Quest Diagnostics

“Government agencies, health plans, consumer-focused health companies and other customers are increasingly focused on helping the healthy stay healthy, detecting symptoms among those at risk and providing preventative insight and care that helps avoid or reduce the negative impacts of a disease.”

Annual report 2025A · The company itself

“ACOs and patient-centered medical homes have grown as a means to deliver patient care. Centers for Medicare and Medicaid Services (“CMS”) has refreshed its strategy to address the national push toward value-based care for Medicare and Medicaid beneficiaries, and set goals for value-based reimbursement to be achieved. CMS has stated that the Medicare Sharing Savings Program for ACOs is a critical component of CMS' vision to drive high-quality, person-centered care and promote affordability and sustainability of the Medicare program. CMS has stated that its goal is for all people in traditional Medicare to be in an ACO by 2030, and is adopting policies to drive growth in ACO participation.”

Annual report 2025A · The company itself

“In 2025, we acquired select clinical testing and dialysis-related water testing assets of Fresenius Medical Care's wholly-owned Spectra Laboratories, a leading provider of renal-specific laboratory testing services in the United States.”

Annual report 2025A · The company itself

“We offer broad access to clinical testing through a network of laboratories, including advanced laboratories as well as rapid response laboratories (smaller facilities where we can quickly perform an abbreviated menu of routine tests for customers that require rapid turnaround times). We operate 24 hours a day, 365 days a year.”

Annual report 2025A · The company itself

“BUSINESS OPERATIONS The Company is made up of two businesses: Diagnostic Information Services and Diagnostic Solutions. Our Diagnostic Information Services business develops and delivers diagnostic information services, providing insights from the results of our laboratory testing to empower people, physicians, and organizations to take action to improve health outcomes.”

Annual report 2025A · The company itself

“We offer health IT solutions, including our products and national healthcare provider network, to help healthcare organizations and clinicians empower better health by leveraging the power of our significant information assets, including one of the world's largest databases of de-identifiable clinical lab results, and our technology prowess, including our history of providing leading IT for diagnostic information services. Our portfolio of offerings is designed to address analytic, clinical and financial needs.”

Annual report 2025A · The company itself

“The patients we serve annually comprise approximately one-third of the adult population of the United States, and over a three-year period, we serve approximately one-half of the adult population of the United States.”

Annual report 2025A · The company itself

“We estimate that annually we serve approximately half of the physicians and half of the hospitals in the United States.”

Annual report 2025A · The company itself

“We play a critical role in healthcare decisions for customers across the healthcare ecosystem, including physicians, hospitals, patients and consumers, health plans, government agencies, employers, retailers, pharmaceutical companies and insurers.”

Annual report 2025A · The company itself

“Physicians We serve approximately half the physicians in the United States each year. We serve virtually all types of physicians from primary care physicians and internists to specialists, including rheumatologists, cardiologists, neurologists, and obstetricians/gynecologists.”

Annual report 2025A · The company itself

“We serve approximately half the hospitals in the United States each year in many ways, including: •Serving as a hospital lab’s laboratory. In 2025, we generated approximately $1.2 billion in revenue from “reference testing,” where we perform testing that hospitals do not perform in their own in-hospital labs. •Helping hospitals operate their labs more efficiently.”

Annual report 2025A · The company itself

“In 2025, our Collaborative Lab Solutions (formerly known as Professional Laboratory Services) offering generated approximately $800 million in revenues and management fees supporting hospitals in the operation of their own labs.”

Annual report 2025A · The company itself

“Customer Channels We provide diagnostic information services to a broad range of customers within our primary customer channels of physicians, hospitals, and patients and consumers.”

Annual report 2025A · The company itself

“Table of Contents Customer Channels Physicians, including those associated with ACOs and FQHCs Physicians and physician assistants requiring diagnostic information services for patients are the primary referral source for our services. For more information see "Our Strategy --Physicians."”

Annual report 2025A · The company itself

“We also serve physicians associated with ACOs and FQHCs. An ACO is a network of providers and facilities that share financial risk in providing or arranging for the provision of healthcare. ACO members collaborate to provide coordinated, high-quality care to their patients; ACOs may manage the health of a population group, exercise operational and financial control over providers across the continuum of care, and function as a payer. Increasingly, ACOs are focusing on driving improvement in healthcare through value-based services arrangements, and to influence reimbursement for healthcare delivery.”

Annual report 2025A · The company itself

“FQHCs are non-profit, community-directed organizations that offer care to medically underserved patients; FQHCs are the largest primary care system in the United States today. Their patients are mostly low income, members of racial and ethnic minority groups, and are uninsured or publicly insured. We offer an array of services that we believe are attractive to FQHCs as they pursue better outcomes for their patients and maintain financial stability for their organizations.”

