Starting Your Own DOT Drug Testing Business

Starting a DOT drug testing business means helping employers meet their testing requirements by collecting specimens for laboratory analysis. The DOT reported approximately 6.9 million drug tests across regulated transportation industries in 2023- an established market with recurring testing needs. Source: DOT

Who Could Your Drug Testing Business Serve?

Potential customers include employers with workers covered by DOT testing rules, such as:

• Trucking companies and owner-operators
• Bus companies and public transit agencies
• Airlines and other covered aviation employers
• Railroads
• Pipeline operators
• Maritime employers with covered crewmembers

The customers you pursue will help shape your services, location, and whether you offer mobile collections at their worksites.

What Training Do You Need?

DOT urine specimen collection
Complete qualification training and five consecutive error-free monitored mock collections before offering DOT urine collections. Explore TeamCME’s DOT Urine Specimen Collector Training.

Adding DOT breath alcohol testing
If you also want to offer DOT breath alcohol testing, you’ll need separate BAT training and demonstrated proficiency with your equipment. Explore TeamCME’s Breath Alcohol Technician Training.

When Do Businesses Require Drug Tests?

For DOT-covered work, such as commercial driving, testing requirements include:

• Pre-employment: Before starting DOT-covered work.
• Random: Unannounced testing throughout the year.
• Post-accident: After certain accidents. Not every crash requires testing.
• Reasonable suspicion: When a trained supervisor observes signs of possible drug use.
• Return-to-duty: Before resuming DOT-covered work after a violation, such as a positive drug test, once the required substance abuse professional steps are completed.
• Follow-up: Additional testing prescribed by the substance abuse professional after the employee returns to work.

Exact requirements depend on the applicable DOT agency’s rules. FMCSA’s testing guidance

What About the Location?

You can see people out of your facility or take the facility to them in a mobile unit. If businesses send a single person for testing, such as part of the onboarding process, it might be easier to have them come to you. However, the mobile version might work best if multiple tests are performed or if you’re needed at the scene of an accident.

Brick-and-mortar locations have some advantages, such as bathrooms for urine samples, space to organize supplies in cupboards, closets, and on shelves, desks to write on, and a seating area for clients. However, these facilities bring with them additional costs, such as rent, electricity and water bills, heating, and air conditioning.

A mobile unit, on the other hand, could be a car, van, or motorhome. The motorhome even comes with a bathroom. There would be less space but also less overhead. The smaller the space, the more organized you will need to be for it to function properly.

Do You Need Employees?

No- not necessarily at first. You can start as a one-person business and add staff as demand grows.

If you already operate a clinic or office, a receptionist, medical assistant, or another staff member could handle collections alongside their existing duties after completing the required collector qualifications. As you begin performing more testing, you may choose to dedicate a part-time or full-time employee to the service.

What Supplies and Equipment Will You Need?

What you need depends on the services you offer. Before buying collection supplies, check what’s included with your laboratory arrangement.

For DOT urine collections:

• Federal Custody and Control Forms (CCFs) or access to an approved electronic CCF system.
• Split-specimen collection kits, including the collection container and two specimen bottles.
• Tamper-evident bottle seals, specimen transport bags, and shipping containers and labels. Some of these are included with the collection kits.
• Collection-site supplies, such as disposable gloves and toilet bluing agent.

If you offer DOT alcohol testing:

• DOT Alcohol Testing Forms (ATFs).
• An approved evidential breath testing device suitable for screening and confirmation tests.
• Device-specific supplies, such as mouthpieces, printer supplies, and calibration-check materials.

Approved saliva alcohol screening devices are another option, but they cannot perform confirmation tests. A screening result of 0.02 or higher requires a confirmation breath test. Before offering screening-only services, complete the applicable training and arrange access to confirmation testing that meets DOT’s timing and transportation requirements.

For paperwork and daily operations:

• Laptop or computer: For scheduling, billing, training, and electronic collection systems.
• Scanner or smartphone: To capture a clear, complete image of paper CCF Copy 2 for the Medical Review Officer (MRO). Send it using the MRO’s accepted submission method, such as an online portal or online fax service.
• Secure record storage, plus a printer if your workflow requires one.

Where Do You Get Collection Supplies?

Start by setting up laboratory services. Collection kits are often supplied at no separate charge through your laboratory arrangement. Confirm what’s included and how testing and shipping are billed before purchasing supplies.

You can arrange laboratory services through TeamCME and receive discounted lab pricing. TeamCME also sells collection supplies and alcohol testing equipment.

Final Thoughts

Starting a business is a big undertaking, but drug testing is a very approachable model. Training doesn’t take long; you can do it all remotely (including mock collections to show proficiency). With labs handing out free (to you) kits, you can charge clients for the cost of the kits as part of your fee and pass it along to the lab. And with the possibility of a mobile unit, you could start the business with a relatively small investment and scale up as you gain clients.

Medical Review & Authorship

Written by: Dr. Jeffrey Carlson – Chief Medical Officer
Dr. Carlson leads TeamCME’s medical training programs and publishes regularly on DOT medical compliance and examiner best practices.

Reviewed by: Dr. Michael Megehee, DC, NRCME – Founder & Senior Advisor
FMCSA subject matter expert selected to help design the original NRCME educational curriculum and first exam questions.