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Michelle Spinosa, MLS(ASCP)^CM, has spent her career solving the same problem at wildly different scales: making sure accurate diagnostic testing exists where it's needed most. Whether that meant building a high-complexity laboratory from scratch for a 60-bed long-term acute care hospital — no template, no predecessor, no existing staff — or designing quality infrastructure across more than 7,000 COVID-19 testing sites statewide, her focus has always been the same: access to care. 

Here she shares her perspective on what drives her, what surprised her, and what she's building next. 

Can you share a moment when you felt especially connected to patient care through your work? 

During the pandemic, we were supporting testing in communities that had never had meaningful access to diagnostics — rural areas, farmworker populations, and facilities serving people experiencing homelessness.  

Many of these sites were built quickly, with staff who had no prior laboratory experience. As we implemented training, oversight, and quality systems, we started to see those sites reach near-100 percent compliance.  

That was a powerful moment — not because of the scale, but because it meant the system was working. It meant someone in a resource-limited setting was receiving an accurate result that would directly influence what happened next in their care. That’s the connection. When the system works, the patient benefits.  

What is something that has surprised you about working in the lab? 

When I went back to school for my MPH at UC Berkeley, my goal wasn't to stay in a clinical lab. I wanted to figure out how to bring diagnostic testing to places that had almost nothing — disaster zones, conflict regions, communities without reliable electricity or healthcare infrastructure. I believed then, and still believe, that access to accurate testing is a public health necessity, not a luxury. 

What surprised me is how that same problem exists much closer to home than I expected. Physician office labs, dialysis centers, outpatient clinics — settings right here in the U.S. — are operating without qualified laboratory oversight, without the quality systems their patients deserve, and often without any clear path to getting there. The resource constraints look different than a field clinic in a crisis zone, but the underlying gap is the same: people are receiving care in settings where the laboratory infrastructure hasn't kept up. 

That realization redirected my career. And it's what drives the work I do now. 

What aspects of laboratory medicine do you find most intriguing and fulfilling? 

What I find most compelling is the intersection of science, systems, and access. 

A test is only as powerful as the ability to deliver it in the setting where it’s needed. I pursued my MPH at the University of California, Berkeley because I wanted to understand how to bring diagnostic testing into environments with limited infrastructure, whether that’s rural communities, post-acute care settings, or large-scale public health responses.  

That perspective shaped my role as Lab Director for California’s COVID-19 and flu testing programs, where we supported more than 7,000 testing sites and tens of thousands of testers. We built a machine learning–assisted compliance system that helped achieve near 100 percent compliance across a highly decentralized network. 

The scale was different. The mission was identical. That same focus carries into my work today. Through LabComplianceSimplified.com, I partner with laboratories, particularly smaller or resource-limited settings, to translate regulatory complexity into practical, sustainable systems that ensure high-quality diagnostics.