For the past several years, Quest has successfully embarked on a consolidation strategy designed to serve its goal of gaining a competitive advantage, in laboratory testing, with superior distribution strength and increased patient access in a high-volume, low-margin industry. Quest's acquisition of LabOne is consistent with those objectives.

Quest Diagnostics' purchase of American Medical Laboratories for $500 million in cash (including assumption of $160 million in debt) is one of a string of acquisitions made by large national laboratories in recent years. While it is by no means Quest's biggest or most strategically critical deal, it gives the nation's largest clinical laboratory a presence in two markets in which it was weak or had no presence, and shores up its rapidly growing esoteric testing business. The deal also eliminates a competitor.

Impath's unorthodox step into the cancer information business has made it attractive to Wall Street, but will its vast, specialized databases allow it to reap benefits from pharmacogenetics? The real value to Impath of its databases resides in their ability to promote work on targeted therapeutics, whose use in patients will depend on critical markers. But targeted therapeutics are a controversial concept that requires pharma companies to make basic changes in the way they operate. There's no guarantee Impath can get the pay-off it wants from its new initiatives.

In the financially besieged clinical laboratory industry, some investors see a bright spot: esoteric labs. Behrman Capital has established Esoterix Inc. to identify and acquire leading providers of esoteric laboratory services focused on specific fields like endocrinology or genetics.