe that the value of detection, prevention, wellness and personalized care is well recognized.
−Removed: Government agencies and other customers discussed herein increasingly focus on helping the healthy stay healthy, detecting symptoms among those at risk and providing preventative insight and care that helps avoid or reduce the negative impacts of a disease.
+Added: Government agencies, health plans, consumer-focused health companies and other customers are increasingly focused on helping the healthy stay healthy, detecting symptoms among those at risk and providing preventative insight and care that helps avoid or reduce the negative impacts of a disease.
Medical innovation Medical developments are creating new opportunities and new challenges while disrupting the healthcare environment.
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We believe this acquisition strengthens our comprehensive oncology portfolio by positioning us well to compete in the higher-growth clinical area of ctDNA solid-tumor MRD testing.
−Removed: We are collaborating with Universal DX and Mainz Biomed Partners, two biotech companies focused on colorectal cancer.
−Removed: The collaborations aim to combine innovative liquid biopsy screening technologies with our expertise and scale.
Demand also is growing toward comprehensive care management solutions that serve patients, payers and healthcare providers by improving clinical decision support and access to patient data, and by increasing patient participation in care management and population health management.
−Removed: Innovation also includes making healthcare services, including laboratory testing services, more convenient for populations and consumers to access, including at home ( e.g.
+Added: Innovation also includes making healthcare services, including laboratory testing services, more convenient for populations and consumers to access alternative site care, including at home ( e.g.
, telehealth) or in retail settings.
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Consolidation is increasing pricing transparency, and may encourage internalization of clinical testing.
−Removed: Physicians frequently now are employed by hospitals, ACOs or large group practices integrated with hospitals, instead of organizing physician-owned practices, which is impacting the dynamics for whether clinical testing is performed in or outside of a hospital.
+Added: Physicians frequently now are employed by hospitals, ACOs or large group practices integrated with hospitals, instead of organized physician-owned practices, which is impacting the dynamics for whether clinical testing is performed in or outside of a hospital.
Physicians and other clinicians also increasingly are being employed by health plans, large retailers, other non-traditional industry entrants ( e.g.
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Several states have taken action to foster greater pricing transparency in healthcare.
−Removed: For example, Massachusetts launched a website to help consumers understand the wide variation in healthcare costs.
Federal laws require healthcare providers to provide good faith estimates of costs to self-pay patients, and provide rights and protections for consumers against surprise billing or balance billing.
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, digital pathology) and growing from non-traditional competitors ( e.g.
−Removed: , a government agency or an employer establishing its own clinical laboratory for testing;
+Added: , a government agency;
providers of consumer-initiated testing).
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Healthcare utilization in the United States has fluctuated based on a number of factors.
−Removed: These factors include, without limitation, the economy, healthcare benefits design, patients delaying medical care, increased consumer financial responsibility for, interest in and control of their healthcare, and efforts by non-governmental third-party payers, including health plans, to reduce utilization of and reimbursement for clinical testing services.
+Added: These factors include, without limitation, the economy, healthcare benefits design, patients delaying medical care, increased consumer financial responsibility for, interest in and control of their healthcare, the general aging of the U.S.
+Added: population, and efforts by non-governmental third-party payers, including health plans, to reduce utilization of and reimbursement for clinical testing services.
Reimbursement pressure;
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The FDA also regulates drugs-of-abuse testing for employers and insurers, testing for blood bank purposes and testing of donors of human cells for purposes such as in vitro fertilization.
−Removed: We offer companion diagnostic testing services to pharmaceutical companies that are regulated by the FDA.
−Removed: As of May 6, 2024, the FDA announced it was phasing out its general enforcement discretion approach so that LDTs manufactured by a laboratory will generally fall under the same enforcement approach as medical devices.
−Removed: A number of advanced tests we develop internally are offered as LDTs.
−Removed: Pursuant to the FDA’s decision to remove enforcement discretion with regard to most LDTs performed by high complexity CLIA-certified laboratories like ours, all new and significantly modified previously offered laboratory tests that do not benefit from continued enforcement discretion will have to comply with the Food, Drug and Cosmetic Act (the "FDCA") over a four-year, five-stage process.
−Removed: Compliance with the FDCA includes, among other things, new quality system regulations and premarket authorization.
−Removed: One major area of the continued FDA enforcement discretion will apply to many tests that were offered for clinical use prior to May 6, 2024 and that do not afterwards undergo certain material modifications.
