MLT Certification

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Medical Laboratory Technician (MLT)


The American Society for Clinical Pathologists (ASCP) Board of Registry (BOR) was established in 1928 (initially as the American Registry of Medical Technicians) to address the need for formally registering and regulating the field of medical technology. Registration was open to practicing medical and laboratory technicians (LT). The first national examination was given in 1933, consisting of practical demonstration, oral, written essay, and psychological components and administered by local examiners in the field. Those who passed the exam were given the designation, “Medical Technologist (MT)” and the LT designation was slowly phased out.

It was not until 1948 that the BOR recognized that the essay portion of the exam was too time-consuming and subjective, and changed the format to all True/False and multiple choice questions. This allowed them to convert to an objective, mechanical scoring system.

By the late 1930’s several related specialty certifications were beginning to emerge, but it was not until 1969 that a unique MLT certification exam was established.[1]

The ASCP merged its BOR with another major credentialing body, the National Credentialing Agency (NCA) in 2009 to form the ASCP Board of Certification (BOC), which became the largest certification body for medical technicians in the United States. At that time, the NCA certification “Clinical Laboratory Technician (CLT)” was replaced with the title “MLT (ASCP) Medical Laboratory Technician”.[2]

The ASCP-BOC began working to earn accreditation from the American National Standards Institute (ANSI) for its MLT certification procedures in 2004 and won accreditation in 2007. While other certification bodies exist, ANSI certification and the combined resources of the ASCP and NCA make ASCP-BOC MLT certification the premier credential for medical laboratory technicians.[3]

Function of the Test

MLT Study Guide

While MLT(ASCP) certification is not required for employment as a medical laboratory technician, studies show that certified MLTs have greater earning power than non-certified medical laboratory technicians.[4]

To be eligible to take the MLT(ASCP) certification exam, an individual must have earned an associate’s degree (or 60 credit hours) from an accredited college or university, and have:

  • Completed a nationally accredited MLT training program within five years prior to application,
  • Taken at least 6 semester hours each of college-level chemistry and biology, having been previously ASCP certified as a Clinical Laboratory Assistant (CLA), or
  • Taken at least 6 semester hours each of college-level chemistry and biology, and completed a 50-week military medical laboratory training course. (See the “Recent/Future Developments” section for important updates on this route) [5]

As of 2013, close to 86,000 medical laboratory technicians had been ASCP-BOC certified. That year, 3422 candidates sat for the exam; 56% of these were recent MLT program graduates. The pass rate among all candidates was 74% while those who had recently graduated fared a little better at 80%.[6]

Test Administration

MLT Flashcards

Current students are encouraged to apply for the MLT examination within 30 days prior to receiving their final grades. There is a non-refundable, $200 application fee due at the time of application. Applications are processed within 45 days of receipt and, once application materials have been approved by the BOC, candidates are given a 3-month window in which to sit for the exam. Exams are given Monday through Saturday and candidates schedule their dates directly through an authorized Pearson VUE testing center in their area.

Applicants with special needs due to disability must submit documentation of their disability along with a request for specific accommodations at the time they apply to take the MLT exam. Requests for accommodation are reviewed on a case-by-case basis in cooperation with Pearson VUE.[7]

Exams may be scheduled within the 3-month eligibility window if sufficient notice is given. However, candidates that do not take the exam before their eligibility expires must reapply and pay an additional $200 fee.[8]

Applicants who fail the exam may sit for it again up to 5 times before they are no longer being eligible. For those who have graduated from an accredited MLT program, the 5 attempts must be completed within 5 years of completing the program. Anyone who cannot pass the exam in 5 attempts will be allowed to reapply for the exam only after completing a different route to eligibility. So, for example, if you qualify to sit for the exam by taking a 50-week military MLT course and fail to pass the exam after 5 attempts, you must return to school and complete an accredited MLT training program in order to be eligible to register for the same exam again.[9]

