Medical Review Officer (MRO) Services


A Medical Review Officer (MRO) is a licensed physician who is responsible for reviewing laboratory results generated by an employer’s drug testing program. Federal regulators require that physicians be a Doctor of Medicine (MD) or Doctor of Osteopathy (DO). Medical Review Officers must have knowledge about the pharmacology and toxicology of prescription as well as illicit drugs, as well as federal agency drug-testing regulations and guidelines, such as the DOT.

The MRO acts as a gatekeeper of laboratory test results by reviewing the documents for possible errors, interviewing donors who have non-negative results to determine if there is a legitimate medical explanation for their results, and providing feedback to employers, collection sites, laboratories, and federal agency representatives regarding performance problems, if necessary.

To become a certified MRO, the physician must pass a written exam administered by a nationally-recognized MRO certification board. It is the MRO’s responsibility to maintain their certification by retaking and passing the exam every five years.


Step 1: Collection Site Test - The employee/donor goes to a collection site to provide the required specimen. The collection site will follow applicable protocols and will ship the specimen along with the lab's copy of the Custody and Control Form (CCF) to the laboratory for testing. The Medical Review Officer will also receive their designated copy of the CCF.

Step 2: Lab Processes Specimen - Once the specimen is received by the laboratory, the required testing will be conducted. The lab will process the specimen and results will be forwarded to the MRO for review and reporting.

Step 3: CCF Entered - Once the Custody and Control Form (CCF) form is received, the donor’s name, chain of custody number, and social security number are now linked, and the document is entered into our proprietary online platform.

Step 4: Results Reviewed - Lab results are received through an electronic interface and entered into our system with the chain of custody number; our program links the lab results with the donor’s information automatically.

Step 5: MRO Interviews the Donor - If the lab results are non-negative, they are reviewed by a Medical Review Officer.  Each donor with a non-negative result will have the opportunity to speak with an MRO that is also a licensed physician.

Step 6: Results are Reported - If the lab result is negative, it reports to the company automatically through the system.  If the laboratory result appears positive, the MRO interviews the donor to discuss the non-negative results and then the final report is distributed to the company.


The medical review process offers a fair opportunity for the donor to provide a prescription or legitimate explanation for any non-negative test results. This process protects individuals from wrongful accusations, as well as protects the employer from any litigation due to an employee being fired or suspended as a result of their drug test result. Our MRO team accomplished more than 1.4 million verifications in 2017, ensuring you meet federal regulations and maintain a safe working environment for all employees.

Other MRO benefits include:

  • Protects the rights of both the employer and employee
  • Determines if there is a legitimate medical explanation for a non-negative test result
  • Validates the forensic integrity of a drug test result
  • Ensures compliance with all federal, state, and local laws


DISA provides a comprehensive line of drug testing solutions to help you make the most informed hiring decisions possible for your business. Call DISA today at 281-673-2530 or contact us below.