−Removed: The removal of enforcement discretion for LDTs could result in a revitalization and passage of legislation or other Congressional action.
−Removed: The current FDA policy to remove enforcement discretion and/or new legislation is expected to have a significant impact on the clinical laboratory testing industry, including regulating LDTs in new ways, while creating new avenues of opportunity and competition regarding clinical laboratory testing.
+Added: We offer companion and complementary diagnostic tests to pharmaceutical companies that are regulated by the FDA.
+Added: In May 2024, the FDA announced it was phasing out its general enforcement discretion approach so that LDTs manufactured by a laboratory would generally fall under the same enforcement approach as medical devices.
+Added: However, in March 2025, a U.S.
+Added: District Court set aside and vacated the FDA’s LDT rule and the FDA did not appeal the court’s decision.
+Added: Accordingly, the FDA does not have the authority to regulate LDTs.
+Added: Although the FDA LDT rule was vacated in 2025, our commitment to maintaining rigorous quality standards, supporting responsible innovation, and ensuring that patient care is optimized has not changed as federal oversight evolves.
+Added: In response to this evolving regulatory landscape, we continue to adapt our quality and regulatory strategies and have accelerated technology and process modernization to support greater transparency, traceability and auditability.
Use of healthcare data;
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It is anticipated that the increased use of data in healthcare, coupled with mobile healthcare IT solutions for doctors and patients, will help to improve patient outcomes and reduce overall healthcare costs.
−Removed: We provide automated next generation genetic sequencing, which will enable genetic screening faster and at lower cost.
Use of healthcare data, including integrated diagnostic and decision support solutions, predictive analytics, and healthcare IT, is spurring advances in precision medicine, including medical decision making and value, for populations and individuals.
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We have experience using advanced technologies, including AI, to automate processes, improve customer service, generate insights from lab and other data, and stimulate innovation.
−Removed: We believe AI can help improve the quality of our screening and diagnostic capabilities, as well as our operating efficiency, and expect to continue to be at the forefront of the innovative, responsible and secure use of AI, including generative AI in the diagnostic information services market.
+Added: We use AI to help drive operational efficiency through improving the quality of our screening and diagnostic capabilities.
+Added: In 2025, we initiated or expanded our use of AI and automation in several areas, ranging from digital cytology, microbiology, parasitology and digital pathology.
+Added: Other areas of focus include reducing denials and patient concessions, and logistics route optimization to speed specimen transport.
+Added: We also continue to broaden our use of AI in customer service to help our representatives access answers more quickly, improving their effectiveness and service quality.
+Added: In 2025, we announced a collaboration with Google to use Google Cloud's data analytics and generative AI to help us streamline our data management, improve data analytics, and personalize the experiences we deliver to patients, providers, and other customers.
+Added: We expect to continue to be at the forefront of the innovative, responsible and secure use of AI, including generative AI in the diagnostic information services market.
These technology developments are creating new opportunities and new challenges, disrupting the healthcare environment.
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We offer an array of services that we believe are attractive to FQHCs as they pursue better outcomes for their patients and maintain financial stability for their organizations.
−Removed: Our services include our financial assistance programs, customized billing solutions that help to assist patients who struggle to afford testing, home-based collection options and our extensive patient service center network.
+Added: Our services include our patient financial assistance programs, customized billing solutions that help to assist patients who struggle to afford testing, home-based collection options and our extensive patient service center network.
We offer solutions for optimizing test utilization, simplifying lab-related tasks, and reducing inefficiencies and duplicative efforts can help FQHCs keep costs in line, and technology solutions that can help them to meet quality reporting requirements and achieve quality measures through benchmarking and identifying areas for improvement.
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we support the needs of third-party administrators as well as employers who retain us directly.
−Removed: Employers also are investing in population health services.
−Removed: We meet their needs by providing nationwide access to our customizable services (discussed above), directly and through health plan and health improvement providers.
+Added: Employers are also investing in population health services.
+Added: We meet their needs by providing nationwide access to our customizable services ( e.g.
+Added: , the Blueprint for Wellness® program) directly and through health plan and health improvement providers.
These services help employers, employees and others manage healthcare costs, capitalize on trends in personalized health and improve health outcomes.
We seek to grow our employer business through offering new and innovative programs to help them with their goals of (1) maintaining a safe and productive workplace, (2) improving healthcare for employees and (3) lowering healthcare costs for employees and employers.
