Medical Review Officer (MRO) Review
Every non-negative drug result must be verified by a qualified Medical Review Officer before it's reported, so a valid prescription never becomes a false positive. Our DOT-qualified MRO network reviews every result — built into our testing, or standalone for specimens you collect.
A Medical Review Officer (MRO) is the licensed physician who reviews every non-negative drug result, confidentially contacts the donor, and verifies legitimate prescriptions before a result is reported. Our DOT-qualified MRO reviews your tests.
A confirmed lab positive isn't the end of the story — and reporting one without proper Medical Review Officer verification violates DOT and invites wrongful-termination claims. A Medical Review Officer (MRO) is the physician who stands between a lab result and a reported violation.
What the MRO does
Our DOT-qualified MRO network reviews every non-negative result. The MRO contacts the driver confidentially, checks for a legitimate medical explanation — a valid prescription, for example — and reports only a verified result to you. A legitimate prescription doesn't become a false positive; a real violation is confirmed and defensible.
Built into our testing — or standalone
MRO review is included in the drug tests we collect. If you collect specimens yourself or through another provider, we also offer standalone MRO review, so your results are verified by a qualified physician before you act on them.
When it's a verified positive
A verified violation removes the driver from safety-sensitive duty and starts the return-to-duty process. We coordinate the next steps — see SAP Coordination and Return-to-Duty & Follow-Up Testing — and report to the FMCSA Clearinghouse for CDL drivers as required.
Key Features
DOT-Qualified MRO Network
Every non-negative result is reviewed by a qualified Medical Review Officer.
Confidential Donor Review
The MRO contacts the driver privately to check for a legitimate medical explanation.
Only Verified Results Reported
A valid prescription never becomes a false positive; a real violation is confirmed and defensible.
Standalone Review — $75
MRO verification for specimens you collect yourself or through another provider.
Clearinghouse Reporting Coordinated
Verified CDL violations are reported to the FMCSA Clearinghouse as part of your program.
Protects Against False Positives
The physician review that stands between a lab result and a reported violation.
Compliance Requirements
Compliance Requirement
MRO verification is required — 49 CFR Part 40, Subpart G
Every laboratory-confirmed non-negative DOT drug test must be reviewed and verified by a qualified Medical Review Officer before it is reported to the employer. The MRO is a licensed physician trained in the medical and regulatory aspects of drug testing.
Confidential medical review
The MRO contacts the donor to discuss the result, evaluates whether a legitimate medical explanation exists, and verifies the result as positive, negative, or — in limited cases — cancelled.
Clearinghouse reporting
For CDL drivers, verified violations must be reported to the FMCSA Clearinghouse. We coordinate that reporting as your C/TPA.
Frequently Asked Questions
An MRO is a licensed physician who reviews non-negative drug results, contacts the donor confidentially to check for a legitimate medical explanation, and reports only verified results to the employer.
DOT requires MRO verification first. A legitimate prescription can explain a laboratory positive, and reporting a result without MRO review is both a regulatory violation and a legal risk.
Usually a short turnaround after the lab result, though the MRO must reach the donor to review any non-negative before a result can be verified.
The driver is removed from safety-sensitive duty, the violation is reported to the FMCSA Clearinghouse for CDL drivers, and the return-to-duty process begins through a Substance Abuse Professional.
Yes. We offer standalone MRO review for specimens you or another provider collected — $75 per test — so your results are physician-verified before you act.
Yes. MRO review is built into the DOT and non-DOT drug tests we collect.
Related Services
C/TPA & Consortium Program
Diversified Drug Testing is your Consortium/Third-Party Administrator — we run your entire DOT drug and alcohol program. Random pool management, every test type collected by our mobile team across Nebraska and Kansas or in-clinic, plus MRO, SAP, and DER support. $129/year per company.
Pre-Employment Drug Testing
A driver can't perform safety-sensitive functions until you have a verified negative pre-employment drug test (49 CFR 382.301). Test at our clinics, on-site with our mobile collectors across Nebraska and Kansas, or at a partner site nationwide. MRO-verified. $75 clinic / $95 mobile.
Post-Accident Testing
When an accident happens, the clock starts: DOT requires alcohol testing within 8 hours and drug testing within 32 (49 CFR 382.303). Our 24/7 dispatch and our own collectors across Nebraska and Kansas get a driver tested — and every attempt documented — so you meet the window and stay defensible.
Make sure a lab positive is a verified violation — DOT-qualified MRO review that protects driver rights and your defensibility.
Contact our testing specialists to learn how we can support your drug and alcohol testing program.
- C/TPA Program Administration
- 24/7 Post-Accident Response
- 3,000+ Testing Sites Nationwide