Keystone Laboratories Inc.

Oral Fluid Toxicology Testing

Multiple Testing Specialties

Keystone Laboratories provides customizable solutions for providers with industry-leading specialists in urine, oral fluid and blood specimen testing.

Dual CAP Accredited

Keystone meets the standards from CLIA, FDA and OSHA. CAP requirements commonly exceed the standards, bolstering patient care and safety.


Years Of Trusted Laboratory Testing Experience

Oral Fluid Toxicology Testing

The Trusted Company For Oral Fluid Toxicology Testing

Providers need to be able to make treatment decisions with absolute confidence. In order to do that, you need an oral fluid toxicology testing solution that is both timely and reliable. Keystone has been working with providers since 1987, and we’ve learned that most providers aren’t able to get the oral fluid toxicology testing they need when they need it. That is why Keystone offers you a host of testing and monitoring services so that every treatment decision you make is a confident one.

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About Oral Fluid Toxicology Testing

Oral fluid is a transparent watery liquid made up of saliva and any other fluids generated by the oral mucosa.  It is a biological specimen that is useful to detect recent drug use and is approved as an alternate matrix in the SAMSHA mandatory guidelines for drug testing. The advantages of using oral fluid are observed collections, less invasiveness and difficulty of adulteration. Disadvantages of oral fluid include lower concentrations of drugs and metabolites, limited sample volume, and shorter detection windows.

Oral fluid analysis requires highly sensitive instrumentation such as Liquid chromatography tandem mass spectroscopy (LC-MS/MS) for detection and identification.  The collection of oral fluid samples is straightforward and is performed by the donor under the direction of the observing collector. Keystone uses Quantisal devices from Immunalysis Corporation for collections, which is a superior oral fluid collection device that has excellent recovery of the analytes of interest for drug testing. All positive oral fluid results are confirmed by LC-MS/MS at Keystone Laboratory.  Our oral fluid test menu includes sixty-seven (67) drugs and metabolite of interest to maximize our client’s needs.

Oral fluid or commonly referred to as saliva drug testing has its roots in roadside testing and alcohol detection, but it is now a popular, non-invasive alternative to a hair or urine drug test. Its benefits include accurate detection of recent drug use and the ability to make observed collections on-site. How does an oral drug test differ from a hair or urine test?

Drug detection times vary depending on:

  • Metabolic and renal clearance variations
  • PH and concentration of the matrix (urine, oral fluid)
  • Molecule or metabolite that is looked for
  • Matrix analyzed
  • Duration of use (acute or chronic)
  • The sensitivity of the testing method used
  • The dose

Drugs in hair can be detected for up to 90 days. This gives hair the longest detection time, followed by urine and oral fluid. But drugs in urine can be detected for one to seven days (or longer in chronic users), and drugs in oral fluid for five to 48 hours.

LCMS For Oral Fluid Testing

The LC/MS/MS technique is a highly selective and sensitive analytical technique for detecting and quantifying analytes in complicated matrices.

As a result, LC/MS/MS in forensic toxicological applications has increased dramatically during the last decade. Oral fluid is increasingly used as an alternative biological matrix for drug testing. When compared to urine or blood, the sample volume is usually significantly less, and medications are present in lower quantities in oral fluid.

The selectivity and sensitivity of LC-MS/MS make it perfect for detecting the presence of opiates in oral fluid.

LCMS oral fluid test would be the preferred method of testing when using oral fluid.

The Advantages of Oral Fluid Testing

Samples can be gathered at any time and from any location, saving time and money by eliminating the need for private facilities or same-gender collectors. It can be gathered just about anywhere, making it much easier to administer. There isn’t a need to find a facility, make an appointment, and go to that facility.   This means that there is less time off from work because of drug testing too.

Perhaps most crucially, the detection window is much narrower than with urine tests.

It takes a couple of hours for drugs to metabolize in the body and show up on a urine drug test, but when they do, they are detectable for longer. This makes making testing for recent impairment using urine testing worthless. On the other hand, an oral fluid test detects drugs shortly after administration and only detects them for 24 to 48 hours after use, making it perfect for a wide range of testing conditions ranging from post-accident testing, reasonable suspicion, and pre-employment.

Regulated employers can continue to use urine tests for pre-employment, but they will now have the option of employing oral fluid for post-accident or reasonable suspicion testing, where it’s crucial to detect the most recent drug use to evaluate probable impairment on the job.

Frequently Asked Questions About Oral Fluid Toxicology Testing

The possibilities are limitless with a drug test as quick and effective as oral fluid toxicology. These exams are useful in a variety of situations, including rehabilitation centers, physician practices, and businesses. Oral toxicology can help a variety of customers, including the following:

  • Doctors avoid harmful drug combinations.
  • Rehabilitation specialists keep track of their patient’s progress.
  • HR representatives are vetting a possible new hire.
  • Employers attempting to preserve a drug-free workplace
  • Officers from the police department conduct field sobriety tests on drivers.

Drug molecules occur in the saliva shortly after metabolization and can stay there for up to two days. As a result, testing is most effective shortly after you suspect the drug was used. Oral tests are the best option if you need immediate results for drug use that has occurred in the last two days.

It is determined by many parameters, including the sensitivity of the test, the type of chemical being tested, and the amount utilized.

Some devices have a higher sensitivity than others. Some drugs can be detected for longer lengths of time than others.

The length of time a person has been using the substance can also influence detection time. According to research, drugs can be detected for longer lengths of time in persons who use them frequently.

Substances in oral fluid are often detected within 30 minutes of consumption. This test is substantially faster than others. Because of the short time frame, they are especially useful for screening after an accident or in instances when there is probable suspicion.

The detection window in oral fluids is generally 5 to 48 hours. However, this window can be extended for those who take a substance often or for a lengthy period.

Most oral swab tests are over 98 percent accurate when conducted correctly.

However, a few factors can have an impact on accuracy, including:

  • Type of test performed
  • Drug type and concentration
  • Test administrator’s experience and understanding of the test and the testing facility
  • Testing takes place during the detection window for the specific drug
    the testing device’s quality

The accuracy of LCMS lab testing differs from that of quick testing. The LCMS oral fluid test will be far more accurate than a simple Instant oral fluid testing kit.

Contact Keystone Laboratories To Get The Testing Solutions Your Practice Deserves!

Our Happy Customers

    Darlene Silver


    Keystone Laboratories has always helped in the line of work I do. Great turn around times and any time I need something Wally Brown makes sure that my lab has it. Shout out to Brittney, my Keystone courier! She is prompt and makes sure my specimens are transported. Very professional and kind.

      Brandy Shook


      As a phlebotomist in a 14 provider office accurate and timely results are a must! Wally Brown is a super representative who always makes sure we have what we need. Keep up the good work Keystone Laboratories!!

        Derrick Sexton


        I had to use this lab for a work related drug screen and they were very professional and prompt. I would recommend Keystone Laboratories to a colleague for sure.

          Amanda Daves

          Asheville Recovery Center

          Keystone lab is dedicated to assisting individuals with all their laboratory needs. I have utilized keystone labs for over 5 years now. They are knowledgeable and professional throughout the process. I highly recommend them!

          Keystone Lab Can Work With Your Preferred EHR Integration

          4th of July Closure Notice

          In observance of Independence Day on July 4th, Keystone will be closed. Normal office hours will resume on the 5th of July.