−Removed: Emerging Retail Healthcare Providers In recent years, we have been seeking the increasing opportunities to provide services to retail providers of healthcare services that have emerged and are growing as customers.
−Removed: These providers include "big-box" retailers, pharmacy chains, supermarkets, urgent care centers and Internet-based service providers.
−Removed: We are taking advantage of opportunities to work with these providers, not only to offer new access partners and new access points for our services ( e.g.
−Removed: , our collaboration with Safeway), but also to grow our business by expanding our service offerings ( e.g.
−Removed: , our collaborations with CVS and Walmart).
−Removed: Pharmaceutical companies We offer clinical trials testing and have expertise with LDTs for companion and complementary diagnostics, and offer an array of assets and services to support the development of companion diagnostics, including our robust data set and patient services network.
+Added: New and Emerging Retail Healthcare Providers We take opportunities to provide services to retail providers of healthcare services, such as "big-box" retailers, like Walmart, pharmacy chains, like CVS Health, supermarkets, like Safeway, urgent care centers and Internet-based service providers.
+Added: The relationships with these types of retailers provide us with new access partners and new access points for our services.
+Added: We are also entering into arrangements with an emerging group of new healthcare services providers that are leveraging the growing trend for consumers to manage and take direct responsibility for their own healthcare.
+Added: Pharmaceutical companies We offer clinical trials testing and have expertise for companion and complementary diagnostics, and offer an array of assets and services to support the development of companion diagnostics, including our robust data set and patient services network.
We also offer data services solutions, leveraging our data, analytics and expertise, to help therapy developers understand markets and patient and disease journeys, and plan commercial activity.
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Reimbursement from our five largest health plans totaled approximately 20%, and no one health plan accounted for 10%, of our consolidated net revenues in 2025.
−Removed: Health plans typically negotiate directly or indirectly with a number of diagnostic information services providers, and represent approximately one-half of our total clinical testing volume and approximately 40% of our net revenues from diagnostic information services.
+Added: Health plans typically negotiate directly or indirectly with a number of diagnostic information services providers, and represent nearly one-half of our total clinical testing volume and approximately 40% of our net revenues from diagnostic information services.
There has been a trend of consolidation among health plans.
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We offer to health plans services and programs that leverage our Company's expertise and resources, including our superior patient access, comprehensive test menu, medical staff, data, IT solutions, and wellness and population health management capabilities.
−Removed: For the last few years, our Company has had access to a very high percentage of the insured lives in the United States, including very strong access in key high-population states.
+Added: Our Company has access to a very high percentage of the insured lives in the United States, including very strong access in key high-population states.
We believe that this strong access increases our attractiveness to other customer channels, including physicians, patients and employers.
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Over the last several years, the federal government has expanded its contracts with private health insurance plans for Medicare beneficiaries and has encouraged such beneficiaries to switch from the traditional programs to the private programs, called “Medicare Advantage” programs.
−Removed: There has been growth of health insurance providers offering
−Removed: Medicare Advantage programs and of beneficiary enrollment in these programs.
+Added: There has been growth of health insurance providers offering Medicare Advantage programs and of beneficiary enrollment in these programs.
States also have mandated that Medicaid beneficiaries enroll in private managed care arrangements.
−Removed: We also provide additional services to and in conjunction with government agencies across the United States.
−Removed: For example, in 2024, we were awarded several contracts by the CDC to support testing and sustained laboratory readiness for two emerging infectious diseases.
−Removed: The arrangements will support the preparedness for certain viruses by ensuring a national commercial laboratory provider is able to quickly supplement public health laboratories in the event there is an infectious disease outbreak in people.
+Added: We also provide additional services to and in conjunction with government agencies across the United States, including arrangements to support the preparedness for certain viruses by ensuring a national commercial laboratory provider is able to quickly supplement public health laboratories in the event there is an infectious disease outbreak in people.
While there has been consolidation in the diagnostic information services industry in recent years, which we expect to continue, our industry remains fragmented and highly competitive.
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government agencies) and market activity may continue to increase the competitive environment.
−Removed: We believe that providing the most attractive service offering in the industry, including the most comprehensive test menu, innovative test offerings, a positive customer experience, deep medical and scientific expertise, high quality, leading access and distribution, and data-powered integrated IT solutions provide us with a competitive advantage.