Annual report 2025A · The company itself

“Hospitals We believe that we are an industry leader in servicing hospitals and serve approximately half the hospitals in the United States each year in many ways.”

Annual report 2025A · The company itself

“We generally bill for diagnostic information services on a fee-for-service basis under one of two types of fee schedules; fees may be negotiated or discounted. The types of fee schedules are: •“Client” fees charged to physicians, hospitals and institutions for which services are performed on a wholesale basis and which are billed on a monthly basis. •“Patient” fees charged to individual patients and certain third-party payers on a claim-by-claim basis.”

Annual report 2025A · The company itself

“Additionally, some traditional customers for anatomic pathology services, including specialty physicians that generate biopsies through surgical procedures, such as dermatologists, gastroenterologists, urologists and oncologists, are consolidating, have added in-office histology labs or have retained pathologists to read cases on site. Hospitals also are internalizing clinical laboratory testing, including some non-routine and advanced testing.”

Annual report 2025A · The company itself

“Healthcare services increasingly are being provided by non-traditional providers (e.g., physician assistants), in non-traditional venues (e.g., retail medical clinics, urgent care centers) and using new technologies (e.g., telemedicine, digital pathology).”

Annual report 2025A · The company itself

“Competitors may compete using advanced technology, including technology that enables more convenient or cost-effective testing (e.g., technology enabled by AI). Digital pathology is an example of this.”

Annual report 2025A · The company itself

“Failure to develop, acquire licenses for, introduce, or commercialize new tests, technology and services could negatively impact our testing volume, revenues and profitability. The diagnostic information services industry is faced with changing technology and regulation and new product introductions.”

Annual report 2025A · The company itself

“The development of new, more cost-effective solutions that can be performed by our customers or by patients, which could accelerate the internalization of testing by hospitals or clinicians, could negatively impact our testing volume and revenues. The diagnostic information services industry is facing rapidly changing technology and innovations in product offerings, including technology that enables more convenient, accessible and cost-effective testing.”

Annual report 2025A · The company itself

“Using AI successfully will require significant resources, including having the technical expertise required to develop, test and maintain AI-based testing services and continually developing the appropriate governance and oversight of our use of AI. In addition, we anticipate that there will continue to be new regulatory requirements concerning the use of AI, which may aim to regulate, limit, or block the use of AI in our testing and other services or otherwise impose other restrictions that may hinder their usability or effectiveness.”

Annual report 2025A · The company itself

“Additionally, new technology that we deploy to automate processes, improve customer 36 Table of Contents service, generate insights from lab and other data and stimulate innovation to improve operational efficiency, including the expanded use of AI, may further expose our IT systems to the risk of cyberattacks and may create the need for rapid modifications to our cybersecurity program.”

Annual report 2025A · The company itself

“(o) Development of technologies that substantially alter the practice of clinical testing, including technology changes that lead to the development of more convenient, accessible and cost-effective testing, or new testing services that can be performed outside of a commercial clinical laboratory, such as point-of-care testing that can be administered by physicians in their offices, complex testing that can be performed by hospitals in their own laboratories or home testing that can be carried out without requiring the services of clinical laboratories.”

Annual report 2025A · The company itself

“(p) Challenges, including the associated competitive pressures, with properly managing the development, implementation, oversight and use of AI.”

Annual report 2025A · The company itself

“We help people make the best decisions to improve health by providing high quality, innovative, convenient and affordable diagnostic testing insights and services using our scale and extensive reach. We drive growth by: •offering an industry-leading menu of testing and other services; •collaborating with healthcare providers and partners to leverage our broad access; •leveraging our data assets and services to improve population health and enable value-based care; and •continuously improving our quality and efficiency by leveraging the Quest Management System and by embracing innovative technologies, such as automation and artificial intelligence ("AI").”

Annual report 2025A · The company itself

“We are leveraging automation and AI to improve quality and productivity across our entire value chain, not just in the laboratory. For example, we advanced our use of automation in front-end specimen processing and labeling in six of our labs, freeing more of our processors to focus on higher-order work.”

Annual report 2025A · The company itself

“We also have significant information assets and offer a robust portfolio of powerful analytics that inspire action and deliver value to our customers. We offer an array of solutions based on data insights, including retrospective analytics solutions for physicians, hospitals, health plans, pharmaceutical companies and public health organizations.”

Annual report 2025A · The company itself

“We use AI to help drive innovation and operational efficiency through improving the quality of our screening and diagnostic capabilities. We also continue to broaden our use of AI in customer service to help our representatives access answers more quickly, improving their effectiveness and service quality.”

