LDT’s in Flux: Will Evolving Regulations Enhance or Complicate Laboratory Practices?

Authors

  • Alejandro R. Molinelli Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA Author https://orcid.org/0000-0002-1105-1271
    • Dennis J. Dietzen Phoenix Children’s Hospital, University of Arizona College of Medicine, Phoenix, AZ USA Author https://orcid.org/0000-0001-7593-4092
      • Jonathan R. Genzen Department of Pathology, University of Utah, Salt Lake City, UT, USA; ARUP Laboratories, Salt Lake City, UT, USA Author
        • Xander M. R. van Wijk Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA USA Author
          • Maria Allice V. Willrich Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA Author
            • Melissa M. Budelier TriCore Reference Laboratories, Albuquerque, NM, USA; Department of Pathology, University of New Mexico, Albuquerque, NM, USA Author https://orcid.org/0000-0002-1779-5757

              DOI:

              https://doi.org/10.21627/ggcs2a65

              Keywords:

              LDT, FDA, regulatory quality, CLIA, laboratory developed test

              Abstract

              Clinical labs help diagnose and manage disease by testing blood and other specimens. They operate under federal rules known as Clinical Laboratory Improvement Amendments (CLIA). Most tests are FDA cleared/approved, but some are laboratory-developed tests (LDTs) created in individual labs, typically to meet unmet needs. LDTs have long existed in a complicated regulatory space. In 2024, the FDA issued a rule to regulate LDTs like devices, prompting concerns about cost, innovation, and access. A federal court struck the rule down in 2025, finding LDTs are services, not devices. The FDA subsequently rescinded its rule. In this article, experts argue that LDTs are essential and already held to strong standards and that future reforms should strengthen CLIA while protecting access and innovation.

              Published

              2026-07-29

              Issue

              Section

              Opinion

              How to Cite

              1.
              LDT’s in Flux: Will Evolving Regulations Enhance or Complicate Laboratory Practices?. J Mass Spectrom Adv Clin Lab [Internet]. 2026 Jul. 29 [cited 2026 Aug. 10];39(1). Available from: https://jmsacl.journals.sup.org/index.php/jmsacl/article/view/94