+Added: We believe that providing the most attractive service offering in the industry, including a comprehensive test menu, innovative test offerings, a positive customer experience, deep medical and scientific expertise, high quality, leading access and distribution, and data-powered integrated IT solutions provide us with a competitive advantage.
We believe that as a large diagnostic information services provider we can serve our customers more effectively due to our larger network and lower cost structure.
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Digital pathology, still in an emerging state, is an example of this.
−Removed: Competitors also may compete on the basis of new service offerings.
−Removed: Competitors also may offer new testing services that can be performed outside of a commercial clinical laboratory, such as point-of-care testing that can be administered by physicians in their offices, complex testing that can be performed by hospitals in their own laboratories, and home testing that can be carried out without requiring the services of outside providers.
+Added: Competitors, including other diagnostic services and healthcare technology companies, also may compete with us using new testing service offerings that can be performed outside of a commercial clinical laboratory, including point-of-care testing that can be administered by physicians in their offices, complex testing that can be performed by hospitals in their own laboratories, and home testing that can be carried out without requiring the services of providers like us.
The risk assessment and healthcare IT industries are highly competitive.
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Additional information about our human capital management strategies and initiatives is available in our annual corporate responsibility report.
−Removed: As of December 31, 2024, we have approximately 56,000 employees globally (including LifeLabs’ approximately 6,600), of whom approximately 45,000 are full-time and the remainder are part-time or on-call.
−Removed: Our employee population is more diverse than the U.S.
−Removed: workforce, taken as a whole.
+Added: As of December 31, 2025, we have nearly 57,000 employees globally (including LifeLabs’ approximately 6,800), of whom approximately 46,000 are full-time and the remainder are part-time or on-call.
Approximately 70% of our employees globally are women (including approximately 75% at LifeLabs).
−Removed: approximately 50% of our global team are diverse.
A majority of our employees work directly with our customers or in our laboratories.
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The 5Cs are integrated into our daily management practices, including recognition, training and performance reviews, to encourage all employees to embody the 5Cs in their daily activities.
−Removed: We understand the need to create an environment where employees can bring their whole selves to work, and our philosophy embodies our commitment to promote inclusion and diversity by consistently inviting new perspectives and exploring new experiences.
+Added: We understand the need to create an environment where employees can bring their whole selves to work, and our philosophy embodies our commitment to promote inclusion by consistently inviting new perspectives and exploring new experiences.
We aim to harness the unique mix of capabilities, talents, cultures, beliefs and experience of our employees and create a workforce that feels comfortable sharing these perspectives.
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Our Quest Management System, supports our effort to maintain a focus on high performance.
−Removed: We also focus on building and maintaining a collaborative, diverse and inclusive culture in which all employees are empowered to raise and discuss difficult issues and are valued for their strengths, experience and unique perspectives.
+Added: We also focus on building and maintaining a collaborative and inclusive culture in which all employees are empowered to raise and discuss difficult issues and are valued for their strengths, experience and unique perspectives.
We encourage our employees to actively participate in their communities, and support their participation, through our Employee Business Networks and Matching Gift Program.
+Added: All Employee Business Networks are open to all employees to participate in.
Our Everyday Excellence program elevates our focus on the 5C of Customer First through guiding principles for our entire organization to support a superior customer experience and inspire employees to be their best every day, with every person and with every customer interaction;
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The health and safety of our employees is of paramount concern.
−Removed: We use a systematic, risk-based approach to develop tailored incident prevention and response programs designed to keep our employees safe in each of our diverse functional areas and use data insights and a detailed audit program to foster the effectiveness of our programs.
+Added: We use a systematic, risk-based approach to develop tailored incident prevention and response programs designed to keep our employees safe in each of our different functional areas and use data insights and a detailed audit program to foster the effectiveness of our programs.
We have a comprehensive curriculum of annual safety training, as well as training for new employees.
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We also offer comprehensive medical and mental health plans.
−Removed: For example, our mental health support service, launched in 2022, is widely used among our employees and their dependents.
HealthyQuest™ focuses on prevention, progression and reversal, through which we offer a HealthyQuest™ Employee Business Network and intervention programs designed to engage employees in managing their health, including access to medical expertise and support programs tailored to their individual needs, helping them to adopt healthier behaviors and access better care at lower costs.
−Removed: These programs include customized
−Removed: programs for conditions such as type 2 diabetes management, chronic kidney disease, cardiovascular disease, specialty drugs, weight management, zero-cost lab testing, and special support for orthopedic surgery and for cancer and other serious diagnoses.