Annual report 2025A · The company itself

“In 2025, we announced a collaboration with Google to use Google Cloud's data analytics and generative AI to help us streamline our data management, improve data analytics, and personalize the experiences we deliver to patients, providers, and other customers.”

Annual report 2025A · The company itself

“We have experience using advanced technologies, including AI, to automate processes, improve customer service, generate insights from lab and other data, and stimulate innovation. We use AI to help drive operational efficiency through improving the quality of our screening and diagnostic capabilities. In 2025, we initiated or expanded our use of AI and automation in several areas, ranging from digital cytology, microbiology, parasitology and digital pathology.”

Annual report 2025A · The company itself

“We have been and expect to continue to use AI technology in our testing services, and we anticipate it will become increasingly important to us over time. This technology, including generative AI, which is in its early stages of broader commercial implementation, presents a number of risks inherent in its use, including risks related to cybersecurity, privacy and data security and use practices and our oversight of how we use AI.”

Annual report 2025A · The company itself

“We are finding increased interest among health plans in driving better value in spending for laboratory testing. Health plans increasingly are taking steps to encourage the movement of testing volume to high value, lower cost providers like our Company, including by identifying preferred provider partners, plan design changes (e.g., zero-dollar out-of-pocket costs for members using preferred providers) and better aligning reimbursement rates for hospital-based providers and independent commercial laboratories.”

Annual report 2025A · The company itself

“Consumerization Consumers are our customers. Increasingly, consumers are engaged and interested in, and empowered to manage and take direct responsibility for, their own healthcare. As a result, they are becoming more sophisticated in their understanding of their healthcare needs and their expectations of healthcare providers. In addition, consumers often are bearing increased financial responsibility for their healthcare (e.g., high deductible health plans; rising deductibles).”

Annual report 2025A · The company itself

“Pricing transparency There has been a trend toward greater pricing transparency in healthcare, including in the laboratory testing marketplace. Several states have taken action to foster greater pricing transparency in healthcare. Federal laws require healthcare providers to provide good faith estimates of costs to self-pay patients, and provide rights and protections for consumers against surprise billing or balance billing. In addition, the federal government has adopted new legislation and issued new regulations designed to increase transparency regarding pricing and quality in healthcare, including requiring providers, group health plans and insurers to disclose cost information to consumers in advance of care being provided.”

Annual report 2025A · The company itself

“For example, value-based reimbursement is increasing (e.g., UnitedHealthcare's Preferred Lab Network) and CMS has set goals for value-based reimbursement to be achieved by 2030. Patients are encouraged to take increased interest in and responsibility for, and often are bearing increased responsibility for payment for, their healthcare.”

Annual report 2025A · The company itself

“Our ability to raise the prices and fees we charge for the services we provide is limited.”

Annual report 2025A · The company itself

“As consumers increasingly seek more involvement and control over their health and wellness, we aim to meet them where they are. Our QuestHealth.com platform empowers health- and wellness-minded consumers to purchase tests and panels without the need to schedule an appointment and visit a doctor’s office.”

Annual report 2025A · The company itself

“Patients and Consumers We are well positioned to provide information and insights to patients and individual consumers to help empower them take actions to improve their healthcare.”

Annual report 2025A · The company itself

“We generally bill for diagnostic information services on a fee-for-service basis under one of two types of fee schedules; fees may be negotiated or discounted. The types of fee schedules are: •“Client” fees charged to physicians, hospitals and institutions for which services are performed on a wholesale basis and which are billed on a monthly basis. •“Patient” fees charged to individual patients and certain third-party payers on a claim-by-claim basis.”

Annual report 2025A · The company itself

“IT systems are used extensively in virtually all aspects of our business, including clinical testing, test reporting, billing, customer service, logistics and management of medical data. Our success depends, in part, on the continued and uninterrupted performance of our IT systems.”

Annual report 2025A · The company itself

“We use information systems extensively in virtually all aspects of our business, including clinical testing, test ordering and reporting, billing, customer service, logistics and management of data.”

Annual report 2025A · The company itself

“For example, in connection with Project Nova, we committed to a multi-year project to modernize our "Order to Cash" business processes, including the related information technology infrastructure and underlying enabling technologies. We are partnering with Epic, a third-party licensor, to assist in the implementation of Project Nova.”

Annual report 2025A · The company itself

“In February 2025, we committed to a multi-year project ("Project Nova") to modernize our "Order to Cash" business processes, which includes the related information technology infrastructure and underlying enabling technologies. We are partnering with Epic, a third-party licensor, to assist in the implementation of Project Nova.”

