Myriad Genetics is a rapidly growing clinical diagnostic test laboratory. They provide a high complexity DNA sequencing test that is run using a high degree of automation. Results of the testing must be perfect. In September of 2006, laboratory reporting was averaging 28 days. While world class, we wished to offer faster turnaround to physicians and patients. We began our lean systems transformation and reduced our average laboratory reporting time to less then 7 days, while improving quality and lowering our rework rate from 20% to 10%. Unlike the previous paradigm of “quality, cost or delivery, pick two” we have improved all three simultaneously. One key aspect of implementing the lean approach is a change in culture.