MRO certification

DOT vs non-DOT testing programs, agency-specific rules (FMCSA, FAA, FRA, USCG, FTA, PHMSA), MRO qualifications and authority, scope of 49 CFR Part 40.

Urine specimen collection sites, personnel, forms, equipment, and procedures including directly observed collections and shy-bladder protocols.

Initial and confirmatory drug tests, cutoff concentrations, validity testing (creatinine, pH, specific gravity, oxidant testing), HHS-certified laboratory requirements.

The MRO interview, evaluation of legitimate medical explanations, prescription review, documentation requirements, and verification decisions.

Drug-class-specific verification considerations (opioids, amphetamines, cocaine, marijuana/THC, PCP, MDMA), permitted prescriptions, and clinical interpretation of positive results.

Identification and handling of substituted, adulterated, and invalid specimens; refusals to test; required follow-up testing under direct observation.

Split (Bottle B) testing requests, timing windows, payment, who may request reconfirmation, and how reconfirmation failures are handled.

Substance Abuse Professional (SAP) evaluation, education, treatment, return-to-duty testing, and follow-up testing schedules.