Annual report 2025A · The company itself

“Continuing advances in genomics and proteomics are expected to give rise to new, more sophisticated and specialized diagnostic tests. These advances also are spurring interest in and demand for precision medicine, which relies on diagnostic and prognostic testing and in which data information services and strategies are used to deliver the most effective healthcare to the right populations and individuals.”

Annual report 2025A · The company itself

“In 2023, we acquired Haystack Oncology, Inc. ("Haystack Oncology") a cancer testing company that has developed a highly sensitive testing technology for detecting minimal-residual disease (“MRD”) by circulating tumor DNA due to residual or recurring cancer.”

Annual report 2025A · The company itself

“The value creation side of our business includes product and commercial marketing and is organized by clinical franchise and focuses on customer solutions for the marketplace, including new test development and diagnostic insights. Our clinical franchises – Cardiometabolic, Endocrine, and Wellness, Drug Monitoring and Toxicology, Infectious Diseases and Immunology, Molecular Genomics and Oncology, Neurology, and Women’s and Reproductive Health – enable us to operate like a boutique laboratory while maintaining our scale advantages, and work with our research and development and commercial organizations to identify and deliver new and improved solutions.”

Annual report 2025A · The company itself

“We develop and introduce new tests through our research and development operations. Our capabilities include discovery, technology development and clinical validation of diagnostic tests.”

Annual report 2025A · The company itself

“Our innovation strategy focuses on new services and solutions for unmet clinical needs that will improve patient care and outcomes as well as economic value for patients, health plans and other payers.”

Annual report 2025A · The company itself

“We are also well positioned to take advantage of advances in next generation sequencing to grow our business in cancer and other disease state testing. This includes inherited genetics, newborn screening, rare disease diagnosis, and solid tumor sequencing, such as to aid treatment selection and monitoring.”

Annual report 2025A · The company itself

“In 2023, we acquired Haystack Oncology, a cancer testing company that has developed a highly sensitive testing technology for detecting MRD due to residual or recurring cancer. We believe this acquisition strengthens our comprehensive oncology portfolio by positioning us well to compete in the higher-growth clinical area of ctDNA solid-tumor MRD testing.”

Annual report 2025A · The company itself

“Table of Contents We are a leading provider of Advanced Diagnostics™ and provide an array of offerings, including certain procedures in the areas of molecular diagnostics (including next-generation sequencing), oncology, neurology, companion diagnostics and non-invasive pre-natal and other germline genetic testing. In 2025, certain Advanced Diagnostics™ test offerings within five clinical areas – oncology, cardiometabolic and endocrine, brain health, autoimmune, women’s health and genetics – generated over $1 billion in revenues on double-digit revenue growth.”

Annual report 2025A · The company itself

“In 2023, we launched our QUEST AD-Detect® test portfolio for assessing Alzheimer's disease risk using blood specimens, as opposed to testing by more costly or invasive methods, such as testing of cerebral spinal fluid by lumbar puncture. We continue to publish evidence on our AD-Detect test, including a study in a publication of the American Academy of Neurology that found two of our innovative panels provide confirmatory accuracy for aiding Alzheimer's diagnosis.”

Annual report 2025A · The company itself

“We also have a portfolio of oncology tests that includes traditional oncology screening and anatomic pathology, such as cervical cancer and skin cancer screening and diagnosis.”

Annual report 2025A · The company itself

“Our services. We primarily provide information and insights based on an industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services.”

Annual report 2025A · The company itself

“We have strong testing capabilities, including services for the predisposition, diagnosis, treatment and monitoring of cancers and other diseases, and offer advanced tests in many fields, including endocrinology, immunology, neurology and oncology.”

Annual report 2025A · The company itself

“Table of Contents We are a leading provider of diagnostic information services, developing and delivering comprehensive offerings to help physicians manage patients across disease stages, from screening for early risk to treatment selection and monitoring to post-treatment evaluation. We have comprehensive test offerings in cardiometabolic and endocrine; cancer; clinical drug monitoring and toxicology; infectious disease, including autoimmune; neurology diagnostics, including Alzheimer’s disease; and women’s health, including prenatal genetics.”

Annual report 2025A · The company itself

“We offer services to pharmaceutical companies, including clinical trials laboratory testing, population analytics and patient engagement services. We also develop in vitro diagnostic tests for FDA submissions as companion diagnostics, laboratory developed testing services (“LDTs”) for complementary diagnostics, and offer an array of assets and services to support the development of diagnostic insights, including our robust data set and patient services network.”

