How Results Flow Through Our MRO
Specimen Collected
Chain-of-custody CCF completed at collection site
Lab Analysis
SAMHSA-certified lab analyzes specimen
MRO Review
Certified MRO reviews results; contacts donor if needed
Employer Notified
Verified result reported to employer portal within 24 hrs
More Than Just Reading Results
An MRO is a licensed physician trained in substance abuse disorders and the federal DOT drug testing program. Their role protects both the employer and the employee.
- Reviews all laboratory results — negative, positive, adulterated, substituted, or invalid
- Contacts the donor to verify legitimate medical explanations for non-negative results
- Evaluates prescription medication disclosures
- Determines final verified result (negative, positive, cancelled, or refusal)
- Reports verified results to employer or designated employer representative (DER)
- Maintains required records per 49 CFR Part 40
- Available to answer employer and employee questions about results
MRO Result Outcomes
- ●Negative — No prohibited substance detected above cutoff
- ●Positive — Prohibited substance confirmed; no valid explanation
- ●Adulterated — Specimen contains foreign substance
- ●Substituted — Specimen not consistent with human urine
- ●Invalid — Unable to test; may require recollection
- ●Cancelled — Fatal flaw or uncorrected error in process
- ●Refusal — Treated as a positive under DOT regulations
MRO Questions
Does an employer need their own MRO?
No. Employers use a service provider's MRO. Our MRO is included in every drug test we process — there's no need to hire or contract a separate MRO.
Can the employee contest an MRO's decision?
If an employee disputes a verified positive result, they may request a split specimen test (Bottle B) within 72 hours of MRO notification. The split specimen is sent to a second SAMHSA-certified lab for confirmation.
Can the employer get results before the MRO review?
No. Under 49 CFR Part 40, employers may only receive results after MRO review. Pre-MRO results cannot be used for employment decisions.
How long does MRO review take?
For negative results, typically same day as lab reporting. For non-negatives requiring donor contact, the MRO has specific timeframes (usually 3–5 business days) to attempt contact before reporting.