+Added: These programs include customized programs for conditions such as type 2 diabetes management, chronic kidney disease, cardiovascular disease, specialty drugs,
+Added: weight management, zero-cost lab testing, and special support for orthopedic surgery and for cancer and other serious diagnoses.
Actively listening to our employees is fundamental to Quest’s culture.
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This approach is designed to build an agile culture, based on continuous feedback that fuels ongoing conversations about priorities, performance, opportunities and growth, to result in a higher performing organization and committed employees.
−Removed: To gain deeper insights, we expanded our 2024 program to include a culture insights survey, providing an enterprise-wide view of the employee experience in relation to our Purpose and the 5Cs.
−Removed: This is complemented by team-level insights from our employee insights, and lifecycle surveys for new hire and departing staff.
−Removed: In addition, we hold regular monthly meetings among hundreds of company leaders to foster increased communication across the company regarding topics of concern to employees.
+Added: This is complemented by lifecycle surveys for new hire and departing staff.
+Added: In addition, we conduct surveys of our employees regarding important topics and hold regular monthly meetings among hundreds of company leaders to foster increased communication across the company regarding topics of concern to employees.
Attracting, Training, Development and Succession Planning .
−Removed: We have a strong program designed to attract a diverse, qualified work force that will assist us to achieve our business goals.
+Added: We have a strong program designed to attract a qualified work force that will enable us to achieve our business goals.
For example, we are partnering with universities and specialized healthcare schools to help build our pipeline of expertise in medical technology, cytology and histology, and we have teamed up with a third-party phlebotomy training program to train and certify phlebotomist candidates who can join our ranks upon graduation.
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Among participants in the My Quest for Education program, 54% have received promotions and 36% have made lateral career moves.
−Removed: In 2024, we introduced INSPIRE, a frontline development program focused on enhancing service excellence for our customer-facing employees.
+Added: We continue to invest in INSPIRE, a frontline development program focused on enhancing service excellence for our customer-facing employees.
In addition, we provide leadership training opportunities for employees at all levels, including a manager essentials curriculum, our Leading Quest Supervisor and Manager Core program, our director-level Leading Quest for Business Impact program, Financial Acumen for Business Leaders, leadership coaching programs and trainings to strengthen critical leadership skills.
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We also maintain distinct sales and marketing organizations for our offerings in Diagnostic Solutions and our employer testing services.
−Removed: Information Technology.
We use information systems extensively in virtually all aspects of our business, including clinical testing, test ordering and reporting, billing, customer service, logistics and management of data.
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We have made significant progress implementing common systems in our regional laboratories, and we continue to standardize laboratory information and billing systems across our operations.
−Removed: We expect that our standardization efforts will take several more years to complete, and will result in significantly more centralized systems, improved operating efficiency, more positive customer experiences and enhanced control over our operational environment.
+Added: In February 2025, we committed to Project Nova, a multi-year project to modernize our "Order to Cash" business processes, including the related information technology infrastructure and underlying enabling technologies.
+Added: We are partnering with Epic, a third-party licensor, to assist in the implementation of Project Nova.
+Added: We expect to deliver value throughout the implementation of Project Nova, which we expect will be completed in 2031 to 2032, as it unlocks a variety of streamlined operational benefits, reduced technology-related operating costs, accelerated revenue opportunities and improvements to the customer and patient experience.
+Added: As each of our standardization projects are completed over the coming years, we expect that they will result in significantly more centralized systems, improved operating efficiency, more positive customer experiences and enhanced control over our operational
Even after we complete our efforts to standardize our legacy systems, we will need to focus on standardizing systems in connection with future business acquisitions.
Quality Assurance.
−Removed: As discussed further under the heading "Continuous Quality Improvement", our goal is to provide every patient with services and products of superior quality, and to meet that goal we employ the Quest Management System.
−Removed: Employing root cause analysis, process improvements and rigorous tracking and measuring, we continuously seek to enhance quality, reduce defects, further increase the efficacy and efficiency of our operations and processes, eliminate waste and help standardize operations across our Company.
+Added: At Quest, our Quality and Regulatory Affairs strategy is rooted in our Purpose:
+Added: working together to create a healthier world, one life at a time.
+Added: Our mission is to ensure the highest standards of quality in every test and insight we deliver – enabling physicians and their patients to make confident, informed decisions about patient health.