Annual report 2025A · The company itself

“Pharmaceutical companies We offer clinical trials testing and have expertise for companion and complementary diagnostics, and offer an array of assets and services to support the development of companion diagnostics, including our robust data set and patient services network. We also offer data services solutions, leveraging our data, analytics and expertise, to help therapy developers understand markets and patient and disease journeys, and plan commercial activity.”

Annual report 2025A · The company itself

“Our Diagnostic Solutions group includes our risk assessment services business, which offers solutions for insurers, and our healthcare IT businesses, which offers solutions for healthcare providers and payers.”

Annual report 2025A · The company itself

“We play a critical role in healthcare decisions for customers across the healthcare ecosystem, including physicians, hospitals, patients and consumers, health plans, government agencies, employers, retailers, pharmaceutical companies and insurers.”

Annual report 2025A · The company itself

“Through these payers, we estimate that we have access to over 90% of insured lives in the United States.”

Annual report 2025A · The company itself

“Diagnostic Solutions Our risk assessment service, ExamOne®, is the largest provider of risk assessment services to the life insurance industry in North America and comprises underwriting support services, including data gathering, paramedical examinations and clinical laboratory testing and analytics, designed to assist life insurance companies objectively to evaluate the mortality 10 Table of Contents risks of applicants.”

Annual report 2025A · The company itself

“Health Plans, Government Agencies and Other Payers Most of the services we perform are paid for by third-party payers, including large national health plans, managed care organizations and other health insurance providers, regional and local health plans and government payers, which includes Medicare and Medicaid. These customers typically reimburse us as a contracted (or out-of-network) provider for services rendered to their members.”

Annual report 2025A · The company itself

“Reimbursement from our five largest health plans totaled approximately 20%, and no one health plan accounted for 10%, of our consolidated net revenues in 2025. Health plans typically negotiate directly or indirectly with a number of diagnostic information services providers, and represent nearly one-half of our total clinical testing volume and approximately 40% of our net revenues from diagnostic information services.”

Annual report 2025A · The company itself

“Consumers increasingly are demanding convenience and a superior and personalized experience relevant to their needs. In recent years, we saw consumers increase their use of telemedicine capabilities, increase their responsibility for their own healthcare (e.g., increased consumer-initiated testing; increased specimen self-collection) and increase their openness to new delivery channels.”

Annual report 2025A · The company itself

“Healthcare services increasingly are being provided by non-traditional providers (e.g., physician assistants), in non-traditional venues (e.g., retail medical clinics, urgent care centers) and using new technologies (e.g., telemedicine, digital pathology).”

Annual report 2025A · The company itself

“Competitors may compete using advanced technology, including technology that enables more convenient or cost-effective testing (e.g., technology enabled by AI). Digital pathology is an example of this.”

Annual report 2025A · The company itself

“Failure to develop, acquire licenses for, introduce, or commercialize new tests, technology and services could negatively impact our testing volume, revenues and profitability. The diagnostic information services industry is faced with changing technology and regulation and new product introductions.”

Annual report 2025A · The company itself

“In February 2025, we committed to a multi-year project ("Project Nova") to modernize our "Order to Cash" business processes, which includes the related information technology infrastructure and underlying enabling technologies. We are partnering with Epic, a third-party licensor, to assist in the implementation of Project Nova.”

Annual report 2025A · The company itself

“Our MyQuest® patient healthcare portal, with more than 45 million registered users at year-end 2025, enables patients to manage healthcare and medical information for themselves and a circle of others, find a Quest Diagnostics location, schedule appointments, receive appointment reminders, assess whether their health plan is in-network and receive and archive their test results.”

Annual report 2025A · The company itself

“We offer a wide range of employer population health services, including biometric screenings, flu shots and related preventative services that leverage clinical data to improve population health outcomes and reduce healthcare spend. Our solutions enable employers to leverage screening insights to identify chronic disease risks, guide employees to needed in-network care, and improve employee health with intervention services.”

Annual report 2025A · The company itself

“Employers Employers use tests for drugs of abuse to determine an individual's employability and “fitness for duty.” Companies with high levels of employee hiring, safety conscious environments or regulatory testing requirements provide the highest volumes of testing. Factors such as the general economy, the job market and changes in the legal environment (e.g., marijuana legalization or decriminalization) can impact the utilization of drugs-of-abuse testing.”

Annual report 2025A · The company itself

“Employers are also investing in population health services. We meet their needs by providing nationwide access to our customizable services (e.g., the Blueprint for Wellness® program) directly and through health plan and health improvement providers. These services help employers, employees and others manage healthcare costs, capitalize on trends in personalized health and improve health outcomes.”