Test Format

Sections of the MLT Test
MLT Test Subject Areas  % of Exam
Blood Bank (BBNK) 15-20%
Urinalysis and Other Body Fluids (UA) 5-10%
Chemistry (CHEM) 20-25%
Hematology (HEMA) 20-25%
Immunology (IMMU) 5-10%
Microbiology (MICR) 15-20%
Laboratory Operations (LO) 5-10%
Total 100%

Test Environment

Candidates for the MLT are expected to arrive half an hour early. Two forms of personal ID are required for admission. One of the two forms of ID must be a driver's license. No electronic devices are allowed in the examination room. A non-programmable calculator is allowed.[10]

Test Structure

The MLT Exam, or Medical Laboratory Technician Examination is made up of 100 questions that have to do with seven topics: Blood Bank (BBNK); Urinalysis and Other Body Fluids (UA); Chemistry (CHEM); Hematology (HEMA); Immunology (IMMU); Microbiology (MICR); Laboratory Operations (LO). The MLT allows two and a half hours to complete all 100 questions.[11]

Sample Questions

More free MLT practice test questions.


The exam consists of 100 multiple choice questions given according to a computer-based, adaptive model. Each question should be answered when it is presented, and there is no penalty for guessing. After answering all of the questions, candidates will have an opportunity to review their answers and change as many as they wish during the allotted total testing time of a total of 2 ½ hours. Immediate pass/fail feedback is displayed on the screen once all questions are completed. An official score report will be produced and sent in the mail.

In an adaptive exam, questions are presented at different levels of difficulty based one’s ability to answer each preceding question correctly. The final score is “scaled” based both on the number of questions answered correctly, and the level of difficulty of the individual questions. Scaled scores range from 0-999. A scaled score of 400 is required to pass the examination.

Those who pass the test will receive a score report that includes their “certification number”. Those who do not pass the test receive a score report for each section of the exam which highlights areas of strength and weakness to assist in preparing to successfully re-take the exam.[12]

Recent/Future Developments

The MLT exam paper application was phased out in the fall of 2014, and the application process is now entirely online. Pay-by-mail is still available, however, for applicants who are unable to use a credit card or PayPal to pay their application fees.

Exam content is periodically revised to reflect developments in the field and the need for new competencies among laboratory technicians. The latest update was effective on October 1, 2014. Individuals who have not yet sat for the exam should refer to the revised content guidelines which were published on the ASCP Web site on July 1, 2014.

Also as of October 1, 2014, those taking the MLT examination outside of the United States will sit for the same exam as their US counterparts. Prior to that date, international candidates took a modified version of the exam which did not include questions on US laws and regulations governing the MLT profession.[13]

Eligibility rules for those whose MLT training was received through military service are changing effective January 1, 2015 to require that training be completed no more than 10 years prior to taking the exam.[14]


  1. ^ BOR Newsletter Spring/Summer 2008 October 17, 2014
  2. ^ BOC Newsletter Special Edition – November 2009 October 17, 2014
  3. ^ ASCP Board of Certification Earns Prestigious Accreditation October 17, 2014
  4. ^ ASCP Board of Certification October 17, 2014
  5. ^ Board of Certification - U.S. Certification Eligibility October 17, 2014
  6. ^ ASCP Board of Certification Examination Statistics CY 2014 October 17, 2014
  7. ^ U.S. (only) Procedures for Examination & Certification October 17, 2014
  8. ^ ASCP Board of Certification – U.S. Certification October 17, 2014
  9. ^ Scheduling, Rescheduling, Cancellation Policy, and Reapplying for Examination October 17, 2014
  10. ^ Exam Prep - Testing Center] 10 October 2014
  11. ^ Content Guideline 10 October 2014
  12. ^ Examination Preparation and Administration Guide for U.S. Certification Examinations October 17, 2014
  13. ^ BOC Newsletter August 2014 October 17, 2014
  14. ^ Board of Certification - U.S. Certification Eligibility October 17, 2014