+Added: Guided by our operating principles, the Quality and Regulatory Affairs function drives quality and regulatory compliance across the enterprise as a true business partner in advancing patient-first decision making.
+Added: We promote a "Speak Up for Quality" culture, where every team member is empowered to raise concerns, ask questions and share ideas that strengthen reliability and patient trust.
+Added: Recently, we enhanced enterprise engagement through our first enterprise-wide Quality Week, celebrating the work of teams across the Company and reinforcing shared accountability for quality outcomes.
In our laboratory operations our quality assurance efforts focus on pre-analytic, analytic and post-analytic processes, including positive patient identification of specimens, appropriate specimen transport, analysis and report accuracy, reference interval establishment and review, statistical process control and personnel training for our laboratories and patient service centers.
As part of our quality assurance program, we utilize internal proficiency testing, comprehensive quality control and rigorous process audits.
−Removed: We have introduced comprehensive and digitized data analytics software that implements advanced automated quality control procedures, offering both real-time and post-analytic analysis of data at the laboratory and corporate level.
+Added: We utilize comprehensive and digitized data analytics software that implements advanced automated quality control procedures, offering both real-time and post-analytic analysis of data at the laboratory and enterprise level.
+Added: In 2025, to modernize our quality ecosystem, we deployed new technology solutions, expanded public health reporting capability, and selected an enterprise electronic Quality Management System platform – investments that build on our strong infrastructure and support future scalability.
We monitor test results to identify trends, biases, instrument failures and population shifts through digitization and data analytics.
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In addition, some of our laboratories also have International Organization for Standardization (ISO) certification for their quality management systems.
−Removed: For example, in 2023, we achieved ISO 14001 certification for our Cleveland HeartLab and laboratory facility in Chantilly, VA.
+Added: For example, we have achieved ISO 14001 certification for our Cleveland HeartLab and laboratory facilities in Chantilly, VA, Marlborough MA, Lewisville TX and San Juan Capistrano, CA.
ISO 14001 is an internationally recognized management system that leverages leadership involvement and employee engagement to help organizations ensure compliance with regulatory standards, improve their environmental performance, provide a competitive advantage and gain the trust of stakeholders, and achieve strategic goals by incorporating environmental issues into business management.
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We maintain a continuous improvement dialogue with our suppliers, and with operationally critical suppliers deliver a supplier scorecard that supports continuous improvement.
−Removed: We also maintain quality assurance programs for hospital laboratories that we manage, and for our services offerings outside laboratories.
+Added: In addition, we maintain quality assurance programs for hospital laboratories that we manage, many of which also maintain their own policies and procedures.
Intellectual Property Rights.
We own significant intellectual property, including patents, patent applications, technology, trade secrets, know-how, copyrights and trademarks in the United States and other countries.
−Removed: From time to time, we also license patents, patent applications, technology, trade secrets, know-how, copyrights or trademarks owned by others;
+Added: From time to time,
+Added: we also license patents, patent applications, technology, trade secrets, know-how, copyrights or trademarks owned by others;
we also may license our intellectual property to others.
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Currently, Medicare does not require the beneficiary to pay a co-payment for diagnostic testing services reimbursed under the Clinical Laboratory Fee Schedule, but generally does require a patient deductible and co-insurance for anatomic pathology services.
−Removed: Part B of the Medicare program contains fee schedule payment methodologies for clinical testing services performed for covered patients, including a national ceiling on the amount that carriers could pay under their local Medicare clinical testing fee schedules.
+Added: Part B of the Medicare program contains fee schedule payment methodologies for clinical testing services performed for covered patients, including a national ceiling on the amount that carriers could pay under their local Medicare clinical
+Added: testing fee schedules.
Historically, the Medicare Clinical Laboratory Fee Schedule and the Medicare Physician Fee Schedule established under that program have been subject to change, including each year.
Pursuant to PAMA, reimbursement rates for many clinical laboratory tests provided under Medicare were reduced during 2018 - 2020.
−Removed: Unfortunately, as a result of a flawed implementation of PAMA, the data collected did not accurately represent the laboratory market as required under PAMA.
−Removed: Independent laboratories were overrepresented, and hospitals and physician office laboratories were underrepresented, making the first round of PAMA cuts too extreme.
−Removed: The three years of cuts exceeded the original 10-year savings projections.