Annual report 2025A · The company itself

“We are leveraging automation and AI to improve quality and productivity across our entire value chain, not just in the laboratory. For example, we advanced our use of automation in front-end specimen processing and labeling in six of our labs, freeing more of our processors to focus on higher-order work.”

Annual report 2025A · The company itself

“Table of Contents It is important that we continue to strengthen our efficiency, including through the use of technology and automation, to promote our competitive position and enable us to mitigate the impact on our profitability of steps taken by government payers and health insurers to reduce the utilization and reimbursement of diagnostic information services, and to partly offset pressures from an inflationary environment, including labor and benefit cost increases, and reimbursement pressures.”

Annual report 2025A · The company itself

“For instance, our QUEST AD-Detect® test portfolio for assessing Alzheimer’s disease risk uses blood specimens, as opposed to testing by more costly or invasive methods, such as testing of cerebral spinal fluid by lumbar puncture.”

Annual report 2025A · The company itself

“The FDA has regulatory responsibility over, among other areas, instruments, software, test systems, collection kits, reagents and other devices used by clinical laboratories to perform diagnostic testing in the United States. The FDA also regulates drugs-of-abuse testing for employers and insurers, testing for blood bank purposes and testing of donors of human cells for purposes such as in vitro fertilization. We offer companion and complementary diagnostic tests to pharmaceutical companies that are regulated by the FDA.”

Annual report 2025A · The company itself

“We also provide services on a fee-for-service basis to federal, state and local governmental agencies. Historically, most Medicare and Medicaid beneficiaries were covered under the traditional Medicare and Medicaid programs administered by the federal government. Over the last several years, the federal government has expanded its contracts with private health insurance plans for Medicare beneficiaries and has encouraged such beneficiaries to switch from the traditional programs to the private programs, called “Medicare Advantage” programs.”

Annual report 2025A · The company itself

“(e) Adverse actions by government or other third-party payers, including healthcare reform that focuses on reducing healthcare costs but does not recognize the value and importance to healthcare of clinical testing or innovative solutions, unilateral reduction of fee schedules payable to us, unilateral recoupment of amounts allegedly owed and competitive bidding. Table of Contents (f) The impact upon our testing volume and collected revenue or general or administrative expenses resulting from compliance with policies and requirements imposed by Medicare, Medicaid and other third-party payers.”

Annual report 2025A · The company itself

“We are also powering the testing offered by leading health, wellness, and wearable brands, where we provide the underlying testing services for their consumer health service offerings.”

Annual report 2025A · The company itself

“New and Emerging Retail Healthcare Providers We take opportunities to provide services to retail providers of healthcare services, such as "big-box" retailers, like Walmart, pharmacy chains, like CVS Health, supermarkets, like Safeway, urgent care centers and Internet-based service providers.”

Annual report 2025A · The company itself

“Our IT systems have been and are subject to potential cyberattacks, tampering or other security breaches. These attacks, if successful, could result in shutdowns or significant disruptions of our IT systems and/or in unauthorized persons exfiltrating and misappropriating intellectual property and other confidential information, including patient and employee data that we collect, transmit and store on and through our IT systems.”

Annual report 2025A · The company itself

“Additionally, new technology that we deploy to automate processes, improve customer 36 Table of Contents service, generate insights from lab and other data and stimulate innovation to improve operational efficiency, including the expanded use of AI, may further expose our IT systems to the risk of cyberattacks and may create the need for rapid modifications to our cybersecurity program.”

Annual report 2025A · The company itself

“For example, in June 2019, the Company reported that Retrieval-Masters Creditors Bureau, Inc./American Medical Collection Agency (AMCA), informed the Company that an unauthorized user had access to AMCA’s system. AMCA previously provided debt collection services for the Company and provided debt collection services for a company that provides revenue management services to the Company.”

Annual report 2025A · The company itself

“(n) Failure of the Company to maintain, defend and secure its financial, accounting, technology, customer data and other operational systems from cyberattacks, IT system outages, telecommunications failures, malicious human acts and failure of the systems of third parties upon which the Company relies.”

Annual report 2025A · The company itself

“We are committed to using AI in an ethical, responsible and compliant way. We have implemented a formal AI governance oversight committee and established multiple AI safeguards to minimize risks associated with AI, including, but not limited to, expanded security and privacy measures, increased user access controls, employee and other end user training and certification, and standard operating procedures.”

Annual report 2025A · The company itself

“Using AI successfully will require significant resources, including having the technical expertise required to develop, test and maintain AI-based testing services and continually developing the appropriate governance and oversight of our use of AI. In addition, we anticipate that there will continue to be new regulatory requirements concerning the use of AI, which may aim to regulate, limit, or block the use of AI in our testing and other services or otherwise impose other restrictions that may hinder their usability or effectiveness.”

