Lab Test Ordering Rights by State: The Ultimate Guide

One of the most common questions we get at Rupa is: “Can I order functional medicine labs?”

The answer to this question is, it depends. States have different rules, it varies on the professional credentials you have, and each lab has different standards of who can order from them.

It can get confusing and overwhelming searching for the answer. But don't worry! We’ve got you covered!

Create a free Rupa Health account to see our Lab Ordering Access Page, and get to know your specific rights. 🧪

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Who Can Order Labs?

MD, DO, DDS, DPM, OD, NP, and PA may order labs in all 50 states. Some states require Nurse practitioners and Physician Assistants to be sponsored by MD or DO.  

Naturopathic Doctors

ND’s scope of practice regulations varies among states and provinces, as do the parameters and restrictions for practitioners located in pre-licensed locations. Naturopathic Doctors receive training in the same biomedical and diagnostic sciences as MDs and DO’s. ND’s who are current with their licensure can order and interpret labs in the following states: AK, AZ, CA, CO, CT, DC, HI, ID, KS, MA, MD, ME, MN, MT, NH, ND, OR, RI, UT, VT, WA, WI, and US Territories: Puerto Rico and U.S. Virgin Islands.

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Doctor of Chiropractic (DC)

Chiropractic health care is a recognized profession in all United States jurisdictions and in all Canadian provinces. All states require the applicant for chiropractic licensure to obtain a Doctor of Chiropractic (DC) degree from an approved educational program accredited by the Council on Chiropractic Education (CCE).

DC’s are allowed to order and interpret labs in all states. (1) Although it’s important to note that Rupa Health and many functional labs do not ship tests to NY, NJ, and RI due to laboratory billing regulations.

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Registered Dieticians (RD)

Each RD has an individual scope of practice determined by education, training, and credentialing.

In 2014 The Centers for Medicare and Medicaid Services (CMS) announced a final rule that now allows RDs lab ordering privileges as long as they meet the following requirements:

1. The RD must be working under a clinic or hospital.

2. The lab tests ordered are specifically meant to monitor the effectiveness of dietary plans.

Private practice RD’s can order functional and integrative lab tests through certain individual lab companies.  All licensed RD’s can also utilize our lab requisition service through Rupa Health.

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Licensed Acupuncturists (LAc)

California, Florida, and New Mexico acupuncturists are granted the status of “primary care provider” and function at a high level of medical practice. Among the many medical privileges granted in these states, using western medical diagnostic tools such as labs test is one of them.

In Colorado and Nevada, LAc’s must also have earned the title of Doctor of Oriental Medicine to order diagnostic and functional medicine labs. LAc’s in Arkansas and Mississippi are not considered primary care but can still order and interpret labs.(4) Licensed LAc, DOM, and DACM in all 50 states can utilize our lab requisition service through Rupa Health.

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Can Nurses Order Labs?

Nurse Practitioners (NPs) can order lab tests because they have special training to diagnose illnesses, prescribe medicine, and do tests like bloodwork. This is a big part of how they take care of patients, especially in places like clinics. But, whether an NP can order these tests on their own or needs to work with a doctor can change depending on the state they're in. The rules are different everywhere.

Check out our article detailing NP lab ordering rights.

Registered Nurses (RNs), on the other hand, usually can't order tests by themselves. They mainly help take care of patients and help with tests, but the decision to order a lab test is often up to NPs or doctors. Sometimes, in certain places like hospitals, RNs might be allowed to order some tests if there's a special rule or agreement.

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What If I’m Just Getting Started With Functional Medicine?

Maybe you just found out that you have lab ordering rights or have access to our lab requisition services, but you aren’t comfortable with Functional Medicine Labs. That’s ok too; our goal at Rupa Health is to make Functional lab ordering as convenient and easy as possible.

We constantly add live courses and boot camps to help practitioners increase their functional medicine knowledge. We have a whole magazine dedicated to you, an in-depth reference guide, and an amazing group of Onboarding Managers available to walk you and your patients through everything.

Join a Live Group Demo to see the Rupa platform in action!

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Not Currently Licensed to Order Lab Work in Certain States

Are you a licensed healthcare practitioner and want to expand your lab ordering access to more states? Sign up for our Physician Services to give your clients access to 3000+ labs.

Who Can Apply To Physician Services?

Any health and wellness practitioner can apply to Rupa Physician Services! To be approved, you must be a certified healthcare practitioner, provide your NPI number, state license if you have it, and proof of all your educational background and credentials.

What if I Have a Doctor That Can Sign Requisitions For Me?

If you work with a physician or other licensed practitioner who can sign off on your patients’ testing, we can set that up through Rupa!

Here’s how:

1. Have your signing practitioner create an account with us.

2. Message us through the portal or at support@rupahealth.com so we can link your account to theirs.

What if it Turns Out I Can Order Labs in My State, But It’s Not Listed?

Please let us know! We’re always looking to improve our knowledge base. If you message us through the portal or via email with an updated reference, we’ll get that lab or state added to our catalog. :)

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Disclaimer

While we strive to always provide up-to-date information for our readers, it's important to keep in mind that laws and regulations are subject to frequent changes. If you have any questions or uncertainties about your rights, feel free to reach out to the licensing board in your state. They're the best resource to help navigate your scope of practice and any legal considerations when it comes to ordering lab testing.  

Have any questions for us? Reach out! We love hearing from you!