−Removed: PAMA calls for further revision of the Medicare CLFS for years after 2020, based on future surveys of market rates.
−Removed: Congress has delayed cuts five times (2021 - 2025) and delayed 2019 reporting six times (2020 - 2025).
−Removed: Reimbursement rate reduction from 2026-28 is capped by PAMA at 15% annually.
−Removed: Congress reintroduced federal legislation in 2023 (the Saving Access to Laboratory Services Act), which would reform PAMA and create a true market-based CLFS.
+Added: Unfortunately, by relying on laboratory reported data alone in 2017, CMS did not receive comprehensive and representative data needed to set Medicare rates that reflected the commercial market, as required under PAMA.
+Added: Independent laboratories were overrepresented, and hospitals and physician office laboratories were underrepresented, making the first round of PAMA cuts excessive.
+Added: The first three years of cuts greatly exceeded the original 10-year savings projections.
+Added: Starting in 2020, Congress has repeatedly acted to delay PAMA implementation by delaying the next round of data reporting (2020-2026) and Medicare cuts (2021-2026).
+Added: However, the structural flaws of PAMA still need to be addressed to mitigate future excessive cuts.
+Added: Congress introduced legislation in 2025, the Results Act, which would reform PAMA and create a true market-based CLFS.
We are subject to extensive and frequently changing laws and regulations in the United States (at both the federal and state levels) and other jurisdictions in which we conduct business, and to government inspections and audits.
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CLIA and State Clinical Laboratory Licensing CLIA regulates the operations of virtually all clinical laboratories, including our laboratories in the United States, requiring that they be certified by the federal government and that they comply with various technical, operational, personnel and quality requirements intended to ensure that the services provided are accurate, reliable and timely.
+Added: CMS, as a federal agency administering CLIA, also requires compliance with applicable federal human subject protection requirements, including the Common Rule, which establishes baseline protections such as institutional review board oversight and informed consent, when laboratory activities involve human subjects.
State laws may require additional personnel qualifications or licenses, quality control, record maintenance, proficiency testing or detailed review of our scientific method validations and technical procedures for certain tests.
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Some states have similar laws that are not limited in applicability to only Medicare and Medicaid referrals and could also affect tests that are paid for by health plans and other non-governmental payers.
−Removed: Violations of these laws and regulations may result in monetary fines, criminal and civil penalties and/or suspension or exclusion from participation in Medicare, Medicaid and other federal or state healthcare programs.
+Added: If these laws and regulations are interpreted or applied by a governmental, prosecutorial, regulatory or judicial authority in an adverse manner, it may result in monetary fines, criminal and civil penalties, settlements, suspension or exclusion from participation in Medicare, Medicaid and other federal or state healthcare programs, and/or a commitment to agree to additional regulatory oversight.
+Added: For example, the Company recently entered into a Corporate Integrity Agreement with HHS.
+Added: For further details, see Note 18 to the audited consolidated financial statements.
FDA The FDA has regulatory responsibility over, among other areas, instruments, software, test systems, collection kits, reagents and other devices used by clinical laboratories to perform diagnostic testing in the United States.
The FDA also regulates drugs-of-abuse testing for employers and insurers, testing for blood bank purposes and testing of donors of human cells for purposes such as in vitro fertilization.
−Removed: We offer companion diagnostic testing services to pharmaceutical companies that are regulated by the FDA.
−Removed: As of May 6, 2024, the FDA announced it was phasing out its general enforcement discretion approach so that LDTs manufactured by a laboratory will generally fall under the same enforcement approach as medical devices.
−Removed: A number of advanced tests we develop internally are offered as LDTs.
−Removed: Pursuant to the FDA’s decision to remove enforcement discretion with regard to most LDTs performed by high complexity CLIA-certified laboratories like ours, all new and significantly modified previously offered laboratory tests that do not benefit from continued enforcement discretion will have to comply with the FDCA over a four-year, five-stage process.
−Removed: Compliance with the FDCA includes, among other things, new quality system regulations and premarket authorization.
−Removed: One major area of the continued FDA enforcement discretion will apply to many tests that were offered for clinical use prior to May 6, 2024 and that do not afterwards undergo certain material modifications.
−Removed: The removal of enforcement discretion for LDTs could result in a revitalization and passage of legislation or other Congressional action.