Annual report 2025A · The company itself

“(p) Challenges, including the associated competitive pressures, with properly managing the development, implementation, oversight and use of AI.”

Annual report 2025A · The company itself

“Our cost excellence program, Invigorate, includes structured plans to drive savings and improve productivity across the value chain, including in such areas as patient services, logistics and laboratory operations, revenue services, information technology ("IT") and procurement. Our Invigorate program has consistently delivered 3% of annual cost savings and productivity improvements, which partly offset pressures from an inflationary environment, including labor and benefit cost increases, and reimbursement pressures.”

Annual report 2025A · The company itself

“Consumerization Consumers are our customers. Increasingly, consumers are engaged and interested in, and empowered to manage and take direct responsibility for, their own healthcare. As a result, they are becoming more sophisticated in their understanding of their healthcare needs and their expectations of healthcare providers. In addition, consumers often are bearing increased financial responsibility for their healthcare (e.g., high deductible health plans; rising deductibles).”

Annual report 2025A · The company itself

“Inflationary pressures over the last number of years have resulted in increases in the costs of the testing equipment, supplies and other goods and services that we purchase from manufacturers, suppliers and others. Inflationary pressures, along with the competition for labor, have also resulted in a rise of our labor costs, which include the costs of compensation, benefits, and recruiting and training new hires.”

Annual report 2025A · The company itself

“Our cost excellence program, Invigorate, includes structured plans to drive savings and improve productivity across the value chain, including in such areas as patient services, logistics and laboratory operations, revenue services, information technology ("IT") and procurement. Our Invigorate program has consistently delivered 3% of annual cost savings and productivity improvements, which partly offset pressures from an inflationary environment, including labor and benefit cost increases, and reimbursement pressures.”

Annual report 2025A · The company itself

“The supply of qualified technical, professional, managerial and other personnel, including cytotechs, phlebotomists and specimen processors, is currently constrained; competition for qualified employees, even across different industries, is intense, including as individuals leave the job market. We may lose, or fail to attract and retain, key management personnel, or qualified skilled technical, professional or other employees.”

Annual report 2025A · The company itself

“(v) Inability to hire or retain qualified employees, including key senior management personnel, and maintain good relations with our employees.”

Annual report 2025A · The company itself

“RISKS RELATED TO CHANGE IN PUBLIC POLICY AND THE REGULATORY AND LEGAL ENVIRONMENT Significant changes or developments in U.S. laws or policies, including changes in U.S. healthcare regulation, may have a material adverse effect on our business. The political environment impacting healthcare regulation in the United States continues to be uncertain.”

Annual report 2025A · The company itself

“(j) Changes in and complexity of federal, state or local laws or regulations, including changes that result in new or increased federal or state regulation of commercial clinical laboratories, tests developed by commercial clinical laboratories or other products or services that we offer or activities in which we are engaged, including regulation by the FDA.”

Annual report 2025A · The company itself

“Table of Contents Privacy and Security of Health and Personal Information We are subject to laws and regulations regarding protecting the security and privacy of certain healthcare and personal information, including, but not limited to: (a) the federal Health Insurance Portability and Accountability Act and the regulations thereunder, which establish (i) a complex regulatory framework including requirements for safeguarding protected health information and (ii) comprehensive federal standards regarding the uses and disclosures of protected health information; (b) state laws (e.g., California) and similar laws in other states; and (c) laws outside the United States, including the European Union's General Data Protection Regulation, Canada’s Personal Information Protection and Electronic Documents Act and provincial health privacy laws, and similar laws in other jurisdictions.”

Annual report 2025A · The company itself

“Table of Contents We are subject to numerous legal and regulatory requirements governing our activities, and we may face substantial fines and penalties, and our business activities may be impacted, if we fail to comply. Our business is subject to or impacted by extensive and frequently changing laws and regulations in the United States (including at both the federal and state levels) and the other jurisdictions where we engage in business, including Canada and Europe.”

Annual report 2025A · The company itself

“Key Trends Reimbursement pressure driven by The Protecting Access to Medicare Act of 2014 (“PAMA”) Pursuant to PAMA, reimbursement rates for many clinical laboratory tests provided under Medicare were reduced during 2018 - 2020.”

Annual report 2025A · The company itself

“Healthcare industry evolution; focus on value Consolidation in the healthcare industry has continued, including among our customers. Certain of our customers are seeking to diversify their service offerings and to partner with other providers to offer value-based care alternatives. Consolidation is increasing pricing transparency, and may encourage internalization of clinical testing. Physicians frequently now are employed by hospitals, ACOs or large group practices integrated with hospitals, instead of organized physician-owned practices, which is impacting the dynamics for whether clinical testing is performed in or outside of a hospital.”