−Removed: The current FDA policy to remove enforcement discretion and/or new legislation is expected to have a significant impact on the clinical laboratory testing industry, including regulating LDTs in new ways, while creating new avenues of opportunity and competition regarding clinical laboratory testing.
+Added: We offer companion and complementary diagnostic tests to pharmaceutical companies that are regulated by the FDA.
+Added: In May 2024, the FDA announced it was phasing out its general enforcement discretion approach so that LDTs manufactured by a laboratory would generally fall under the same enforcement approach as medical devices.
+Added: However, in March 2025, a U.S.
+Added: District Court set aside and vacated the FDA’s LDT rule and the FDA did not appeal the court’s decision.
+Added: Accordingly, the FDA does not have the authority to regulate LDTs.
+Added: Although the FDA LDT rule was vacated in 2025, our commitment to maintaining rigorous quality standards, supporting responsible innovation, and ensuring that patient care is optimized has not changed as federal oversight evolves.
+Added: In response to this evolving regulatory landscape, we continue to adapt our quality and regulatory strategies and have accelerated technology and process modernization to support greater transparency, traceability and auditability.
Environmental, Health and Safety We are subject to laws and regulations related to the protection of the environment, the health and safety of employees and the handling, transportation and disposal of medical specimens, infectious and hazardous waste and radioactive materials.
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(a) the federal Health Insurance Portability and Accountability Act and the regulations thereunder, which establish (i) a complex regulatory framework including requirements for safeguarding protected health information and (ii) comprehensive federal standards regarding the uses and disclosures of protected health information;
−Removed: (b) state laws (e.g., California) and similar laws in other states;
−Removed: and (c) laws outside the U.S., including the European Union's General Data Protection Regulation, Canada’s Personal Information Protection and Electronic Documents Act and provincial health privacy laws, and similar laws in other jurisdictions.
−Removed: We may be subject to penalties for non-compliance and may be required to notify individuals or state, federal or county governments if we discover certain breaches of personal information or protected health information.
+Added: (b) state laws ( e.g.
+Added: , California) and similar laws in other states;
+Added: and (c) laws outside the United States, including the European Union's General Data Protection Regulation, Canada’s Personal Information Protection and Electronic Documents Act and provincial health privacy laws, and similar laws in other jurisdictions.
+Added: We may be subject to penalties for non-compliance and may be required to notify individuals or state, federal or county governments, or other data protection regulatory authorities, if we discover certain breaches of personal information or protected health information.
Drug Testing;
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Cardiovascular, Metabolic, Endocrinology and Wellness, Drug Monitoring and Toxicology, Infectious Disease and Immunology, Neurology, and Women’s and Reproductive Health.
−Removed: He is also responsible for the Company's genomic customer services, medical affairs, regulatory, LifeLabs and global markets.
+Added: He is also responsible for the Company's genomic customer services, medical affairs, and regulatory.
+Added: Kuppusamy assumed responsibility for R&D, Oncology, including Haystack Oncology, and Genomics.
Previously, Mr.
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Plewman assumed his current role in April 2022.
−Removed: He is responsible for a portfolio of data driven analytics and services offerings, including Workforce Health Solutions, Healthcare Analytic Solutions, Pack Health, Risk Assessment (ExamOne), Consumer Initiated Testing and Pharma Services.
+Added: He is responsible for a portfolio of data driven analytics and services offerings, including Workforce Health Solutions, Healthcare Analytic Solutions, Risk Assessment (ExamOne), Consumer Initiated Testing and Pharma Services.
+Added: Plewman assumed responsibility for global markets.
Since joining the Company in 2013, Mr.
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In 2003, he assumed responsibility for governmental affairs.
−Removed: Prevoznik also is the Vice Chair of the Quest Foundation.
+Added: Prevoznik also is Vice Chair of the Quest Foundation, Executive Co-Sponsor of the Company's Quest for Health Initiative, and Executive Co-Sponsor of the QuestCAN Employee Business Network.
From 1999 until April 2009, Mr.
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He is responsible for the Company's finance, accounting, investor relations, internal audit and treasury activities.
+Added: Samad assumed responsibility for LifeLabs.
Prior to joining the Company, Mr.
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Samad held several senior leadership positions at Cardinal Health, including Senior Vice President and Treasurer, with operational and financial responsibility for Cardinal Health's China business, and before that in sales and finance roles at Eli Lilly and Company, both domestically and internationally.
+Added: Samad is also a director at IDEXX Laboratories, Inc.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.