Annual report 2025A · The company itself

“There has been a marked increase in the number of physician practices owned by hospitals and other companies. There also has been a notable increase in some branches of medicine of the establishment of very large "rolled-up" physician practice groups. Hospitals that own physician practices may encourage or require the practices to refer outreach testing to the hospital's affiliated laboratory. Large specialty physician groups may encourage their members to refer testing to other members of the group or to a lab owned by the large physician group.”

Annual report 2025A · The company itself

“There has been a trend of consolidation among health plans. Some health plans also have narrowed their provider networks. In addition, some health plans have established "preferred provider" networks within their broader networks (e.g., UnitedHealthcare's Preferred Lab Network), in effect distinguishing among contracted providers.”

Annual report 2025A · The company itself

“Hospitals that own physician practices may encourage or require the practices to refer testing to the hospital's laboratory. There has been a trend of hospitals acquiring physician practices, increasing the percentage of physician practices owned by hospitals. Increased hospital ownership of physician practices may enhance clinician ties to hospital-affiliated laboratories and may strengthen their competitive position.”

Annual report 2025A · The company itself

“We strive to provide diagnostic solutions for emerging infectious diseases, and were the first commercial laboratory to introduce a test for the H5 avian flu virus based on a preparedness contract from the Centers for Disease Controls and Prevention (“CDC”).”

Annual report 2025A · The company itself

“Any future public health emergency or pandemic could expose us to the risks we experienced during the COVID-19 pandemic and result in, among other things, a reduction in physician office visits and diagnostic testing volume, the cancellation of elective medical procedures, or customers closing or curtailing their operations, as well as increased unemployment and loss of health insurance. We may also experience labor shortages and supply chain disruptions, including shortages, delays and price increases in testing equipment and supplies, as a result of a public health emergency or pandemic.”

Annual report 2025A · The company itself

“Table of Contents (w) Terrorist and other criminal activities, hurricanes, earthquakes or other natural disasters, geopolitical hostilities or other global conflicts, public health emergencies and pandemics, which could affect our customers or suppliers, transportation or systems, or our facilities, and for which insurance may not adequately reimburse us.”

Annual report 2025A · The company itself

“Chronic diseases and conditions; gaps in care We believe that the cost and challenges of identifying, treating and controlling chronic diseases and conditions such as diabetes and heart disease are now well recognized. As a result of multiple factors, including increased focus on population health management and pressure to reduce the systemic costs associated with such diseases and conditions, there is increased focus on better identifying and attempting to reduce or eliminate the gaps in care historically associated with these diseases and conditions.”

Annual report 2025A · The company itself

“Consumers increasingly are demanding convenience and a superior and personalized experience relevant to their needs. In recent years, we saw consumers increase their use of telemedicine capabilities, increase their responsibility for their own healthcare (e.g., increased consumer-initiated testing; increased specimen self-collection) and increase their openness to new delivery channels.”

Annual report 2025A · The company itself

“Table of Contents (w) Terrorist and other criminal activities, hurricanes, earthquakes or other natural disasters, geopolitical hostilities or other global conflicts, public health emergencies and pandemics, which could affect our customers or suppliers, transportation or systems, or our facilities, and for which insurance may not adequately reimburse us.”

Annual report 2025A · The company itself

“(u) Increases in interest rates and negative changes in our credit ratings from Standard & Poor's, Moody's Investor Services or Fitch Ratings causing an unfavorable impact on our cost of or access to capital.”

Annual report 2025A · The company itself

“Tariffs, sanctions and other barriers imposed or 33 Table of Contents threatened by the U.S. government, and the responses to those actions from other countries, may result in adverse impacts to the global economic environment, including the global financial and trading markets, which could have a negative impact on our results of operations and financial condition. These actions could also negatively impact our supply chain costs or availability of products we need to operate our business.”

Annual report 2025A · The company itself

“In 2024, we acquired LifeLabs, a company that provides laboratory diagnostic information and digital health connectivity systems in Canada. During the full year of 2025, LifeLabs performed approximately 23 million test requisitions to help diagnose, treat, monitor and prevent diseases for millions of Canadians.”

Annual report 2025A · The company itself

“Our services primarily are provided under the Quest Diagnostics brand, but we also provide services under other brands, including AmeriPath,® Dermpath Diagnostics,® ExamOne,® and Quanum.® We are a leading provider of diagnostic information services in the United States, where we conduct substantially all of our business.”

Annual report 2025A · The company itself